Would you offer contraception to a 14-year-old girl? Perspectives of health students and professionals in Dar es Salaam, Tanzania

Plain language summary In Tanzania, adolescent pregnancies are culturally unwanted, abortion remains illegal and yet the utilization of family planning services among adolescents is still low. The community myths and misconceptions about the side effects of contraceptives, healthcare providers' attitudes, and barriers within the healthcare system hinder adolescents' utilization of family planning services. The effective use of family planning methods will prevent the use of unsafe induced abortions and hence reduce morbidity and mortality among young women. This will be possible only if healthcare providers are equipped with the knowledge and skills to address these sexual and reproductive health challenges among adolescents in Tanzania. Therefore, in this study, we decided to explore the perceptions of health professionals and students on the provision of contraception to adolescents. We conducted 18 focus groups stratified among health professionals and students (midwives, nurses, medical doctors). Participants were supplied with a theoretical scenario wherein a 14-year-old girl presented to a family planning clinic seeking contraceptive services to determine how health professionals and students would handle the case. We found that the decision of providers with regards to offering contraception is highly dependent on having a baseline knowledge of the rights and contraceptive services available to adolescents. Some barriers identified as reasons for providers not to offer contraceptive services include a lack of awareness of the reproductive health rights for adolescents, judgmental behavior (implicit and explicit biases among providers), as well as religious and cultural dynamics. Participants also acknowledged that the presence of guidelines and proper training among providers might avoid the infringement of adolescents' rights to sexual and reproductive health services. In conclusion, these findings support the need for comprehensive sexual health education in Tanzanian health professional training programs. Background Rates of unplanned adolescent pregnancy and unsafe induced abortions are very high in Sub-Saharan African countries including Tanzania. Despite their availability and accessibility, modern family planning methods are reported to be critically underutilized by adolescents. This study is part of a broader study that aims to develop a curriculum that will be used in training health professionals by investigating the sexual health trainin