Addressing Obstacles to Contraceptive Continuation Among Young People

A new analysis of Demographic and Health Survey and Service Provision Assessment data highlights the unique patterns and drivers of contraceptive continuation among youth. The study found that among women of reproductive age in low- and middle-income countries, 218 million have an unmet need for contraception, with 14 million adolescent girls aged 15 to 19 being among those who wish 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. Youth ages 15 to 24 have higher rates of contraceptive discontinuation than older women, with side effects and poor quality of care contributing to low rates of contraceptive continuation across age groups. However, youth may be particularly sensitive to side effects and face significant barriers to accessing quality family planning care, including provider bias. Waiting time is the most common issue reported during a family planning visit to a health facility among women under age 25. Policies that support high-quality counseling, active follow-up mechanisms, and access to the full complement of contraceptive methods are essential for sustaining contraceptive use among youth. Countries should consider the following policy recommendations for increasing contraceptive continuation among youth: elevating attention and resources to supporting existing family planning users while promoting initiation among new users, supporting youth access to the full range of family planning methods regardless of age, marital status, and parity, and providing client-centered care in recognition of youth's diverse reproductive health needs. Training and supporting providers to offer high-quality, supportive contraceptive counseling to youth is also crucial. Strengthening youth's ability to access contraceptives in the private and informal sector, including a range of active follow-up mechanisms between appointments, and ensuring that healthcare delivery points maintain the full complement of methods and advance distribution of self-administered methods are also key strategies. By implementing these policies, countries can increase contraceptive continuation among youth and address the significant impact of unmet need for contraception.