Effect of peer counselling on acceptance of modern contraceptives among female refugee adolescents in northern Uganda: A randomised controlled trial.

<h4>Background</h4>The unmet need for contraceptives among refugee adolescents is high globally, leaving girls vulnerable to unintended pregnancies. Lack of knowledge and fear of side effects are the most reported reasons for non-use of contraceptives amongst refugee adolescents. Peer co...

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Autores principales:	Ritah Bakesiima, Jolly Beyeza-Kashesya, James K Tumwine, Rose Nabirye Chalo, Kristina Gemzell-Danielsson, Amanda Cleeve, Elin C Larsson
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f065225765ce4ab5ac460eb910df0b4f
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spelling	oai:doaj.org-article:f065225765ce4ab5ac460eb910df0b4f2021-12-02T20:08:36ZEffect of peer counselling on acceptance of modern contraceptives among female refugee adolescents in northern Uganda: A randomised controlled trial.1932-620310.1371/journal.pone.0256479https://doaj.org/article/f065225765ce4ab5ac460eb910df0b4f2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0256479https://doaj.org/toc/1932-6203<h4>Background</h4>The unmet need for contraceptives among refugee adolescents is high globally, leaving girls vulnerable to unintended pregnancies. Lack of knowledge and fear of side effects are the most reported reasons for non-use of contraceptives amongst refugee adolescents. Peer counselling, the use of trained adolescents to offer contraceptive counselling to fellow peers, has showed effectiveness in increasing use of contraceptives in non-refugee adolescent resarch.<h4>Objective</h4>To determine the effect of peer counselling on acceptance of modern contraceptives among female refugee adolescents in northern Uganda.<h4>Methods</h4>A randomised controlled trial carried out in Palabek refugee settlement in northern Uganda, May to July 2019. Adolescents were included if they were sexually active or in any form of union, wanted to delay child bearing, and were not using any contraceptives. A total of 588 consenting adolescents were randomised to either peer counselling or routine counselling, the standard of care.<h4>Results</h4>Adolescents who received peer counselling were more likely to accept a contraceptive method compared to those who received routine counselling (PR: 1·24, 95% CI: 1·03 to 1·50, p = 0·023). Adolescents whose partners had attained up to tertiary education were more likely to accept a method than those whose partners had secondary or less education (PR: 1·45, 95% CI: 1·02 to 2·06, p = 0·037). In both groups, the most frequently accepted methods were the injectable and implant, with the commonest reasons for non-acceptance of contraception being fear of side effects and partner prohibition.<h4>Conclusion</h4>Our data indicates that peer counselling has a positive effect on same day acceptance of modern contraceptives and should therefore be considered in future efforts to prevent adolescent pregnancies in refugee settings. Future peer counselling interventions should focus on how to effectively address adolescents' fear of side effects and partner prohibition, as these factors continue to impede decision making for contraceptive uptake.Ritah BakesiimaJolly Beyeza-KashesyaJames K TumwineRose Nabirye ChaloKristina Gemzell-DanielssonAmanda CleeveElin C LarssonPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 9, p e0256479 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ritah Bakesiima Jolly Beyeza-Kashesya James K Tumwine Rose Nabirye Chalo Kristina Gemzell-Danielsson Amanda Cleeve Elin C Larsson Effect of peer counselling on acceptance of modern contraceptives among female refugee adolescents in northern Uganda: A randomised controlled trial.
description	<h4>Background</h4>The unmet need for contraceptives among refugee adolescents is high globally, leaving girls vulnerable to unintended pregnancies. Lack of knowledge and fear of side effects are the most reported reasons for non-use of contraceptives amongst refugee adolescents. Peer counselling, the use of trained adolescents to offer contraceptive counselling to fellow peers, has showed effectiveness in increasing use of contraceptives in non-refugee adolescent resarch.<h4>Objective</h4>To determine the effect of peer counselling on acceptance of modern contraceptives among female refugee adolescents in northern Uganda.<h4>Methods</h4>A randomised controlled trial carried out in Palabek refugee settlement in northern Uganda, May to July 2019. Adolescents were included if they were sexually active or in any form of union, wanted to delay child bearing, and were not using any contraceptives. A total of 588 consenting adolescents were randomised to either peer counselling or routine counselling, the standard of care.<h4>Results</h4>Adolescents who received peer counselling were more likely to accept a contraceptive method compared to those who received routine counselling (PR: 1·24, 95% CI: 1·03 to 1·50, p = 0·023). Adolescents whose partners had attained up to tertiary education were more likely to accept a method than those whose partners had secondary or less education (PR: 1·45, 95% CI: 1·02 to 2·06, p = 0·037). In both groups, the most frequently accepted methods were the injectable and implant, with the commonest reasons for non-acceptance of contraception being fear of side effects and partner prohibition.<h4>Conclusion</h4>Our data indicates that peer counselling has a positive effect on same day acceptance of modern contraceptives and should therefore be considered in future efforts to prevent adolescent pregnancies in refugee settings. Future peer counselling interventions should focus on how to effectively address adolescents' fear of side effects and partner prohibition, as these factors continue to impede decision making for contraceptive uptake.
format	article
author	Ritah Bakesiima Jolly Beyeza-Kashesya James K Tumwine Rose Nabirye Chalo Kristina Gemzell-Danielsson Amanda Cleeve Elin C Larsson
author_facet	Ritah Bakesiima Jolly Beyeza-Kashesya James K Tumwine Rose Nabirye Chalo Kristina Gemzell-Danielsson Amanda Cleeve Elin C Larsson
author_sort	Ritah Bakesiima
title	Effect of peer counselling on acceptance of modern contraceptives among female refugee adolescents in northern Uganda: A randomised controlled trial.
title_short	Effect of peer counselling on acceptance of modern contraceptives among female refugee adolescents in northern Uganda: A randomised controlled trial.
title_full	Effect of peer counselling on acceptance of modern contraceptives among female refugee adolescents in northern Uganda: A randomised controlled trial.
title_fullStr	Effect of peer counselling on acceptance of modern contraceptives among female refugee adolescents in northern Uganda: A randomised controlled trial.
title_full_unstemmed	Effect of peer counselling on acceptance of modern contraceptives among female refugee adolescents in northern Uganda: A randomised controlled trial.
title_sort	effect of peer counselling on acceptance of modern contraceptives among female refugee adolescents in northern uganda: a randomised controlled trial.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/f065225765ce4ab5ac460eb910df0b4f
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Effect of peer counselling on acceptance of modern contraceptives among female refugee adolescents in northern Uganda: A randomised controlled trial.

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