Modern Contraceptive Use Among Young Women in Kampala Slums: Research Findings from the TOPOWA Study

Monica H. Swahn (), Josephine Namuyiga, Gideon Matovu, Charles Natuhamya, Jane Palmier, Anna Nabulya and Harriet Kebirungi
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Monica H. Swahn: School of Public Health, Virginia Commonwealth University, Richmond, VA 23219, USA
Josephine Namuyiga: Uganda Youth Development Link, P.O. Box 12659 Kampala, Uganda
Gideon Matovu: Uganda Youth Development Link, P.O. Box 12659 Kampala, Uganda
Charles Natuhamya: Uganda Youth Development Link, P.O. Box 12659 Kampala, Uganda
Jane Palmier: Uganda Youth Development Link, P.O. Box 12659 Kampala, Uganda
Anna Nabulya: Uganda Youth Development Link, P.O. Box 12659 Kampala, Uganda
Harriet Kebirungi: Department of Development Studies, Kyambogo University, P.O. Box 1 Kyambogo Kampala, Uganda

IJERPH, 2025, vol. 22, issue 11, 1-19

Abstract: Unintended pregnancies among adolescent and young women in low- and middle-income countries pose major public health challenges, underscoring the need for improved access to modern contraceptives. This study examined prevalence, preferences, and correlates of modern contraceptive use among young women living in urban slums of Kampala, Uganda, to inform targeted interventions. We analyzed baseline data from The Onward Project On Wellbeing and Adversity (TOPOWA), an NIH-funded, multi-component prospective cohort study on mental health among women aged 18–24 years. In 2023, 300 participants were recruited from three sites (Banda, Bwaise, Makindye). Interviewer-administered surveys assessed contraceptive choices, lifestyle, and demographic factors. Modified Poisson regression was used to examine correlates of contraceptive use. Among participants, 66.0% had ever used contraception, 40.0% were current users, and 38.0% reported modern contraceptive use. Multivariable analyses showed that having a consistent partner (PR = 3.28; 95% CI: 1.90–5.67), engaging in sex work (PR = 2.10; 95% CI: 1.46–3.02), older age (PR = 1.08; 95% CI: 1.01–1.16), and having children (PR = 1.72; 95% CI: 1.12–2.66) were associated with higher modern contraceptive use. Findings highlight important gaps in sustained contraceptive use and the need for tailored interventions addressing economic, social, and educational barriers to improve reproductive health in this low-resource setting.

Keywords: contraceptive use; women’s health; sexual and reproductive health; urban; Kampala; Uganda; Africa (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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