Republic of Albania - adolescent contraceptive use

Publication date: 2016

Adolescent contraceptive use DATA FROM THE ALBANIA DEMOGRAPHIC AND HEALTH SURVEY (ADHS), 2008-09 R E PU B LI C O F A LBA N I A What can be done to support Albanian adolescents to prevent unintended pregnancy? Plan for how, when and where different groups of sexually active adolescents (married and unmarried, boys and girls, rural and urban) use and do not use contraception. Learn the reasons why adolescents are not using contraception, and develop policies and programmes to better address their needs. Understand that adolescents may get contraception from a variety of sources and ensure that each of these sources can provide high quality services for adolescents. COMPILED IN 2016 | UPDATED NOVEMBER 2016 Adolescent population: who are they? In the Republic of Albania, there are 515 000 adolescents aged 10–19 years – 22.6% of the country’s total population.i The majority of adolescents live in urban areas, 54.0% of adolescent girls and 54.1% of adolescent boys.i By age 19, the mean number of years of schooling attended by adolescent girls is 10.2, while for adolescent boys it is 10.3.ii Among adolescent girls who become parents before age 20, the average age at which they have their first baby is 18.2 years. ii Sexual activity and marital status Analysis of data from the ADHSii shows that over 35 000 Albanians aged 15–19 are currently sexually active – they are either unmarried and have had sex in the last three months or they are in a union (i.e. married or living together). On average, among adolescents who had sex before age 20, both adolescent girls and boys first have sexual intercourse at age 17.6 years. Among unmarried adolescents, 5.4% of adolescent girls report ever having sex and 3.7% are currently sexually active; among adolescent boys, 18.3% report ever having sex, while 12.5% are currently sexually active. Among all Albanian adolescents, 7.4% of adolescent girls and 1.0% of adolescent boys are in a union. Among these adolescents, the mean age of the first union is 17.6 years for adolescent girls and 18.7 for adolescent boys. Contraceptive use and non-use among adolescent girls FIGURE 1. Use and non-use of contraception: unmarried sexually active adolescent girls, aged 15–19 years (%) Not using Withdrawal Male condom Pill FIGURE 2. Use and non-use of contraception: adolescent girls in union, aged 15–19 years (%) LISTED FROM LEAST EFFECTIVE TO MOST EFFECTIVE LISTED FROM LEAST EFFECTIVE TO MOST EFFECTIVE Unmarried, sexually active According to ADHSii analyses, 50.6% of unmarried, sexually active adolescent girls report not wanting a child in the next two years, yet only 52.1% of them are currently using any method to prevent pregnancy. The main reasons these adolescents report for not using a contraceptive method include: • partner is opposed (32.1%) • not married (21.3%) • infrequent sex (16.1%) Among all unmarried, sexually active adolescent girls aged 15–19, 38.7% are not using a method of contraception. Male condoms are the most common modern method used (21.4% of these adolescent girls), while pills are used by 0.7%. Withdrawal, a traditional method, is used by 39.3% of these adolescent girls (see Figure 1). In union According to ADHSii analyses, 35.2% of adolescent girls in a union report not wanting a child in the next two years, yet only 27.2% of them are currently using any method to prevent pregnancy. The main reasons these adolescents report for not using a contraceptive method include: • infrequent sex (55.7%) • she is opposed (19.7%) • breastfeeding (18.7%) Among all adolescent girls in a union aged 15–19, 45.3% are not using a method of contraception. Male condoms are the most common modern method used (9.4% of these adolescent girls), while 1.7% are using pills and 1.1% are using injectable contraceptives. Withdrawal, a traditional method, is used by 40.8% of these adolescent girls (see Figure 2). i Urban and rural population by age and sex, 1980–2015 [online database]. New York (USA): United Nations Department of Economic and Social Affairs, Population Division; 2014 (https://esa. un.org/unpd/popdev/urpas/urpas2014.aspx, accessed 4 November 2016). ii Institute of Statistics [Albania], Institute of Public Health [Albania], ICF Macro. Albania Demographic and Health Survey 2008–09 [Datasets]. ALIR50.DTA and ALMR50.DTA. Calverton (MD): ICF International; 2010 (http://dhsprogram.com/data/dataset/Albania_Standard-DHS_2008.cfm?flag=0, accessed 4 November 2016). Not using Withdrawal Periodic abstinence Male condom Pill Injectable contraceptives Lactational amenorrhea (LAM) 1.0 9.4 1.1 0.71.7 40.8 45.3 38.7 39.3 21.4 0.7 LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use Source: analysis of ADHS 2008-09ii Source: analysis of ADHS 2008-09ii Unmarried, sexually active adolescents who are using a modern method most often get it from a pharmacy (49.6%) or friends or a partner (43.5%). Adolescents in a union who are using a modern method most often get it from a pharmacy (90.7%) or a government facility (9.3%). Adolescent contraceptive use R E P U B L I C O F A L B A N I A Use and non-use of contraception adolescent girls, aged 15-19 million adolescents ages 10-19 0.5 17.6 years for adolescent girls 17.6 years for adolescent boys Among adolescents who had sex before age 20, the average age at first sex is Among adolescents who become parents before age 20, the average age at first birth is What can be done to support Albanian adolescents to prevent unintended pregnancy? Main reasons for not using contraception Report not wanting a child in the next two years Sexually active, unmarried In union 50.6% sexually active, unmarried adolescent girls 35.2% adolescent girls in union 9.3% from a government facility 43.5% from friends or a partner Understand that adolescents may get modern contraception from a variety of sources. Learn the reasons why adolescents are not using contraception. Plan for how, when, and where different groups of adolescents use or don’t use contraception. ANALYSIS OF THE ALBANIA DEMOGRAPHIC AND HEALTH SURVEY, 2008-09 COMPILED IN 2016 | UPDATED NOVEMBER 2016 Institute of Statistics [Albania], Institute of Public Health [Albania], ICF Macro. Albania Demographic and Health Survey 2008–09 [Datasets]. ALIR50.DTA and ALMR50.DTA. Calverton (MD): ICF International; 2010 (http://dhsprogram.com/data/dataset/Albania_Standard-DHS_2008.cfm?flag=0, accessed 4 November 2016). 18.2 for adolescent girls LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use Sexually active, unmarried In union 32.1% partner is opposed 55.7% infrequent sex 21.3% not married 19.7% she is opposed 16.1% infrequent sex 18.7% breastfeeding Method Sexually active, unmarried In union Not using 38.7% 45.3% Withdrawal 39.3% 40.8% Periodic abstinence -- 1.0% Male condom 21.4% 9.4% Pill 0.7% 1.7% Injectable contraceptives -- 1.1% Lactational amenorrhea (LAM) -- 0.7% 90.7% from a pharmacy 49.6% from a pharmacy REASONS FOR NON-USE: Not married Not having sex Infrequent sex Menses has not returned after birth Breastfeeding Fatalistic (up to god) She is opposed Husband/partner is opposed Religious prohibition Knows no method Knows no source Fear of side effects/health concerns Inconvenient to use Others opposed Lack of access/too far SOURCE OF METHOD: Government facility Private facility Pharmacy Shop Friends or parents Other Community Health Worker Icon Directory METHODS: Not using Withdrawal Periodic abstinence Rhythm/calendar Female condom Male condom Standard days/cycle beads Pill Injectable contraceptives Lactational amenorrhea (LAM) Implants IUD Male sterilization Female sterilization © WHO 2016. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO licence WHO/RHR/16.49

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