Published July 3, 2026 | Version v1

Barriers and facilitators to access to contraception among young people: a systematic review

  • 1. Planned Parenthood Association of Zambia, Nkanchibaya Road, Box 32221, Lusaka, Zambia.
  • 2. University of Zambia, School of Public Health, P.O. Box 32379, Lusaka Zambia.

Description

Abstract

Background: In Low-and Middle-Income Countries, access to contraception remains a challenge, particularly among young people, as millions encounter difficulties in acquiring and utilizing modern contraceptive methods. This systematic review synthesizes existing evidence relating to barriers and facilitators to access to contraception among young people aged 10 to 24 years in Low-and Middle-Income Countries (LMICs).

Methods: We conducted a search of various databases for peer-reviewed studies published in English from January 1, 2015, to December 31, 2025, and we focused on research that explored the factors affecting access to contraception among young people in LMICs.  We identified twenty-four studies that met the inclusion criteria, which were then thematically analyzed.

Results: Individual factors, such as fear of side effects and insufficient knowledge, were identified as barriers to access to contraception. Family dynamics, including lack of support from family members and peers, were also noted as obstacles to contraceptive use. Additional barriers include health systems factors such as extended waiting times, negative attitudes from service providers, and lack of confidentiality. Social factors, such as fear of stigma, adherence to religious teachings, and cultural beliefs, presented further challenges. On the other hand, family support, approval from peers, easy access to options of contraceptive methods, and the assurance of confidentiality were recognized as facilitators promoting access to contraception.

Conclusion: Young people in LMICs encounter numerous challenges in accessing contraception.  To overcome these impediments, it is necessary to implement wide-ranging interventions that are aimed at addressing individual, health systems, social, familial, and economic factors.

Files

MSIJMR5302026 GS.pdf

Files (442.1 kB)

Name Size Download all
md5:ba7899a5a60efd2b1e93c50612ef65a5
442.1 kB Preview Download

Additional details

Identifiers

URL
https://msipublishers.com/volume-3-issue-7-2026-msijmr/
Other
MSI Journal of Multidisciplinary Research (MSIJMR)

Dates

Accepted
2026-07-03

References

  • Alidou S, Dahourou LD, Dah TTE, Sogo A, Kenao TS, Yehadji D, Meda N, and Ekouevi DK (2023). Unmet need for modern contraceptive methods among sexually active adolescents and young women in Togo: a national Cross-Sectional study. Frontiers in Public Health, 11:1169180. doi:10.3389/fpubh.2023.1169180.
  • Amoah EJ (2023). Determinants and prevalence of modern contraceptive use among sexually active female youth in the Berekum East Municipality, Ghana. PLOS ONE, 18(6): e0286585. PMCID: PMC10249812, PMID: 37289674. doi:10.1371/journal.pone.0286585.
  • Arije O, Madan J, and Hlungwani T (2024). Preferences in adolescents and young people's SRH services in Nigeria: A Discrete Choice Experiment. Health Economics Review, 14, 24. https://doi.org/10.1186/s13561-024-00497-4.
  • Bhatt N, Bhatt B, Neupane B, Karki A, Bhatta T, Thapa J, Basnet LB, and Budhathoki SS (2021). Perceptions of family planning services and its key barriers among adolescents and young people in Eastern Nepal: A qualitative study. PLOS ONE, 16(5): e0252184. doi:10.1371/journal.pone.0252184. PMID: 34038439; PMCID: PMC8153486.
  • Burke E, Kebe F, Flink I, van Reeuwijk M, and le May A (2017). A qualitative study to explore the barriers and enablers for young people with disabilities to access sexual and reproductive health services in Senegal. Reproductive Health Matters, 25(50): 43-54. doi:10.1080/09688080.2017.1329607.
  • Chandra-Mouli V and Akwara E (2020). Improving access to and use of contraception by adolescents: what progress has been made, what lessons have been learnt, and what are the implications for action? Best Practice & Research Clinical Obstetrics & Gynaecology, 66, 107-118. doi:10.1016/j.bpobgyn.2020.02.007.
  • Chola M, Hlongwana K, and Ginindza TG (2023). Understanding adolescent girls' experiences with accessing and using contraceptives in Zambia. BMC Public Health, 23, Article number 2149. https://doi.org/10.1186/s12889-023-17071-7.
  • Cohen N, Mendy FT, Proti A, Cissé C, Gueye EB, Trupe L, Floreak R, Guichon D, Lorenzana K, and Buttenheim A (2020). Behavioral barriers to use of modern methods of contraception among unmarried youth and adolescents in eastern Senegal: a qualitative study. BMC Public Health, 20, Article number 1025. https://doi.org/10.1186/s12889-020- 09132-4.
  • Dioubate N, Manet H, Bangoura C, Sidibe S, Kouyate M, Kolie D, Ayadi AME, and Delamou A (2021). Barriers to contraceptive use Among Urban Adolescents and Youths in Conakry, in 2019, Guinea. Frontiers in Global Women's Health, 2:655929. https://doi.org/10.3389/fgwh.2021.655929.
  • Dombola AM, Manda WC, and Chipeta E (2021). Factors influencing contraceptive decision-making and use among young adolescents in urban Lilongwe, Malawi: a qualitative study. Reproductive Health, 18, Article number 209. https://doi.org/10.1186/s12978-021- 01259-9.
  • Gbagbo FY and Nkrumah JC (2019). Family planning among undergraduate University students: A case study of a public University in Ghana. BMC Women's Health, 19:12. https://doi.org/10.1186/s12905-019-0708-3.
  • Hailu S, Assefa N, Dingeta T, Abdurahman C, and Adem M (2022). Unmet need for contraception among married adolescent girls and young women in Haramaya Health and Demographic Surveillance System, Eastern Ethiopia. Frontiers in Global Women's Health, 3:999860. https://doi.org/10.3389/fgwh.2022.999860.
  • Harris LH and Grossman D (2020). Complications of unsafe and Self-Managed Abortion. New England Journal of Medicine, 382:1029-1040. doi:10.1056/NEJMra1908412.
  • Henry D, Wood S, Moshashane N, Ramontshonyana K, Amutah C, Maleki P, Howlett C, Brooks MJ, Mussa A, Joel D, Steenhoff AP, Akers AY, and Morroni C (2021). Facilitators and Barriers to implementation of Long-Acting Reversible Contraceptives Services for Adolescents and Young Women in Gaborone, Botswana. Journal of Pediatric and Adolescent Gynecology, 34(4): 504-513. https://doi.org/10.1016/j.jpag.2021.03.003.
  • Islam MM, Khan MN, and Rahman MM (2021). Factors affecting child marriage and contraceptive use among Rohingya girls in Refugee Camps. The Lancet Regional Health - Western Pacific, 12:100175. doi:10.1016/j.lanwpc.2021.100175.
  • Jonas K, Duby Z, Maruping K, Harries J, and Mathews C (2022). Rumours, Myths, and Misperceptions as barriers to contraceptive use among Adolescent Girls and Young Women in South Africa. Frontiers in Reproductive Health, 4:960089. doi:10.3389/frph.2022.960089.
  • Kantorova V, Wheldon MC, Ueffing P, and Dasgupta ANZ (2020). Estimating progress towards meeting women's contraceptive needs in 185 Countries: a Bayesian hierarchical modeling study. PLOS Medicine, 17(2): e1003026. doi:10.1371/journal.pmed.1003026.
  • Kisongo E, Tumwesigye R, Anyolitho MK, Musinguzi M, Kwizera G, Achan E, Nabasirye CK, Udho S, Kabunga A, and Omech B (2024). Access to family planning services and associated factors among young people in Lira City, Northern Uganda. BMC Public Health, 24, Article number 1146. https://doi.org/10.1186/s12889-024-18653-5.
  • Makwinja AK, Maida ZM, and Nyondo-Mipando AL (2021). Delivery strategies for optimizing uptake of contraceptives among adolescents aged 15–19 years in Nsanje District, Malawi. Reproductive Health, 18, 1-9. doi:10.1186/s12978-021-01149-0.
  • Masonbrink AR, Hurley EA, Schuetz N, Rodean J, Rupe E, Lewis K, Boncoeur MD, and Miller MK (2023). Sexual behaviors, Contraceptive use and barriers among adolescents and young adults in rural Haiti. BMC Women's Health, 23, Article number 137. https://doi.org/10.1186/s12905-023-02268-5.
  • Mazibuko NE, Saruchera M, and Okonji EF (2023). A qualitative Exploration of Factors Influencing Non-Use of SRH services among university students in South Africa. International Journal of Environmental Research and Public Health, 20(3): 2418. https://doi.org/10.3390/ijerph20032418.
  • Mulubwa C, Munakampe MN, Namakula H, Hernandez A, Ssekamatte T, Afuyambe LM, Birabwa C, Chemonges D, Namatovu F, Makumbi F, and Tetui M (2021). Framing Contraceptive Use Motivations Among Adolescents and Young Adults Living in Informal Settlements in Kira Municipality, Wakiso District, Uganda. Frontiers in Global Women's Health, 2:658515. https://doi.org/10.3389/fgwh.2021.658515.
  • Munakampe MN, Zulu JM, and Michelo C (2018). Contraception and abortion knowledge, attitudes, and practices among adolescents from low- and middle-income countries: a systematic review. BMC Health Services Research, 18, 1-13. doi:10.1186/s12913-018-3720- 3.
  • Namukonda ES, Rosen JG, Simataa MN, Chibuye M, Mbizvo MT, and Kangale C (2020). Sexual and Reproductive Health knowledge, attitudes, and Service uptake barriers among Zambian in-school adolescents: a Mixed methods study. Sex Education, 21(4): 436-451. doi:10.1080/14681811.2020.1832458.
  • Namukwambi RN, Kangoya EN, and Muyunda R (2020). Barriers to Access of contraceptives by adolescents in the Keetmanshoop Urban Constituency of the //Kharas Region, Namibia. International Journal of Medical and Health Sciences, 9(2): 110-118.
  • Ofogba LE, Adeyemo F, and Agofure O (2022). Perceived barriers influencing uptake of contraceptives among female undergraduates in a Nigerian University. African Journal of Biomedical Research, 25(1): 19-25.
  • Simegn A, Tiruneh D, Seid T, and Ayalew F (2020). Contraceptive Demand, Utilization and Associated Factors Among University Students in Amhara Region, Ethiopia: InstitutionalBased Cross-Sectional Study. Open Access Journal of Contraception, 11: 153–163. PMID: 33116966, PMCID: PMC7553260. doi:10.2147/OAJC.S267966.
  • Sully EA, Biddlecom A, Darroch J, Riley T, Ashford L, Lince-Deroche N, Firestein L, and Murro R (2020). Adding It Up: Investing in Sexual and Reproductive Health 2019. New York: Guttmacher Institute.
  • Toweka A, Stanzia M, Marvelous M, Makochekanwa A, and Mandizadza E (2022). Practices regarding modern contraceptive use among female students: A comparative study between University of Zimbabwe with Chinhoyi University of Technology. International Journal of Sexual and Reproductive Health Care, 5(1): 034-041. doi:10.17352/ijsrhc.000021.
  • Tucho GT, Workneh N, Abera M, and Abafita J (2022). A Cross-Sectional Study Design to assess the sexual experiences and contraceptive use of adolescents and youths attending high school and College in Jimma Town. Contraception and Reproductive Medicine, 7, Article number 7. doi:10.1186/s40834-022-00172-5.
  • Wachamo D, Tegene Y, Tibeso A, and Washo A (2020). Sexual and Reproductive Health services utilization and Associated Factors among College students at West Arsi Zone in Oromia Region, Ethiopia. The Scientific World Journal, 2020, Article ID 3408789. https://doi.org/10.1155/2020/3408789.
  • WHO (2023). Adolescent Pregnancy. Fact Sheets; World Health Organization. https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy.
  • Wondimagegne YA, Debelew GT, and Koricha ZB (2023). Barriers to contraceptive use among Secondary School adolescents in Gedeo Zone, South Ethiopia: a formative qualitative study. BMJ Open, 13: e060582. doi:10.1136/bmjopen-2021-060582.
  • Zulu B, Maharaj P, and Dunn S (2023). A qualitative study on contraceptive use among young females University students: What still matters? Journal of African Population Studies, 36(1): 5281. https://doi.org/10.59147/japs.v36i1.5281.