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Modern contraceptive use among sexually active women aged 15–19 years in North-Western Tanzania: results from the Adolescent 360 (A360) baseline survey
  1. Mussa Kelvin Nsanya1,
  2. Christina J Atchison2,
  3. Christian Bottomley2,
  4. Aoife Margaret Doyle2,
  5. Saidi H Kapiga1,3
  1. 1 Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
  2. 2 MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
  3. 3 Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
  1. Correspondence to Dr Mussa Kelvin Nsanya; kelvin.nsanya{at}


Objectives To describe differences in modern contraceptive use among adolescent women aged 15–19 years according to their marital status and to determine factors associated with modern contraceptive use among sexually active women in this population.

Design Cross-sectional analysis of Adolescent 360 evaluation baseline survey.

Setting The 15 urban and semiurban wards of Ilemela district, Mwanza region, North-Western Tanzania.

Participants Adolescent women aged 15–19 years who were living in the study site from August 2017 to February 2018 and who provided informed consent. Women were classified as married if they had a husband or were living as married. Unmarried women were classified as sexually active if they reported having sexual intercourse in the last 12 months.

Outcome measure Prevalence of modern contraceptive among adolescent women aged 15–19 years.

Results Data were available for 3511 women aged 15–19 years, of which 201 (5.7%) were married and 744 (22.5%) were unmarried-sexually active. We found strong evidence of differences in use of modern contraceptive methods according to marital status of adolescent women. Determinants of modern contraception use among unmarried-sexually active women were increasing age, increasing level of education, being in education, hearing of modern contraception from interpersonal sources or in the media in the last 12 months, perceiving partner and/or friends support for contraceptive use, as well as higher knowledge and self efficacy for contraception.

Conclusions Sexual and reproductive health programmes aiming to increase uptake of modern contraceptives in this population of adolescent women should consider the importance of girl’s education and social support for contraceptive use particularly among unmarried-sexually active women.

  • adolescents
  • contraception
  • family planning
  • reproductive health
  • Africa

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  • Contributors MKN, CJA, SHK, CB and AMD were involved in conception and study design. CB provided statistical expertise. MKN and CJA were involved in drafting of the manuscript. SHK, CB and AMD were involved in critical revision of the manuscript for important intellectual content. All the authors were involved in final approval of the manuscript and decision to submit the manuscript for publication.

  • Funding The Bill & Melinda Gates Foundation and the Children’s Investment Fund Foundation. The funding bodies had no role in the design of the study and collection, analysis and interpretation of data and in writing the manuscript.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by the Tanzania National Health Research Ethics review sub-committee of the National Institute for Medical Research (Ref: NIMR/HQ/R8a/Vol.IX/2549), and the research ethics committee of the London School of Hygiene & Tropical Medicine (LSHTM, Ref: 14145).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.