Background: Modern contraceptive uptake and utilization still remains a significant global health issue among young people. Despite a number of interventions on modern contraceptive services targeting young people in primary and out of schools, evidence on Modern contraceptive use in Malawi tertiary institutions is limited. Hence, an assessment on uptake and utilisation of modern contraceptives among tertiary institutions of Lilongwe University of Agriculture and Natural Resources and Kamuzu College of Nursing was carried out in Lilongwe between 2017 and 2019.
Methods: A cross sectional exploratory study which used a mixed methods approach to assess uptake and utilisation of modern contraceptive methods among young people in tertiary institutions of LUANAR and KCN in Lilongwe. 8 focus groups were conducted, 6 key informants were interviewed and 220 females and male students were interviewed using self-administered questionnaires from the two institutions which were purposively selected.
Results: Modern contraceptives uptake was higher among young people of LUANAR and KCN while utilisation was lower. On comparative basis, utilisation and knowledge of modern contraceptives was higher among students at KCN than LUANAR. Male condoms and emergency contraceptive services were frequently accessed. The type of tertiary institution was statistically significant to utilization of modern contraceptives. The odds of utilizing modern contraceptives was almost 2 times higher for students at KCN than LUANAR students. Barriers to access modern contraceptives were noted and included: provider attitudes, privacy and confidentiality, shortage of some modern contraceptives and long waiting time at the clinics.
Conclusion: Access to modern contraceptives among young people in tertiary institutions is influenced by individual, health system related and environmental factors. Tertiary institutions students need information on modern contraceptives to reduce sexual and reproductive health problems. Providing young people with access to modern contraceptives in tertiary institutions can reduce teenage pregnancies, abortions and maternal deaths.