Use of Modern Contraceptives Among Adolescents

The indicator assesses the proportion of sexually active young girls who have used a modern contraceptive method at a time of sexual intercourse(s) in the past 6 months. This practice is essential for preventing the significant health risks associated with early and/ or unintended pregnancies.

Collect the following data by conducting individual interviews with a representative sample of girls aged 15-19 years:

RECOMMENDED SURVEY QUESTIONS (Q) AND POSSIBLE ANSWERS (A)

Introduction: Now I am going to ask two more sensitive questions. There are no right or wrong answers, so please be as honest with your answers as you can. I would again like to assure you that your answers will be kept secret and they will not be shared with anyone living in this area.

Q1: During the past 6 months, have you had sexual intercourse?

A1: yes / no / does not want to reply

(ask the following question only if the previous reply is YES)

Q2: During the last time you had sex, did you or your partner do something or use any method to avoid or delay getting pregnant? 

A2: yes / no / does not want to reply

Q3: What has been the main method that you or your partner have used to delay or avoid getting pregnant?

A3 (only one answer possible; do not read the options)

1. pill
2. intra uterine device
3. male condom
4. female condom
5. injectables
6. implants
7. diaphragm
8. foam/jelly
9. lactational amenorrhea method
10. standard days method / cyclebeads
11. female sterilization
12. male sterilization
13. exclusive breastfeeding

Note: adjust the options based on your pre-testing and knowledge of the most common options. See WHO's overview of "modern contraceptive methods".

To calculate the indicator’s value, divide the number of girls who in the past 6 months had sex and used any of the above listed modern contraception methods by the total number of girls who in the past 6 months had sex. Multiply the result by 100 to convert it to a percentage.

Disaggregate the data by marital status (single, married), location (rural/ urban), socio-economic characteristics (wealth quintile, level of education) and respondent’s age.

1) Keep in mind that your target sample is not “girls aged 15-19 years” but “sexually active girls aged 15-19 years” which are identified by conducting individual interviews with girls aged 15-19 years. Therefore, the number of interviewed “girls aged 15-19 years” must be high enough so that even if some are discounted due to not being sexually active, the resulting number of interviewed sexually active girls still meets the minimum sample size.

2) It is important that you understand the main limitation of the proposed methodology - it only measures the proportion of sexually active girls using contraception. It does not consider whether the respondent is currently pregnant, trying to conceive a baby, and other reasons for not using contraception. If you want to assess the proportion of girls who currently do not wish to become pregnant but who are not using a contraceptive method (i.e. the "unmet need for family planning"), you will have to use a much more complex methodology (read guidance at Measure Evaluation's website). 

3) Consider including additional question assessing the main reasons for not using contraception. If the answer to Q1 is "no", you can ask:

Q: What is the main reason why you did not use a contraceptive method?

A: (multiple answers possible) 

1) was pregnant

2) wanted to get pregnant

3) did not agree with using contraception (for religious or other reason)

4) her partner did not agree with using contraception

5) she thought that her partner would not agree with using contraception

6) someone else in her family / community disagreed with her using contraception

7) did not know any contraceptive method

8) did not know where to purchase contraception 

9) felt too shy or affraid to go and purchase contraception

10) the contraceptive method she normally uses was not available

11) forgot contraception at home / elsewhere

12) did not have money for purchasing contraception

13) was affraid of contraception's side effects

14) was exclusively breastfeeding

15) other reason - specify: ...........................

4) This topic can, in many contexts, be very sensitive – consider therefore only having women as your interviewers. Ensure that no one can hear the respondent's answers. 

5) For a useful guide on the monitoring and evaluation of adolescent reproductive health programs (including a wealth of additional indicators), read Pathfinder International’s Guide to Monitoring and Evaluating Adolescent Reproductive Health Programs (see below).