Extreme Weather Events and Adolescent Contraception in Sub-Saharan Africa.

PURPOSE: Little is known about the associations between extreme weather events (drought and heavy rains) and adolescent family planning. The current analysis contributes to this evidence gap by examining the association between extreme weather events and adolescent modern contraception use. METHODS: We analyzed the 2011-2020 Demographic and Health Surveys in 22 countries in sub-Saharan Africa. Drought and heavy rainfall were defined based on the extent to which annual rainfall deviated from the historical average. Logistic regression examined the association between extreme weather events (drought and heavy rains) and contraception, adjusting for sociodemographic factors and survey month, incorporating survey-level fixed effects. Analyses were stratified by gender and climate zones (e.g., tropical, temperate, and arid). RESULTS: The study included 224,761 participants aged 15-24 years (70.5% female) and 21.1% reported current modern contraceptive use. Drought (adjusted odds ratio: 0.89, 95% confidence interval [CI]: 0.83-0.95) and heavy rainfall (adjusted odds ratio: 0.82, 95% confidence interval: 0.73-0.91) were associated with lower odds of modern contraception use in adjusted models. In gender-stratified analyses, heavy rainfall was more strongly associated with lower modern contraception use among males compared to among females. In tropical zones, heavy rainfall, but not drought, was associated with lower modern contraception use. In temperate and arid zones, drought was associated with lower modern contraception use, but heavy rainfall was not associated with modern contraception use. DISCUSSION: Both drought and heavy rainfall were associated with lower modern contraception use among adolescents in sub-Saharan Africa, adding to a growing body of evidence on the deleterious health impacts of climate change.