Determinants of Emergency Contraceptive Use among Adolescent Girls aged 15-19 Years in West Asembo Ward, Rarieda Sub County, Siaya County, Kenya: A Mixed method, Cross-sectional Study.

Despite high uptake of conventional contraceptive services, adolescent pregnancies remain high in West Asembo ward, Siaya County, Kenya. This study determined the utilization, factors associated with use, and perceptions towards emergency contraception (EC) among adolescent girls in this region. A cross-sectional study design using a mixed-methods approach was employed. Quantitatively, 400 female adolescents aged 15–19 years were randomly sampled using stratified sampling across five sub-locations. Data were collected via interviewer-administered electronic questionnaires. Qualitatively, ten purposively selected Key Informant Interviews were conducted with healthcare and pharmaceutical providers, alongside four Focus Group Discussions with adolescents in sub-locations representing the highest and lowest teenage pregnancy rates. Quantitative data were analyzed using descriptive and inferential statistics (α=0.05) in SPSS v.29, while qualitative data underwent thematic analysis in NVivo 14 before triangulation. Results showed that 34.8% of the respondents had ever used emergency contraception. In the bivariate analysis, being aged 18–19 years significantly reduced the likelihood of EC use compared to those aged 15–17 years (COR: 0.32, 95% CI: 0.21–0.50, p < 0.0001). Lower primary education was associated with a lower likelihood of EC use compared to no formal education (COR: 0.04, 95% CI: 0.003–0.49, p = 0.012). Crucially, adolescent girls who were single and living alone were significantly more likely to use ECs than single counterparts living with parents or guardians (COR: 5.23, 95% CI: 2.86–9.56, p < 0.0001). In conclusion, emergency contraceptive use among adolescent girls in West Asembo Ward is relatively low. The findings underscore the need for a comprehensive, adolescent-centered approach involving health facilities, schools, community health promoters, and private pharmacies to empower adolescents with accurate information while ensuring confidential, accessible EC services coupled with reproductive health counseling.