A retrospective analysis of the trends in modern contraceptive use among adolescents and young women (15-24 years) in the Democratic Republic of the Congo in the last two decades.

INTRODUCTION: The increasing rate of unsafe abortion among adolescents and young women (AYW) in Sub-Saharan Africa may be attributed to a high rate of undesirable pregnancies and limited access to contraception services. The study looked at the prevalence of current contraception use among young women (15-24 years old) in the Democratic Republic of the Congo (DRC).

METHODS: The study analyzed secondary data from the demographic health survey (DHS) and UNICEF concerning AYW aged 15-24 years using IBM Corp. Released 2021. IBM SPSS Statistics for Windows, Version 28.0. (Armonk, NY: IBM Corp.). The study population included 15,319 female adolescents and young adults in DRC. DHS datasets for 2001, 2010, 2017/2018, and UNICEF 2007 and 2013-2014 were downloaded after permission to use the data.

RESULTS: The AYW aged 20-24 accounted for 67% of the study population. The use of modern contraceptives has followed a roller coaster course. It dropped significantly from 2.6% in 2001 to 0.1% in 2007; it climbed to 2.7% in 2010 and 3.3% in 2013/14 but dropped to 2% in 2017/18. The most used method was male condoms (1.76%). A higher proportion of unmarried (2.3%) used any methods than married (1.8%). Those who attained secondary/higher education (2.6%) used modern contraceptives more than those with no formal education (1.5%), P < 0.0001. Those residing in the urban areas (4.5%) used modern contraceptives compared to those who lived in rural areas (1.7%) P < 0.0001. Modern contraceptive use among those with birth histories (2.6%) was comparatively higher than those who have not (2.3%), P < 0.0001. Those who lived in urban areas were adjusted odds ratio (AOR) = 2.504 times (95% confidence interval (CI): 1.793-3.497) more likely to use birth control than those in rural areas ( P < 0.001).

CONCLUSION: As reported in this study, the proportion of AYW's awareness of modern contraceptives is deficient in DRC, which might be attributed not only due to a lack of knowledge or enlightenment but also due to healthcare facilities' limited capacity to provide reproductive and sexual health services. Educating the AYW about modern contraceptive methods and interventions, including parents, the school system, and youth organizations, and strengthening the capacity of health facilities to provide modern contraception should be considered.