Use of contraceptives, empowerment and agency of adolescent girls and young women: A systematic review and meta-analysis
Document Type
Review Article
Department
Medical College Pakistan
Abstract
Introduction: The evidence on adolescent empowerment, which involves access to personal and material resources for reproductive autonomy and economic equity, is limited. This systematic review assesses the use of contraceptives in empowering and strengthening the agency and vice versa among adolescents and young women.
Methods: We ran the searches in six electronic databases: Cochrane Database of Systematic Reviews (CDSR) and the Cochrane Central Register of Controlled Trials (CENTRAL), The Campbell Library, MEDLINE (PubMed), EMBASE, Cumulated Index to Nursing and Allied Health Literature (CINAHL) and Web of Science. The methodological quality of studies was assessed using ROBINS-I and ROB-II tools as appropriate. Meta-analysis was performed using Review Manager 5.4.
Results: Forty studies that assessed the impact of empowerment on contraceptive use were included. Of these, 14 were non-randomised studies for intervention (NRSIs), and the remaining 26 were randomised controlled trials (RCTs). The results from RCTs show a significant effect of the sexual and reproductive health empowerment in increasing ever use of contraception (RR 1.22; 95% CI 1.02, 1.45; n=9; I²=77%; GRADE: Very Low), and insignificant effect on unprotected sex (RR 0.97; 95% CI 0.74, 1.26; n=5; I²=86%; GRADE: Very Low) and adolescent pregnancy (RR 1.07; 95% CI 0.61, 1.87; n=3; I²=36%; GRADE: Very Low). None of the studies assessed impact of contraceptive use on empowerment.
Conclusions: Empowerment of adolescents and young women certainly improves contraceptive use in the immediate or short-term period. However, more robust studies with low risk of bias, longer-term outcomes, and impact of contraceptive use on empowerment and agency-strengthening are required. To increase contraceptive use uptake, tailored policies and delivery platforms are necessary for youth in low- and middle-income countries.
Publication (Name of Journal)
BMJ Sexual & Reproductive Health
DOI
10.1136/bmjsrh-2023-202151
Recommended Citation
Lassi, Z. S.,
Rahim, K. A.,
Stavropoulos, A. M.,
Ryan, L. M.,
Tyagi, J.,
Adewale, B.,
Kurji, J.,
Bhaumik, S.,
Meherali, S.,
Ali, M.
(2024). Use of contraceptives, empowerment and agency of adolescent girls and young women: A systematic review and meta-analysis. BMJ Sexual & Reproductive Health.
Available at:
https://ecommons.aku.edu/pakistan_fhs_mc_mc/422
Comments
Volume, issue and pagination are not provided by the author/publisher.