Communication, Social Norms, and Contraceptive Use among Adolescent Girls and Young Women in Lilongwe, Malawi

Citation

Bhushan, Nivedita L.; Fisher, Edwin B.; Maman, Suzanne; Speizer, Ilene S.; Gottfredson, Nisha C.; Phanga, Twambilile; Vansia, Dhrutika; Pettifor, Audrey E.; & Rosenberg, Nora E. (2021). Communication, Social Norms, and Contraceptive Use among Adolescent Girls and Young Women in Lilongwe, Malawi. Women & Health, 61(5), 440-451. PMCID: PMC8182971

Abstract

In Malawi, 50% of adolescent girls and young women (AGYW) have had a first child by age 19 and 45% report their pregnancies as unintended or mistimed. Yet, uptake of contraception remains low. Understanding how interactions with social ties impact AGYW contraceptive use might explain low uptake beyond individual and environmental factors. Data are from Girl-Power, a study among sexually active AGYW, aged 15-24, in Malawi. We used logistic regression models to examine whether contraceptive communication and social norms (descriptive and injunctive) were associated with contraceptive use (non-barrier methods and condoms) and how associations differed across social ties (older women in the family, peers, and partners). The sample included 942 participants: 28% reported using non-barrier methods and 66% reported using condoms. Contraceptive communication with older women in the family (aOR: 1.48, 95% CI: 0.99, 2.20), peers (aOR: 3.12, 95% CI: 1.96, 4.96), and partners (aOR 5.15, 95% CI: 3.13, 8.48) was associated with non-barrier method use. Descriptive norms were associated with non-barrier methods among peers (aOR 2.57, 95% CI: 1.63, 4.96) but not among older women in the family (aOR: 1.22, 95% CI 0.80, 1.88). There were no associations among contraceptive communication, social norms, and condom use across older women in the family, peers, and partners. The findings highlight the need to consider the influence of social ties in the design of future family planning interventions and suggest that interventions that encourage interpersonal communication about contraception and target peer-based descriptive norms have the potential to impact uptake of non-barrier methods.

URL

http://dx.doi.org/10.1080/03630242.2021.1917479

Reference Type

Journal Article

Year Published

2021

Journal Title

Women & Health

Author(s)

Bhushan, Nivedita L.
Fisher, Edwin B.
Maman, Suzanne
Speizer, Ilene S.
Gottfredson, Nisha C.
Phanga, Twambilile
Vansia, Dhrutika
Pettifor, Audrey E.
Rosenberg, Nora E.

Article Type

Regular

PMCID

PMC8182971

Data Set/Study

Girl Power-Malawi

Continent/Country

Malawi

Sex/Gender

Women

ORCiD

Speizer - 0000-0001-6204-1316
Pettifor - 0000-0002-3387-0817