BACKGROUND: Gender power differences between males and adolescent girls and young women (AGYW) limit AGYW’s ability to make decisions about sex and relationships and to access sexual and reproductive health services and rights (SRHR). In Mozambique, 46% of AGYW aged 15–19 have a child or were pregnant and 26% report an unmet need for contraception. Pathfinder International’s Impacto Project aims to empower AGYW in Manica and Tete Provinces to exercise their rights to bodily integrity and access contraception and abortion.
METHODS: This mixed methods study explored the multilevel factors that influence gender equality and modern contraceptive use (MCU) among AGYW aged 15–24 in Impacto Project communities. Using previously-collected project baseline data, logistic regression was used to determine factors associated with: 1) MCU among AGYW and 2) measures of gender equality using the Gender Equitable Men (GEM) Scale among AGYW and males aged 18–49. To expand on these findings, we conducted 19 focus group discussions with AGYW and males and 25 key informant interviews with project stakeholders.
RESULTS: MCU was associated with higher education levels and being in a relationship. For rural AGYW, MCU was also associated with having more children, higher contraceptive knowledge, greater wealth, shared or partner-led contraceptive decision-making, and having a moderate or high GEM score. Greater wealth was also associated a high GEM score for men and urban AGYW. A high GEM score was associated with mass media access for all men and urban residence for men who completed secondary school or higher. AGYW, males, and stakeholders elucidated individual-, relationship-, community-, and societal-level factors influencing AGYW MCU, such as relationship status, discussions with family, harmful myths, and SRHR and gender policies. Some positive changes were reported, including growing acceptance of AGYW MCU and improved contraceptive decision-making for AGYW.
RECOMMENDATIONS: SRHR interventions should be adapted to meet AGYW’s needs. Study findings informed programmatic and policy recommendations that can enhance efforts to improve MCU, gender equality, and women’s empowerment for AGYW. Key recommendations include: engaging parents and community members more closely in project activities, training AGYW in negotiation and media literacy, and expanding the reach of the Impacto Project. / 2026-01-31T00:00:00Z
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/43684 |
| Date | 24 January 2022 |
| Creators | Ivankovich, Megan Beth |
| Contributors | Messersmith, Lisa J. |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
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