The use of condoms and other birth control methods among sexually active school-going adolescents in nine sub-Saharan African countries

Background: Adolescents in sub-Saharan Africa still face sexual and reproductive health challenges. Contraceptives have been used to address these challenges. However, contraceptive uptake among young people in Africa remains a challenge despite efforts at national and global levels. We estimated the prevalence and correlates of condom use and other birth control methods among sexually active school-going adolescents in nine sub-Saharan African (SSA) countries. Methods: : We conducted a secondary analysis of the Global School-based Student Health Surveys (GSHS) datasets pooled from nine SSA countries. We included a sample of 27504 school-going adolescents aged 11 and 18 years. We employed meta-analysis using a random-effects model to estimate the total prevalence of the use of condoms, other birth control methods other than a condom and any birth control method at last sexual intercourse. We conducted complex sample descriptive and logistic regression analyses. Results: : More than half [n=4430, 53.8% (43.9- 63.8)], two-fifth [n=3242, 39.5% (33.2-45.9) and two-thirds of adolescents [n=4838, 65.6% (57.5-73.7)] of sexually active in school adolescents across the nine sub-Saharan African countries used condom, other birth control methods and any form birth control method during their last sexual intercourse, respectively. The non-use of condoms at last sex was associated with being younger (less than 16 years) [AOR=1.48;95%CI: 1.12-1.94], early sexual debut [AOR=1.81(1.47-2.22)], having two or more sexual partners [AOR=1.30(1.06-1.58)] and no/minimal parental support [AOR=1.54(1.17-2.03)]. The non-use of other birth control methods at last sex was associated with being male [AOR=1.37 (1.09- 1.73)], early sexual debut [AOR=1.83(1.48-2.27) and no/minimal parental support [AOR=1.64(1.34-2.00)]. Conclusion: Contraceptive need among sexually active school adolescents in the nine sub-Saharan African countries is high. Such a need calls for the development of country-specific and or the review of existing school-based sexual health education and youth-friendly sexual and reproductive health interventions that target risky adolescents and promote adolescent-parent effective communication, connectedness and support.