Trends and determinants of modern contraceptive utilisation among adolescent girls aged 15-19 years in Sierra Leone: an analysis of Demographic and Health Surveys, 2008-2019

Background Modern contraceptives are effective interventions for preventing unwanted pregnancies, but their use remain low among adolescent girls in sub-Saharan Africa. First, we aimed to assess the trends of modern contraceptive aged 15-19 years Sierra Leone period 2008-2019. Second, explored how individual and contextual determinants changed during this period. Methods We used a combined sample 8,774 from 2008, 2013, 2019 Demographic Health Surveys (SLDHS), respectively, estimate prevalence rate (MCPR) unmet need family planning. described method mix sources users. then conducted multivariable logistic regression examine sexually active girls, separately 2008 2019. Results MCPR increased 5.9% (95% CI=4.5-7.8) 21.0% CI=19.2-22.9) Most increase had occurred by 2013. Norplant (48.8%) injectables (39%) were common methods Unmet planning declined 15.4% CI=13.2-17.9) 11.3% CI=9.9-12.7) 2019, while 13.1% CI=10-17.0) 43.5% CI=40.2-46.9) In both surveys, adjusted odds using higher those with more than one sexual partner past 12 months, secondary or tertiary education. also lower who married living partner, child, lived Western province. Conclusions The stalled since Interventions, including increasing awareness accessibility contraceptives, urgently needed, particularly adolescents without formal Comprehensive affordable community school-based interventions, adolescent-friendly services, would be helpful.