Abstract
The aim of this paper was to assess the adequacy of family planning (FP) services to adolescents’ needs in the DRC.
Methods:
A cross-sectional study was conducted in 61 health facilities providing the FP. The data were collected by interview with managers, direct observation, and document review. The dependent variable was « Uptake of FP by adolescents aged 15-19 », a dichotomous variable assessed “yes” when the FP was used by at least one adolescent and “no” when no adolescent used the FP during the study period. Independent variables were: wide range of contraceptives methods; audio and visual privacy of FP room; community support; FP free or subsidized and Nonjudgmental service provision. The index of availability of adolescent-friendly FP services was calculated; Pearson’s chi-square and Odd Ratio were used to test all associations and the logistic regression helped to measure the effect size of specific associations. All hypotheses were verified using the alpha significance level of .05.
Results:
About 80.3% of health facilities offered FP to adolescents. Most of contraceptives were offered to adult than to adolescents. Of all facilities, 11.5% were assessed as “high Friendly”, 63.9% as “moderate Friendly” and 24.6% as “Low Friendly” in FP. Overall, Uptake of FP by adolescents reported in 68.9% health facilities was significantly associated to the availability of a “wide range of the contraceptive methods” (OR=.030; CI95% [0,003 – 0,285]; p=.002) and the “Nonjudgmental service provision” (OR=.019; CI95% [0.001 – 0.265]; p=.003).
Conclusions:
Several FP services remain inaccessible to adolescents. The majority of health facilities do not meet the criteria needed to provide friendly FP to adolescents. To improve the uptake of FP among adolescents, health authorities need to take into account all elements considered important by teenagers.