This study investigated factors that have an influence on sexual activity and subsequent contraceptive use among school-going adolescent girls in Lesotho, focusing on the districts of Berea, Maseru and Mohale’s Hoek. The factors under investigation from a reproductive health survey included demographic variables (age, district, rural urban residence, class and religion), behavioural variables (drinking alcohol, boyfriend status), and attitude and knowledge variables (including attitude toward sex before marriage, contraceptive use before marriage, and communication with a boyfriend about sex). The methodology comprised a secondary analysis of the 1999 Adolescent Reproductive Health Survey of Lesotho. Bivariate analysis and binary logistic regression were used to establish if significant relationships existed between sexual activity and contraceptive use and the independent factors. A limitation of the study is that the survey instrument contained a limited set of indicators. Thus a number of theories of sexual decisionmaking were excluded from the conceptual framework. Prevalence of sexual activity was lower than expected. This research confirmed that the likelihood of adolescents being sexually active increases with age. A somewhat surprising result was that Catholic adolescents were more likely to become sexually active than adolescents of other religions. Adolescents who live in rural areas, as well as those with a boyfriend were also found to be more likely to become sexually active. Contraceptive use was higher for this Lesotho sample than has been reported for research from other African countries. Nevertheless, the proportion of adolescents not using contraceptives is argued to be a matter of concern. Adolescents in the lowest school class were least likely to use contraceptives, which suggests a lack of control over decisionmaking in this group. Contraceptive use was found to be lower among adolescents who were coerced into their first sexual experience. Adolescents from Mohale’s Hoek, designated the least developed area for this research, were the least likely to use contraceptives. Those adolescents who reported having a boyfriend were more likely to use contraceptives, suggesting a regular partner allows the adolescent some control over decision-making. A positive view of use of contraceptives before marriage was associated with higher likelihood of use. Somewhat surprisingly, use of alcohol was associated with higher likelihood of contraceptive use. The findings suggest adolescent girls can be grouped into different risk categories. Some practice abstinence and some who are sexually active appear to have control over sexual decision-making, specifically in being able to negotiate use of contraceptives. However, there is a group which is sexually active but does not use contraception. This group has a higher rate of coercion as the reasons for sexual activity. The analysis suggests a multi-dimensional set of factors explain sexual activity and associated contraceptive use (or non-use) and that beliefs and attitudes do not always predict an expected behaviour. Interventions should target the most at-risk group and must take into account that belief and attitude does not necessarily predict behaviour.A / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

The study is titled 'Determinants of contraceptive use among young women in Lesotho'. Caldwell and Caldwell (2002:80) assert, "The most serious problem with existing subSaharan family planning programs is their neglect at adolescents' needs". The main objective of the study is to investigate factors influencing the use of modern contraceptives among young women (15-24 years old) in Lesotho and to contribute towards improvements in health care services for adolescents. The study will examine the levels of contraceptive use among young people in Lesotho, and explore social and demographic factors that promote contraceptive use. The study is based on the data from 2004 Lesotho Demographic and Health Survey which is a representative sample. The study showed that young people have high knowledge of modern methods of contraceptive (knowledge ranked up to 91 percent) however use of methods is lower (ranked up to 44 percent). Traditional methods were the least known except for withdrawal which had a plausible percentage (64.7 percent). Most of sexually active young people have ever used contraceptives and injectables were the leading method while condoms were the most generally known. The study also showed that contraceptive use increases with age, level of education, wealth and discussion of family planning with partner. Results of the logistic regression analysis, however, showed unexpected results where adolescents' from the rural areas had a higher likelihood of using contraceptives than those from urban areas. Married young women had a high level of contraceptive use than those never married. Socio-cultural context hinders the establishment of reproductive programs on adolescents as their sexuality is attached to marriage and childbearing. It was recommended that intensive programs informing young people about their reproductive decision-making is needed. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2010.

Unintended pregnancy has been the subject of considerable research in Lesotho. Lack of priority placed on young people’s sexuality and reproductive health was found to be a major factor exacerbating the rate of unintended pregnancy in the country. The study draws on qualitative data collected from in-depth interviews with university students in Lesotho. In total, 15 in-depth interviews were conducted with 10 women and 5 men. The findings of the study show that unsafe sex coupled with low contraceptive use are the leading causes of unintended pregnancy among young women in Lesotho. Evidence suggests that even though contraceptive prevalence is noticeably low, modern contraceptive methods have a greater potential than other means for reducing the prevalence of unintended pregnancy. The findings of the study also suggest that there is a considerable gender differences in sexual behaviour; males are more likely than females to experience earlier sexual onset, have more sexual partners and to practise unsafe sex. This study recommends that increasing contraceptive prevalence among young people will lead to better reproductive health outcomes. The study also suggests that family planning services should be more male friendly because men play a major role in decision making, and have a great influence on their partners’ decisions to use contraceptives. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2011.