Psychosocial determinants of contraceptive desire and use among sexually-active adolescent girls in Kenya and Nigeria: implications for girl-centered contraceptive programs
Outcomes: Child, Early, and Forced Marriage, Gender‑Based Violence, Sexual and Reproductive Health
View SourceKey Social Norms Take-aways Social norms—particularly descriptive norms around contraceptive acceptability—play a meaningful role in shaping adolescent girls’ desire for and use of contraception, but operate alongside individual psychosocial factors such as knowledge, perceived relevance, and self-efficacy. Norms that valorize early childbearing and fertility within marriage can suppress contraceptive demand, while normalization of contraceptive use increases uptake. Importantly, norms alone are insufficient; they interact with girls’ confidence and perceived life goals, highlighting that effective norm-shifting must be paired with interventions that strengthen agency and self-efficacy.
Objectives The study aimed to examine how psychosocial determinants, including social norms, influence three outcomes among sexually active adolescent girls aged 15–19 in Kenya and Nigeria: desire for contraception, current contraceptive use, and preference-aligned contraceptive use.
Methods This study used a secondary analysis of pooled data from cross-sectional household surveys (n=2,327) conducted across multiple regions in Kenya and Nigeria. Psychosocial determinants—contraceptive knowledge, perceived relevance, self-efficacy, future aspirations, perceived reproductive control, and descriptive norms—were measured using composite indices and validated scales. These were analyzed using generalized linear mixed-effects models to assess associations with contraceptive outcomes, controlling for socio-demographic factors. Social norms were operationalized primarily through measures of descriptive norms and perceived reproductive control.
Intervention Details Not applicable (analysis used baseline data from evaluations of the Adolescents 360 program but did not evaluate the intervention itself).
Results Contraceptive desire (46%) and use (37.2%) were relatively low despite high fertility desires. Contraceptive knowledge, perceived relevance, self-efficacy, and descriptive norms were positively associated with both desire for and current use of contraception. Descriptive norms showed a modest but consistent influence, indicating that perceptions of what others do or approve of matter for behavior. However, none of the psychosocial determinants, including norms, were associated with preference-aligned contraceptive use in the main analysis.
Conclusions The study concludes that improving contraceptive uptake among adolescent girls requires addressing both psychosocial and social normative factors. Programs should prioritize increasing knowledge, strengthening self-efficacy, enhancing the perceived relevance of contraception to girls’ life goals, and shifting social norms that influence acceptability. However, aligning contraceptive behavior with individual preferences may require additional focus on autonomy and structural factors beyond psychosocial determinants alone.
Disclaimer: These summaries were generated with the assistance of artificial intelligence and are based on the interpretation of source documents. While efforts have been made to ensure accuracy and clarity, there may be errors or omissions. Users are encouraged to consult the original documents for complete and authoritative information.