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Long acting reversible contraceptives utilization and associated factors among women of reproductive age in Arsi Negele town, Southeastern Ethiopia.

ABSTRACT: Background:Ethiopia is the second populous country in Africa with a total fertility rate of 4.6 and contraceptive prevalence of 35%, where implant and intrauterine contraceptive devices account for 8 and 2% respectively. The aim of this study was to determine the magnitude of long acting reversible contraceptives utilization and its associated factors among women of reproductive age in Arsi Negele town, Southeastern Ethiopia. Methods:Facility-based cross-sectional study was conducted from April 01-May 30, 2017. A total of 361 women using modern contraceptives were selected by a systematic random sampling technique. Pre-tested and interviewer administered structured questionnaire was used to collect quantitative data. Bivariate and multivariate logistic regressions were performed using SPSS version 20.0 software. Result:The magnitude of long acting reversible contraceptives (LARCs) utilization was 33.5% [95% CI, 28.5-38.8]. Husband with no formal education [AOR?=?0.41, CI: 0.16, 0.78] and unemployed women [AOR?=?0.35, CI: 0.42, 0.65] were negative predictors while having media exposure [AOR?=?7.14, CI: 3.85, 13.25], women who desired only one child [AOR?=?3.28, CI; 1.28, 8.39] and husband support [AOR?=?7.33, CI: 3.48, 15.43] were positive predictors of LARCs utilization. Conclusion:The overall utilization of LARCs is 33.5%. Creating employment opportunities, male involvement, advertisement and advocacy activities through mass media need to be considered to improve utilization of LARCs.

SUBMITTER: Hibstu DT

PROVIDER: S-EPMC7262748 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Long acting reversible contraceptives utilization and associated factors among women of reproductive age in Arsi Negele town, Southeastern Ethiopia.

Hibstu Desalegn Tsegaw DT Alemayehu Akalewold A

Contraception and reproductive medicine 20200601

<h4>Background</h4>Ethiopia is the second populous country in Africa with a total fertility rate of 4.6 and contraceptive prevalence of 35%, where implant and intrauterine contraceptive devices account for 8 and 2% respectively. The aim of this study was to determine the magnitude of long acting reversible contraceptives utilization and its associated factors among women of reproductive age in Arsi Negele town, Southeastern Ethiopia.<h4>Methods</h4>Facility-based cross-sectional study was conduc ...[more]

PMID: 32514372

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Project description:Background:Long acting reversible contraceptive methods are highly effective, safe and provide uninterrupted protection to women for 3 to 12?years, yet are little used in the Ethiopia. Assessment of the utilization and predictors of long acting reversible contraceptive methods assist health planners to prioritize promotion strategies, and is a fundamental step for intervention. Therefore, this study aimed to assess the utilization and predictors of long acting reversible contraceptives among reproductive age women in Hawassa city, South Ethiopia; 2019. Methods:A community-based cross-sectional study was conducted using a mixed method among the sample of 660 reproductive age women in Hawassa city, South Ethiopia from January 1-30, 2019. We have used a systematic and purposive sampling technique to select the study participants. A structured interview-administrated questionnaire and focus group discussion were used to collect the data. The data were entered using Epi data version 3.1 and analyzed using SPSS version 20. Chi-square (X2) test was used to determine the overall association between explanatory and outcome variables. The variables were entered into the multivariable model using the backward stepwise regression approach. Bi-variable and multivariable logistic regression analyses were conducted. The qualitative data were analyzed using a manual thematic analysis technique. Results:The overall utilization of long acting reversible contraceptive methods was 22% (95% CI?=?19.50-25.50%). Among this, 17.5 and 4.5% of women utilized the implants and IUCD, respectively. Good knowledge (AOR?=?4.0; 95% CI?=?1.66-9.60; P =?0.001) and positive attitude (AOR?=?7.9; 95% CI?=?3.84-16.10; P =?0.001) of women about LARC methods were positively associated with utilization of LARC methods. The odds of utilizing LARC methods increased 8.2 times for women who have no desire to have a child (AOR?=?8.2, 95% CI?=?3.13-21.30) as compared to those who have the desire to have a child. The discussion of women about LARC methods with providers (AOR?=?4.1; 95% CI?=?1.24-5.24) and husbands (AOR?=?2.7; 95% CI =1.02-7.20) were positively associated with utilization of LARC methods. These findings were supported by the individual, institutional and socio-cultural qualitative findings. Conclusions:The utilization of LARC methods far below the national target (22?V 40%) in the study area. Good knowledge and positive attitude about LARC methods, no desire to have a child, discussion with husbands and providers were major predictors of the LARC methods utilization. Increasing knowledge and positive attitude of the women about LARC methods using various methods of health education should be considered.

Project description:BackgroundPreconception care is highly important in reducing a number of adverse pregnancy outcomes and helps to improve maternal health. Preconception care optimizes women's health and improves pregnancy outcomes. It is a cost-effective first-line preventive strategy for birth defects. However, preconception care utilization in Ethiopia was very low. Studies on these issues are limited in Ethiopia in general and in Mizan-Aman town in particular.ObjectiveTo assess preconception care utilization and associated factors among reproductive age women in Mizan-Aman town, Bench-Sheko Zone, Southwest Ethiopia.MethodsA community based cross-sectional study design was employed from April 16 to May 26, 2020 in Mizan-Aman town. The total study participants were 624 reproductive age women. Data were collected by using pre-tested interviewer administered questionnaires and entered into Epi-data version 3.1 then exported to STATA version 14 and analyzed accordingly. Univeriate and Bivariable analysis was done by analysis of variance (ANOVA) and independent t-test. Multivariable statistical analysis using generalized linear regression model (GLM) approach was used to classify factors of preconception care utilization. Since our response variable is measured in terms of count variable, we used a Poisson regression model with a log link function. Finally, Statistical significance between dependent and independent variables were assessed by odds ratios and 95% confidence intervals.ResultsOverall, 28.6% of the women receipt atleast one item of preconception care while only 1.5% were taken the whole recommended components of preconception care services. The most common item received in the study area was taking micronutrient supplementation (18.5%). Age of women, educational status, husbands educational status, husbands occupation, wealth status, distance from the health facility, waiting time to get services, planning to pregnancy, age at first pregnancy, previous ANC use, Previous PNC use, adverse pregnancy experience, women's knowledge of preconception care, and attitude on preconception care were determinants of preconception service utilization.ConclusionsPreconception care component utilization was lower as compare with recommended service with different disparities. Multipurpose tailored strategies which incorporate a woman with no formal education, poor knwledge on preconception care,never take maternal services previously and distant from health facility could improve preconception care service utilization. Advocative strategies on preconception care component and planning pregnancy may elicite more women to use the services of preconception care.

Project description:BackgroundHigh levels of unmet need for contraception and unwanted pregnancies are high in developing countries despite efforts to reduce them. Long-acting reversible contraceptive (LARC) methods are more than 99% effective in preventing pregnancy. Discontinuation of LARC within the first year of initiation contributes to the high levels of unmet need. This study aimed to determine the prevalence and factors associated with the first-year discontinuation of LARC at Kawempe National Referral hospital.MethodsA facility-based cross-sectional study was conducted from February 2020 to June 2021. We consecutively recruited 354 participants who discontinued a LARC (intrauterine device {IUD} and sub-dermal implant) during the study period after informed written consent. Data on duration of use, reasons for discontinuation, and factors associated were collected using a face-to-face interviewer-administered questionnaire and review of client records. Early LARC discontinuation was defined as the termination of the contraception within the first 12 months of use. Data were entered using SPSS version 14/0 and analyzed in STATA version 15. Prevalence was expressed as a proportion while logistic regression was used to assess factors associated with early LARC discontinuation. Variables with a p-value of < 0.05 were considered statistically significant.ResultsThe proportion of first-year discontinuation of LARC was 29%. Women Age less than 25 years (OR = 5.07; 95% CI: 1.1-24.8) and those who desired a family size of fewer than four children (OR = 3.19; 95%CI: 1.2-8.7 ) were more likely to discontinue the LARC within 12 months of initiation after multivariate analysis. Method-related reasons for removal were painful menstrual cramps for implants, recurrent infections for IUDs, and a non-side effect reason was the desire to get pregnant.ConclusionA high proportion of women discontinue LARC within 12 months following initiation. Young adults and those who desire small families are more likely to have first-year discontinuation of LARC. We recommend age-specific counseling for patients receiving the LARC and further studies looking at the depth analysis of reasons for the first-year discontinuation.

Project description:Background: Uncontrolled population development can prompt an assortment of populace issues and can be one of the reasons for increasing maternal death rates. The utilization of contraceptives in Indonesia was progressively dominated by injectable contraceptives and pill contraceptives in 2015 (52.21% and 24.36%, respectively). However, the rate of termination of the use of short-acting contraceptives by family planning clients was higher than other methods, therefore the use of short-acting contraceptives is less efficient than long acting reversible contraceptives (LARCs) for longer term spacing because it is easy to skip a treatment for economic or other reasons, which can result in unintended pregnancy. Therefore, the National Family Planning Program in Indonesia is encouraging the use of LARCs to control population growth. Pameungpeuk is a region which has the second largest population, with the highest total fertility rate in South-West Java. The proportion of active users of LARCs in Pameungpeuk is very low (10.66%). This study aimed to analyze factors associated with the utilization of LARCs among family planning clients at the Pameungpeuk Rural Hospital. Methods: This study design was cross-sectional with systematic random sampling. The sample group in this study was 84 family planning clients. We performed statistical analyses using chi-square test. Results: We found significant associations between the age of women (p=0.024), the cost of contraception (p=0.022), knowledge (p=0.042), beliefs (p=0.002), skill of health workers (p=0.008) and support from health workers (p=0.014). However, education (p=0.212), family income (p=0.087), attitude (p=0.593), exposure to information on LARCs (p=0.378), support from partners (p=0.094), support from friends (p=0.414) and the support of community leaders (p=0.367) had no significant association with the utilization of LARCs. Conclusions: These findings highlight a critical need for improved education among family planning clients at the Pameungpeuk rural hospital regarding the use of LARCs for both medical and elective reasons.

Project description:BackgroundLong-Acting Reversible Contraceptives (LARC) contribute significantly to a decline in unintended pregnancies globally. However, not much is known about women's sexual empowerment and their utilization of Long-Acting Reversible Contraceptives in Ghana. The main objective of this study was to examine the association between women's sexual empowerment and LARC utilization in Ghana.MethodsWe used data from 5116 sexually active women who participated in the 2014 Ghana Demographic and Health Survey. Women's sexual empowerment was defined as women's perception of their right to self-determination and equity in sexual relations, and their ability to express themselves in sexual decision-making. A sum of scores was created with four dichotomous items as sexual empowerment score (0 = low sexual empowerment; 1, 2, and 3 = medium sexual empowerment; and 4 = high sexual empowerment). Multivariable binary logistic regression analyses were performed to establish the association between women's sexual empowerment and the use of LARC. Pearson Chi-square test was used in data analysis. The results are presented as adjusted odds ratios (aOR), with their respective confidence intervals (CIs) at a statistical significance of p < 0.05.ResultsThe prevalence of LARC utilization among sexually active women in Ghana was 6%. Majority of the women had medium sexual empowerment (91%). Although not statistically significant, the likelihood of utilizing LARC was lowest among women with high level of sexual empowerment (aOR = 0.62; CI = 0.27-1.43). On the other hand, Utilization of LARC increased with an increase in age. Women with parity four or more had higher odds of utilizing LARC as compared to women with zero birth (aOR = 9.31; CI = 3.55-24.39). Across religion, women who belong to the Traditional religion (aOR = 0.17; CI = 0.04-0.71) and Islam religion (aOR = 0.52; CI = 0.36-0.76) had lower odds of LARC utilisation as compared to Christian women. Women who make health decisions with someone else (aOR = 1.52; CI = 1.12-2.09) had higher odds of LARC utilisation as compared to women who make health decision alone.ConclusionAge, health decision maker, parity and religion were found to have a significant relationship with LARC utilization. Specifically, uneducated women, unemployed women and women who practice traditional religion were less likely to utilise LARC. However, women's sexual empowerment did not have a significant relationship with LARC. There is therefore the need for planning interventions for LARC utilization in line with educating women on the benefits and potential side effects of LARC. Also, there is a need for interventions targeted at increasing access to LARC among sexually active women.

Project description:BackgroundThough long-acting reversible contraceptives (LARCs) are highly effective, have minimal side effects, require minimal follow-up, and are low cost, only 10% of contraceptives used in Ethiopia are LARCs. The reason for this low uptake is not understood at the country or regional level. Therefore, this study identified determinants of LARC utilization in Northwest Ethiopia.MethodsA facility-based unmatched case control study, using LARC users as cases and short- acting reversible contraception (SARC) users as controls, had been conducted at fourteen public health institutions in Northwest Ethiopia. A systematic random sampling technique was used to select participants with a 1:2 case to control ratio (n = 1167). Binary logistic regression analysis was used to identify determinants of LARC utilization among family planning service users.ResultsWealth status [AOR:1.87, 95%CI (1.08, 3.24)], history of abortion [AOR:2.69, 95%CI (1.41, 5.12)], limiting family size [AOR: 2.38, 95%CI (1.01, 5.62)], good knowledge about LARCs [AOR: 2.52, 95%CI (1.17, 5.41)], method convenience [AOR: 0.23, 95%CI (0.16, 0.34)], good availability of method [AOR:0.10 (0.05, 0.19)], less frequent visits to health facility [AOR:2.95, 95% CI(1.89, 4.62)], health care providers advice [AOR:10.69, 95%CI (3.27, 34.87)], partner approval [AOR:0.66, 95%CI (0.45, 0.97)], and favorable attitude towards LARCs [AOR:13.0, 95%CI (8.60, 19.72)] were significantly associated with LARC utilization.ConclusionProfessional support, favorable attitude towards LARC use, high economic status, history of abortion, advantage of less frequent visits, having good knowledge towards LARC and interest of limiting births were significantly associated with LARC Utilization. On the other hand, perceived method convenience, and contraception availability were inversely associated with it. Family planning education about the benefits of LARC should be done by health providers and media. Male involvement in the counselling and decision making about the advantage of using LARC may improve the negative influence of partners on LARC utilization. It is also recommended that, future qualitative research further explore perceptions of LARC use.

Project description:Background An immediate postpartum period is a good opportunity to utilize immediate postpartum long-acting reversible contraceptives for women whom they want to delay pregnancy. Long-acting reversible contraceptive methods like intrauterine device, Jaddel and implants can improve maternal and newborn health by preventing unintended pregnancy. Despite on their advantage, evidence on its utilization and associated factors is limited in our study area.Ethiopia. This study assessed the utilization of immediate postpartum long acting reversible contraceptives and its associated factors among mothers who delivered in selected public hospitals of Addis Ababa, Ethiopia, 2022. Method An institutional-based cross-sectional study design was conducted among 420 study participants to assess the immediate postpartum long-acting reversible contraceptive utilization and its associated factors from August 30- September 25, 2022. Systematic sampling technique was used to select study participants. Data was entered into epi-data version 4.6 and analysis was performed by using SPSS version 25. Descriptive statistics and logistic regression were used. All statistical tests were significant at P-value < 0.05. Result A total of 417 postpartum women were participated in the study making a response rate of 99.3%. Of the total study participants, 30.7% [95% CI (26.1, 35.3)] utilized immediate postpartum family planning. Women at the age of 25–34 years (AOR = 3.228[95% CI: 1.140–9.136]), had discussion with their partners about family planning (AOR = 1.891[95% CI: 1.003, 3.565]), received counseling about immediate post-partum long acting reversible contraceptive (AOR = 3.146 [95% CI: 1.489, 6.647]), had positive attitude towards immediate post postpartum long acting reversible contraceptive (AOR = 3 [95% CI: 1.770–5.648]) were associated with utilization of immediate post-partum long acting reversible contraceptive. Conclusion and recommendation Almost one in three women delivering in health facilities of Addis Ababa Ethiopia started using immediate post-partum long acting reversible contraceptives. Discussion about contraception with partners, getting counseling about family planning on antenatal care, attitude toward contraception and the age of women were all factors that could increase IPPLARC uptake. Healthcare providers clarify any rumors about contraceptives to assure a positive and supportive attitude to increase its uptake.

Dataset Information

Long acting reversible contraceptives utilization and associated factors among women of reproductive age in Arsi Negele town, Southeastern Ethiopia.

Publications

Long acting reversible contraceptives utilization and associated factors among women of reproductive age in Arsi Negele town, Southeastern Ethiopia.

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