What is stopping young women in Benin from using contraception?

Research from Benin suggests young women are struggling to access contraception. But the challenges they face are different depending on whether they are married or not.

What is the research about?

The research looked at contraceptive use among young women (ages 15–24) in Benin.

Data was analysed from Benin’s 2017/2018 Demographic and Health Survey. Around 15,900 women of reproductive age (15–49 years old) took part, 39% of whom were 15–24 years old.

Researchers also looked at how community attitudes influence young women’s contraceptive use by speaking to 50 young women and men, healthcare providers, relatives and non-governmental organisation leaders.

Why is this research important?

Globally, adolescent girls and young women have the highest risk of unintended pregnancy of any age group.

In Benin, half of all adolescent girls (ages 15-19) are sexually active, and one in five has had a child or is pregnant. But research on contraception in Benin has focused on all women of reproductive age. Little is known about the contraceptive needs of young women.

Understanding this will help inform programmes to reduce unintended pregnancies, and potentially HIV and sexually transmitted infection transmission too (in the case of condom use).

What did they find out?

Only 8.5% of young women and 13% of older women (aged 25-49) use modern contraceptives.

Around 60% of unmarried young women want to use contraception but cannot access it. This is a much higher unmet need than among all other groups of women.

Around two-thirds (63%) of unmarried young women who use contraception use short-term methods, like the pill or condoms. Most (60%) use external condoms. These come from shops, pharmacies or relatives, and men normally get them. So the decision about using condoms often depends on whether the man has any and is willing to use them.

Although many unmarried young women are struggling to access contraception, they are four times more likely to use modern contraception methods than other women.

Reasons contraception is not used

• Young women do not have decision-making power in relationships.
• Having sex before marriage, particularly getting pregnant, is seen as bad. So unmarried young women tend to use more discreet but less reliable methods, like fertility awareness, instead of modern contraception.
• The view that a married young woman should have several children before she should be ‘allowed’ to use contraception.
• The view that contraception causes promiscuity, so is bad.
• The fear that modern contraceptives have bad side effects.
• Some people mistakenly think contraception is a form of abortion and see it as wrong.
• Some people mistakenly think aspirin works as contraception and use it because it is discreet. But aspirin does not prevent pregnancy.

What does this mean for sexual and reproductive health services?

It shows that the barriers unmarried young women face are different to the ones married young women experience, so they need different responses.

The view that unmarried young women should not be having sex makes many reluctant to ask for contraceptives. So providing non-judgemental contraceptive services for unmarried young women is likely to encourage more to come forward.

For married young women, challenging the view that it is important to have lots of children could help reduce unintended pregnancies. This group also needs access to non-judgemental contraceptive services.

There is a need to share clear, youth-friendly information about contraception with young women, whether they are married or not. This could reduce fears about side effects and address myths and misconceptions.

Working with young women, men and the wider community to challenge the view that only men should make decisions in relationships is also important.