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Addressing Obstacles to Contraceptive Continuation Among Young People

How Can Policymakers Support Youth in Use of Modern Contraceptive Methods?

This article highlights key findings and recommendations from the PACE project’s policy brief, Best Practices for Sustaining Youth Contraceptive Use. It explores the unique patterns and drivers of contraceptive continuation among youth based on a new analysis of Demographic and Health Survey and Service Provision Assessment data. It outlines policy and program strategies to address obstacles to contraceptive continuation among young women who wish to prevent, delay, or space pregnancies.

Supporting contraceptive continuation, particularly among youth, could have significant impact on global unmet need for contraception. Despite recent advances in expanding access to voluntary family planning, 218 million women of reproductive age in low- and middle-income countries, including 14 million adolescent girls (ages 15 to 19), would like to prevent, delay, or avoid pregnancy but are not using modern contraception. Among these women with an unmet need, an estimated 38 percent are former family planning users who have discontinued use of a modern contraceptive method.

In many countries, youth ages 15 to 24 have higher rates of contraceptive discontinuation than older women. While side effects and poor quality of care contribute to low rates of contraceptive continuation across age groups, youth may be particularly sensitive to side effects and face significant barriers to accessing quality family planning care, including provider bias. A new analysis of Demographic and Health Survey and Service Provision Assessment data found that waiting time is the most common issue reported during a family planning visit to a health facility among women under age 25.

Figure 2 from Best Practices for Sustaining Youth Contraceptive Use
Figure 2 from Best Practices for Sustaining Youth Contraceptive Use. Source: PRB analysis of DHS Service Provision Assessment data in 7 countries

Policies that support high-quality counseling, active follow up mechanisms, and access to the full complement of contraceptive methods are best practices for sustaining contraceptive use among youth who wish to prevent, space, or delay pregnancies. Countries should consider the following seven policy recommendations for increasing contraceptive continuation among youth:

  1. Elevate attention and resources to supporting existing family planning users while also promoting initiation among new users.
  2. Support youth access to the full range of family planning methods regardless of age, marital status, and parity, and without requiring the consent of a third party.
  3. Provide client-centered care in recognition of youth’s diverse reproductive health needs.
  4. Train and support providers to offer high-quality, supportive contraceptive counseling to youth.
  5. Strengthen youth’s ability to access contraceptives in the private and informal sector.
  6. Include a range of active follow-up mechanisms between appointments.
  7. Ensure that health care delivery points maintain the full complement of methods and advance distribution of self-administered methods.

Learn more about this topic in the full policy brief, available in English and French. Contact the PACE Project for a companion resource for youth advocates. Please reach out to Cathryn Streifel at cstreifel@prb.org with any questions or expressions of interest.

Join Knowledge SUCESS and FP2030 on April 29 at 7AM EDT for a session in the Connecting Conversation series to listen to Cathryn Streifel and other distinguished speakers share their perspectives on how health systems can continue to respond to young people as they grow and change.

This post is brought to you by the NextGen RH Community of Practice.

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Cathryn Streifel

Senior Policy Advisor, PRB

Cathryn Streifel is a senior policy advisor at PRB, where she works with national and global partners to enhance policy advocacy efforts related to family planning and reproductive health by conducting policy communication workshops for family planning experts and contributing to PRB’s written publications. Before joining PRB in 2019, she was associate director of the CSIS Global Health Policy Center and a business development associate at Palladium/Futures Group. Cathryn holds a master’s degree in public health from The George Washington University and bachelor’s degree in political science from McGill University. She is fluent in French.