Interventions to improve adolescents' contraceptive behaviors in low- and middle-income countries: a review of the evidence base.

Objective(s): Many adolescents in developing countries have an unmet need for contraception, which can contribute to poor reproductive health outcomes. Recent literature reviews have not adequately captured effective contraceptive services and interventions for adolescents in low- and middle-income countries (LMICs). This study aims to identify and evaluate the existing evidence base on contraceptive services and interventions for adolescents in LMICs that report an impact on contraceptive behavior outcomes.

Study Design: Structured literature review of published and unpublished papers about contraceptive services and interventions for adolescents in LMICs that report an impact on contraceptive behavior outcomes.

Results: We identify common elements used by programs that measured an impact on adolescent contraceptive behaviors and summarize outcomes from 15 studies that met inclusion criteria. Effective programs generally combined numerous program approaches and addressed both user and service provision issues. Overall, few rigorous studies have been conducted in LMICs that measure contraceptive behaviors. Few interventions reach the young, the out of school and other vulnerable groups of adolescents.

Conclusion(s): Though the evidence base is weak, there are promising foundations for adolescent contraceptive interventions in nearly every region of the world. We offer recommendations for programmers and identify gaps in the evidence base to guide future research.