Background

Global high rates of unplanned pregnancy and abortion among young women demonstrate the need for increased access to modern contraceptive services. In sub-Saharan Africa, the birth rate for those aged 15 to 19 years is 121 per 1000. In the USA, 6% of teens aged 15 to 19 years became pregnant in 2010. Most pregnancies among young women to age 25 are unintended. In addition, 87% of unintended pregnancies occur among women who do not use a modern contraceptive method. In low- and middle-income countries (LMICs), 33 million women from 15 to 24 years old have an unmet need for contraception. While multifaceted interventions help address the complexity of contraception behavior, most contraception counseling occurs in a clinical setting. Time and counseling expertise are often limited, along with knowledge about specific contraceptive methods, such as long-acting reversible contraception.

Key findings

- Special counseling plus phone follow-up was more effective than counseling alone on use of oral contraceptives (OC) and condoms among young women, 16 to 24 years old;

- Two other types of special counseling also had effects on contraceptive use compared with standard care;

- The need is still great for strategies to improve contraceptive use among young people that are feasible for clinics.