Abstract
BACKGROUND: Limited emergency contraception (EC) use contributes to unintended pregnancies and health risks among adolescents and young adults in conflict-affected regions. In Northern Uganda's post-conflict setting, there is a need for research on EC utilization among adolescents and young adults. OBJECTIVE: We assessed emergency contraceptive utilization and associated factors among adolescents and young adults in Gulu East Division, Northern Uganda, following 25 years of post-conflict recovery. METHODS: A community-based cross-sectional study was conducted among 400 adolescents and young adults in Gulu East Division using self-administered questionnaires. Data analysis involved descriptive statistics and logistic regression using STATA (StataCorp LLC) to identify factors associated with EC utilization. RESULTS: Among 400 participants, 322 (80.5%) were aware of EC, but only 173 (43.3%) utilized it. Correlation analysis revealed negative correlations between age and employment status and living arrangement, and a positive correlation between education level and marital status. Multivariate analysis showed that EC utilization was significantly associated with age, education level, employment status, living arrangement, and EC service offer. Women aged 14-19 years and those not offered EC services were less likely to use EC (adjusted odds ratio (aOR) = 0.47), while women with secondary education (aOR = 3.05), employed women (aOR = 2.76), and those living alone (aOR = 9.76) were more likely to use EC. CONCLUSION: There is a gap between awareness and utilization of EC among adolescents and young adults in Gulu East Division. Targeted interventions are needed for adolescents and those with limited access to EC services to increase utilization and prevent unintended pregnancies.