Utilization Status and Perceived Barriers Towards Long-Acting Reversible Contraceptives Among Female Youth College Students in Northern Ethiopia: A Mixed-Methods Study

BACKGROUND: In Ethiopia, teenage sexual activity, unintended pregnancy, and unsafe abortions among youth college students have become the most prevalent public health problems. Contraceptive misuse, low use, and a high unmet need for long-acting reversible contraceptives are attributed to the high rate of unintended pregnancy. OBJECTIVE: To assess the utilization status of long-acting reversible contraceptives and to explore the perceived barriers among youth female college students in Mekelle City, Northern Ethiopia, in 2019. METHODS: An institutional-based, concurrent, mixed cross-sectional study with quantitative and qualitative components was conducted among four private and two public colleges in Mekelle City from March 1 to April 30, 2019. A total of 580 female youth college students were included in the quantitative study, and six in-depth and four key informant interviews were conducted for the qualitative study. The quantitative data were analyzed using descriptive statistics, frequency, and percentages. The chi-square test was done to assess the crude association between the outcome variable and independent categorical variables. A p-value of <0.05 was considered a statistically significant difference. In addition, ATLAS.ti qualitative software version 7.5 was used to code and analyze the qualitative data. RESULTS: With a 93.8% response rate, 544 female youth college students participated, and 177 (32.5%) were sexually active. Seventy-five (42.3%) of students had a history of pregnancy, and of these, 85% of the pregnancies were unplanned. The utilization of long-acting reversible contraceptives among sexually active college students was 7.3%. Qualitatively, the following themes emerged as perceived barriers to the utilization of long-acting reversible contraceptives: knowledge barriers, fear of side effects, misperceptions, health providers’ approach, discrimination, and poor confidentiality. CONCLUSION: This study revealed low utilization of long-acting reversible contraceptives among college students. The findings indicate that college students are at high risk of unintended pregnancy, unsafe abortion, and complications.