Interventions for preventing unintended pregnancy include any activity (health education or counselling only, health education plus skills-building, health education plus contraception education, contraception education and distribution, faith-based group or individual counselling) designed to increase adolescents’ knowledge and attitudes relating to risk of unintended pregnancies; promote delay in initiation of sexual intercourse; encourage consistent use of birth control methods and reduce unintended pregnancies.
This review included 53 randomised controlled trials comparing these interventions to various control groups (mostly usual standard sex education offered by schools). The search for trials was not limited by country, though most of the included trials were conducted in high-income countries, with just four trials in middle- and low-income countries, mainly representing the lower socio-economic groups. Interventions were administered in schools, community centres, healthcare facilities and homes. Meta-analysis was performed for studies where it was possible to extract data.
Only interventions involving a combination of education and contraception promotion (multiple interventions) was seen to significantly reduce unintended pregnancy over the medium-term and long-term follow-up period. Results for behavioural (secondary) outcomes were inconsistent across trials.
Limitations of this review include reliance on programme participants to report their behaviours accurately and methodological weaknesses in the trials.
This research is supported by the Department for International Development’s Evidence Building and Synthesis Research Programme which is led by Liverpool School of Tropical Medicine
Oringanje, C.; Meremikwu, M.M.; Eko, H.; Esu, E.; Meremikwu, A.; Ehiri, J.E. Interventions for preventing unintended pregnancies among adolescents. Cochrane Database of Systematic Reviews (2016) DOI: 10.1002/14651858.CD005215.pub3
Interventions for preventing unintended pregnancies among adolescents
Published 3 February 2016