Speaker
Description
Background
Adolescent pregnancies remain a pressing issue in many low- and middle-income countries, including Zambia, with a prevalence of 29%, most of which are unintended. Such pregnancies pose significant physical, mental, and socio-economic risks, including unsafe abortions, maternal complications, and disrupted education. Long-acting reversible contraceptives (LARC) offer a promising solution to reducing unintended pregnancies. Still, cultural norms, gender dynamics, and misinformation often lead to a preference for short-term or natural methods. This study aimed to explore adolescent girls’ and young women’s perceptions of LARC use in Lusaka, Zambia.
Methods
A qualitative descriptive study was conducted among adolescent girls and young women in Lusaka between October and December 2024. We conducted in-depth interviews (IDIs) with sexually active adolescents and young women to assess their perceptions of LARC using the health belief model. Participants were recruited through purposive sampling until theoretical saturation was achieved. Experienced researchers conducted the
interviews. All IDIs were audio-recorded, transcribed verbatim and analysed deductively using thematic analysis. Ethics approval was obtained from the University of Zambia Biomedical Research Ethics Committee, and informed consent, including assent and parental consent for minors, was secured.
Results
Interviews were conducted with 30 adolescent girls and young women aged 13–24, with an average parity of one child. Many had multiple sexual partners but demonstrated low perceived susceptibility to pregnancy despite prior sex experiences. Those who had used or were currently using contraception had a higher perception of its benefits. The most typical method of LARC among the users was the injectable contraceptive. At the same time, most participants acknowledged the severity of an unintended pregnancy, including unsafe abortions, school dropout and limited career prospects. Barriers to LARC uptake included low knowledge, misinformation, myths, and restrictive community norms. Health professionals’ guidance was identified as a key motivator for adoption. Most participants expressed interest in LARC after receiving brief health education during the interviews.
Conclusion
Adolescent pregnancies remain a significant challenge in Zambia, exacerbated by limited contraceptive awareness and prevailing cultural norms. While LARC is highly effective in preventing unintended pregnancies, its uptake remains hindered by misinformation and societal barriers. Findings underscore the need for targeted health education and professional counselling to improve contraceptive perceptions and access. Addressing these gaps through healthcare interventions and community engagement can enhance LARC utilisation and improve adolescent reproductive health outcomes.
Key words
Contraception, adolescent girls, young women, Zambia, LARC, health belief model, perceptions
