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Adolescent contraceptive use

DATA FROM THE UKRAINE DEMOGRAPHIC AND HEALTH SURVEY (UDHS), 2007

U K R A I N E

What can be done to support Ukrainian 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 Ukraine, there are over 3.9 million adolescents aged 10–19 years – 8.9% of the country’s total population.i Just over a third of adolescents live in rural areas, 33.7% of adolescent girls and 34.2% of adolescent boys.i

By age 19, the mean number of years of schooling attended by adolescent girls is 13.1, while for adolescent boys it is 12.8.ii Among adolescents who become parents before age 20, the average age at which Ukrainian adolescent girls have their first baby is 18.1 years, while the average age at which adolescent boys first become fathers is 18.4.ii

Sexual activity and marital status

Analysis of data from the UDHSii shows that over 468 000 Ukrainians 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, adolescent girls first have sexual intercourse at age 17.4 years and adolescent boys at 17.3 years.

Among unmarried adolescents, 13.1% of adolescent girls report ever having sex and 10.2% are currently sexually active; among adolescent boys, 30.2% report ever having sex, while 25.4%

are currently sexually active.

Among all Ukrainian adolescents, 5.7% of adolescent girls and 3.0% of adolescent boys are in a union. Among these adolescents, the mean age of the first union is 17.8 years for adolescent girls and 18.1 for adolescent boys.

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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 Spermicides 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 UDHSii analyses, 78.7% of unmarried, sexually active adolescent girls report not wanting a child in the next two years, yet only 63.2% 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 (51.1%)

• knows no source (15.9%)

• not married (12.6%)

Among all unmarried, sexually active adolescent girls aged 15–19, 17.2% are not using a method of contraception. Male condoms are the most common modern method used (74.4% of these adolescent girls), while spermicides are used by 3.2% and pills are used by 2.9%. Withdrawal, a traditional method, is used 3.2%

(see Figure 1).

In union

According to UDHSii analyses, 51.0% of adolescent girls in a union report not wanting a child in the next two years, yet only 49.9%

of them are currently using any method to prevent pregnancy.

The main reasons these adolescents report for not using a contraceptive method include:

• breastfeeding (34.1%)

• husband or partner is opposed (20.7%)

• not having sex (17.9%)

Among all adolescent girls in a union aged 15–19, 51.7% are not using a method of contraception. Male condoms are the most common modern method used (37.0% of these adolescent girls), while 5.6% are using spermicides. Withdrawal, a traditional method, is used by 5.6% 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 Ukrainian Center for Social Reforms (UCSR), State Statistical Committee (SSC) [Ukraine], Ministry of Health (MOH) [Ukraine], Macro International Inc. Ukraine Demographic and Health Survey 2007 [Datasets]. UAIR51.DTA and UAMR51.DTA. Calverton (MD): ICF International; 2008 (http://dhsprogram.com/data/dataset/Ukraine_Standard-DHS_2007.

cfm?flag=0, accessed 4 November 2016).

Not using Spermicides Withdrawal Male condom 37.0

5.6 5.6 51.7

3.2 74.4

17.2 3.2 2.9

LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use

Source: analysis of UDHS 2007ii

Source: analysis of UDHS 2007ii

Unmarried, sexually active adolescents who are using a modern method most often get it from friends (69.7%) or a government facility (18.5%).

Adolescents in a union who are using a modern method most often get it from a government facility (57.8%) or a pharmacy (48.5%).

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Adolescent contraceptive use

U K R A I N E

Use and non-use of contraception adolescent girls, aged 15-19

million adolescents ages 10-19 17.4 years

3.9

for adolescent girls

17.3 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 Ukrainian 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

78.7%

sexually active, unmarried adolescent girls

51.0%

adolescent girls in union

48.5%

from a pharmacy 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 UKRAINE DEMOGRAPHIC AND HEALTH SURVEY, 2007

COMPILED IN 2016 | UPDATED NOVEMBER 2016

Ukrainian Center for Social Reforms (UCSR), State Statistical Committee (SSC) [Ukraine], Ministry of Health (MOH) [Ukraine], Macro International Inc. Ukraine Demographic and Health Survey 2007 [Datasets]. UAIR51.DTA and UAMR51.DTA. Calverton (MD): ICF International; 2008 (http://dhsprogram.com/data/dataset/Ukraine_Standard-DHS_2007.cfm?flag=0, accessed 4 November 2016).

18.4 18.1

for adolescent girls for adolescent boys

LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use

Sexually active,

unmarried In union

51.1% infrequent sex 34.1% breastfeeding

15.9% knows no source

20.7% husband or partner is opposed 12.6% not married 17.9% not having sex Method Sexually active,

unmarried In union

Not using 17.2% 51.7%

Spermicides 3.2% 5.6%

Withdrawal 3.2% 5.6%

Male condom 74.4% 37.0%

Pill 2.9% --

69.7%

from friends

18.5%

from a government

facility

57.8%

from a government

facility

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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

Spermicides 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/16.53

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