Mapping research evidence on the use of contraceptives among adolescent girls in Africa: a scoping study

Low- and middle-income countries have an estimated 21 million adolescent pregnancies each year, of which approximately 50% are unintended. Many countries have barriers to obtaining and using contraceptives, preventing adolescents from avoiding unintended pregnancies. This study aimed to identify gaps in contraceptive use, as well as obstacles and enabling factors affecting adolescent girls in Africa, through a scoping review. To document the current trends and developments in the literature on the use of contraceptives, a methodological framework by Arksey and O’Malley, enhanced by Levac, Colquhoun, and O’Brien, was employed. A comprehensive search was conducted across four electronic databases: CINAHL Complete, MEDLINE Ovid, Scopus, and Web of Science. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) checklist was utilised for consistency and formality. Of the 26 studies included, 84.6% (n = 22) reported adolescent access to various contraceptives, including depo injections, oral pills, emergency contraception, implants, intrauterine contraceptive devices (IUCDs), and condoms. Out of the 26 studies included in this review, (n = 17) 65.4% were quantitative, (n = 5) 19.2% were qualitative, and (n = 4) 15. 4% were mixed methods. Challenges to utilisation among adolescents included the attitude of healthcare providers, unavailability of contraceptives, urban-rural inequalities, poor health literacy about contraceptives and reproductive health, cultural beliefs, and fear of stigmatisation. Adolescents faced many challenges in preventing unwanted pregnancies. Promoting the use of contraceptives should be enhanced through a multidimensional approach that includes educational intervention of adolescents and healthcare providers, government and community involvement, improved availability, and subsidy of contraceptives.