Factors Influencing Contraceptive Decision Making and Use Among Young Adolescents in Urban Lilongwe, Malawi: A Qualitative Study

Abstract Background : The prevalence of teenage pregnancies in Malawi is 29% and about 25% of married and 30% of unmarried adolescents (15-19) use contraceptives. Data on contraceptive use has focused on older adolescents (15-19) leaving out the young adolescents (10-14). This study assessed factors that influence contraceptive decision-making and use among young adolescents aged 10-14 years. Methods : This was a qualitative study which used Theory of Reasoned Action (TRA) model to understand the processes that influence contraceptive decision making among young adolescents (10-14) in urban Lilongwe. The study was conducted in 6 youth health friendly service centers and in 12 youth clubs. Two focus group discussions and 26 in-depth interviews were conducted among sexually-active in and out of school young adolescents and key informants. The results are organized into themes identified during analysis. Results: Results showed that contraceptive decision making is influenced by social factors (individual, interpersonal, society) and adolescents` perceptions regarding hormonal contraceptives. There is also disconnect between Education and adolescent Sexual and Reproductive Health policies. Conclusion : The findings suggest the need for empowering girls in decision making, addressing myths around contraceptives, and harmonization of Education and Sexual and Reproductive Health policies in the country.