A narrative review of adolescents’ knowledge, attitudes and utilisation of contraception in Cambodia, Lao PDR, Myanmar, Thailand and Vietnam.

Abstract

An estimated 25 million unsafe abortions have taken place around the globe in 2019, and nearly four million of these are adolescents aged 15–19. Similarly, in the countries under study: Cambodia, Lao People's Democratic Republic (Lao PDR), Myanmar, Thailand and Vietnam still experience high adolescent birth rates and unplanned pregnancies, the leading cause of abortion. Furthermore, adolescents also encounter challenges in obtaining contraceptives and seeking advice. Due to the increasing size of the adolescent populations in the countries under study, attention is needed to understand their health and wellbeing, particularly their sexual reproductive health experience. Thus, it is essential to explore adolescent knowledge, attitudes, and contraceptive use in the selected countries, which could help to identify the gaps in accessing health-related information.

This study aims to review the literature related to knowledge, attitudes and utilisation of contraception, and the factors influencing the use of contraception and family planning services among adolescents in the five countries under study. A narrative literature review was utilised. The study systematically searched for eligible articles by using health-related databases: PubMed, MEDLINE, EMBASE, PsycINFO, and CINAHL. To avoid missing unpublished papers, a manual search was carried by using key terms in the Google Scholar website, and the thesis and dissertation repository. The results of this literature search brought sixteen eligible publications.

The findings indicate that adolescents’ knowledge of contraceptive methods in the focused countries was below average, even though their awareness was generally high. Lack of sex education was one reason for not having comprehensive knowledge. Adolescents mostly had negative attitudes toward contraceptives, particularly hormonal methods. This was because many adolescents had myths and misinformation about contraceptive side effects. The use of contraceptives was found to be low and also dependent on the nature of the relationship with their partners. Overall, the study results show that having high awareness of contraceptive methods is not equivalent to high contraceptive utilisation. The contributing factors for using or not using contraceptives were personal beliefs, interpersonal communication, societal influence, and perceptions towards contraceptive products. In conclusion, the policymakers and governments of the selected countries need to consider revising the sex education curriculum and to ensure that it is available nationwide, whilst also ensuring that youth-friendly health clinics are accessible for all adolescents without cultural, financial and geographical barriers.