Young women’s access to and use of contraceptives: the role of providers’ restrictions in urban Senegal

Context: Contraceptive prevalence is very low in Senegal, particularly among young women. Greater knowledge is needed about the barriers young women face to using contraceptives, including barriers imposed by health providers.

Methods: Survey data collected in 2011 for the evaluation of the Urban Reproductive Health Initiative in Senegal were used to examine contraceptive use, method mix, unmet need and method sources among urban women aged 15–29 who were either currently married or unmarried but sexually active. Data from a sample of family planning providers were used to examine the prevalence of contraceptive eligibility restrictions based on age and marital status, and differences in such restrictions by method, facility type and provider characteristics.

Results: Modern contraceptive prevalence was 20% among young married women and 27% among young sexually active unmarried women; the levels of unmet need for contraception—mostly for spacing—were 19% and 11%, respectively. Providers were most likely to set minimum age restrictions for the pill and the injectable two of the methods most often used by young women in urban Senegal. The median minimum age for contraceptive provision was typically 18. Restrictions based on marital status were less common than those based on age.

Conclusions: Training and education programs for health providers should aim to remove unnecessary barriers to contraceptive access.

Comment: Senegal is a country where family planning products are not always available with the choices that couples want. In addition, if available, providers sometimes put unnecessary age restrictions on those methods that could help young women the most. Training of providers and adequate information to prospective users remain very important. (HMV)