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Knowledge and factors influencing long acting reversible contraceptive use among women of reproductive age in Nigeria.

ABSTRACT: Background: Approximately 48% of unintended pregnancies occur as a result of contraceptive failure around the world, which is largely due to incorrect use, poor adherence and/or technology failure. Long-acting reversible contraceptive (LARC) methods have been developed to close this gap because it's not dependent on compliance with a pill-taking regimen; remembering to change patch or ring; or fixing an appointment with physicians. The main aim of this study is to identify the factors influencing the women associated with use of LARC and to examine the relationship between knowledge of LARC and its current use. Methods: This study assessed the PMA2020 methodology and secondary dataset using female datasets from PMA 2016 (Round 3) exercise. PMA 2016 was a survey carried out in seven states of Nigeria. The target population for this study was women of reproductive age (15-49 years) currently using contraception prior to the survey. The sample size of women meeting inclusion criteria in this study was 1927. The data were analyzed using frequency distribution, chi-square and logistic regression at 5% level of significant. Results: The results showed that 21.0% of women were using traditional methods. Concerning LARC methods, the table showed that 14.8% of the sampled women were using LARC methods. Findings further showed that at both levels of analyses there is a significant relationship (P<0.05 and P=0.00 for binary and multivariable logistic regression, respectively) between knowledge of LARCs and uses in this study. This means that knowledge of LARC & other socio-demographic variables among women of reproductive age in Nigeria can influence the use of it. Conclusions: From the result of the study we concluded that 14.8% of women using contraception were using LARC. Additionally, level of education, age of women, household wealth and number of living children were significantly associated with using LARC.

SUBMITTER: Bolarinwa OA

PROVIDER: S-EPMC7447856 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Knowledge and factors influencing long-acting reversible contraceptives use among women of reproductive age in Nigeria.

Bolarinwa Obasanjo Afolabi OA Olagunju Olalekan Seun OS

Gates open research 20190101

<b>Background:</b> Approximately 48% of unintended pregnancies occur as a result of contraceptives failure around the world, which is mostly due to incorrect use, poor adherence, and/or technology failure. Long-acting reversible contraceptive (LARC) methods have been developed to close this gap. The main aim of this study is to identify factors associated with the use of LARCs among women of reproductive age and to examine the relationship between knowledge of LARCs and the current use of LARCs ...[more]

PMID: 32875280

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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:ObjectivesThis analysis aimed to estimate the average annual cost of available reversible contraceptive methods in the United States. In line with literature suggesting long-acting reversible contraceptive (LARC) methods become increasingly cost-saving with extended duration of use, it aimed to also quantify minimum duration of use required for LARC methods to achieve cost-neutrality relative to other reversible contraceptive methods while taking into consideration discontinuation.Study designA three-state economic model was developed to estimate relative costs of no method (chance), four short-acting reversible (SARC) methods (oral contraceptive, ring, patch and injection) and three LARC methods [implant, copper intrauterine device (IUD) and levonorgestrel intrauterine system (LNG-IUS) 20 mcg/24 h (total content 52 mg)]. The analysis was conducted over a 5-year time horizon in 1000 women aged 20-29 years. Method-specific failure and discontinuation rates were based on published literature. Costs associated with drug acquisition, administration and failure (defined as an unintended pregnancy) were considered. Key model outputs were annual average cost per method and minimum duration of LARC method usage to achieve cost-savings compared to SARC methods.ResultsThe two least expensive methods were copper IUD ($304 per women, per year) and LNG-IUS 20 mcg/24 h ($308). Cost of SARC methods ranged between $432 (injection) and $730 (patch), per women, per year. A minimum of 2.1 years of LARC usage would result in cost-savings compared to SARC usage.ConclusionsThis analysis finds that even if LARC methods are not used for their full durations of efficacy, they become cost-saving relative to SARC methods within 3 years of use.ImplicationsPrevious economic arguments in support of using LARC methods have been criticized for not considering that LARC methods are not always used for their full duration of efficacy. This study calculated that cost-savings from LARC methods relative to SARC methods, with discontinuation rates considered, can be realized within 3 years.

Project description:BackgroundSame-day placement of long-acting reversible contraceptives, occurring when the device is requested and placed within a single visit, reduces barriers to the patient and reduces unintended pregnancies. Despite the safety and efficacy of same-day placement, access to same-day services remains low.ObjectiveThis study aimed to evaluate the effects of the Delaware Contraceptive Access Now initiative, a statewide initiative in Delaware focused on increasing same-day access to effective contraception on same-day receipt of long-acting reversible contraceptives.Study designWe used Medicaid claims and encounter data to identify instances of same-day and multivisit receipts of long-acting reversible contraceptives among Medicaid-enrolled individuals in Delaware and Maryland aged 15-44 years who were covered in a full-benefits or family planning Medicaid aid category during the month of the placement and the 2 previous months. We used a difference-in-differences design that compared changes in the outcome from before to after implementation of the initiative among placements at agencies that participated in the initiative (n=6676) vs 2 alternative comparison groups: placements at Delaware agencies that did not participate (n=688) and placements in Maryland (n=35,847).ResultsWe found that the intervention was associated with a 13.3 percentage point increase (95% confidence interval, 1.9%-24.7%) in receipt of same-day long-acting reversible contraceptives using a nonparticipating Delaware comparison group, a 21.1 percentage point increase (95% confidence interval, 13.7%-28.6%) using a Maryland comparison group, and a 21.0 percentage point increase (95% confidence interval, 14.1%-27.9%) using a pooled comparison group. The effects were larger for implants than intrauterine devices.ConclusionThe Delaware Contraceptive Access Now initiative substantially increased the number of patients receiving long-acting reversible contraceptives through a single-visit encounter. Our findings suggested that coordinated interventions involving provider and staff training and capital investments that seed device stocking can increase the number of patients receiving same-day long-acting reversible contraceptives.

Project description:Background:The sharp fertility drop-off in the Amhara region between 2000 and 2011 was due to an increase in modern contraceptive utilization of rural women. However, long-acting contraceptive method utilization was higher among urban than rural women. Therefore, this study aimed to assess rural-urban differentials of long-acting contraceptive method utilization and the contributing factors among reproductive-age women in the Amhara region: analysis of the 2016 EDHS. Methods:The 2016 EDHS data were used. A weighted sample of 2188 (1675 rural and 513 urban) fecund reproductive-age women was used, and a mixed-effects logistic regression model was fitted. Multivariable logistic regression analysis at a P-value <0.05 and adjusted odds ratio with a 95% confidence interval were used to declare significant associations. Results:The overall long-acting contraceptive method use was 13.3% (95% CI=11.6-15.8), and it was 14.8% (95% CI=12.4-17.2) among rural and 8.3% (95% CI=4.5-12.4) among urban women. Among urban women, the odds of long-acting contraceptive method use was higher for women living with a partner (AOR=6.83; 95% CI=1.23-37.84), married women (AOR=5.21; 95% CI=1.95-13.89), women living in a male-headed household (AOR=5.29; 95% CI=1.26-22.38), and women whose partner wanted fewer children (AOR=11; 95% CI=3.46-16.2). Among rural women, the odds of long-acting contraceptive use was higher for women in the richest wealth index (AOR=6.69; 95% CI=3.02-14.83), married women (AOR=30.26; 95% CI=8.81-42.9), women with good knowledge of LACMs (AOR=1.75; 95% CI=1.25-2.46), and women who had no correct knowledge of their ovulatory cycle (AOR=1.93; 95% CI=1.16-3.19). Conclusion:Long-acting contraceptive method use was lower than the national target. LACM use was 8.3% (95% CI=4.5-12.4) among urban and 14.8% (95% CI=12.4-17.2) among rural women. Overall, marital status, educational level, the total number of children, knowledge of LACMs, and correct knowledge of the ovulatory cycle were significantly associated with LACM use.

Project description:BackgroundThe postpartum period is an opportune time for contraception adoption, as women have extended interaction with the reproductive healthcare system and therefore more opportunity to learn about and adopt contraceptive methods. This may be especially true for women who experience unintended pregnancy, a key target population for contraceptive programs and programs to eliminate mother-to-child HIV transmission. Among women in Zimbabwe surveyed in 2014, we examined the relationship between pregnancy intention associated with a woman's most recent pregnancy, and her subsequent postpartum contraceptive use.MethodsIn our analysis we utilized a dataset from a random selection of catchment areas in Zimbabwe to examine the association between pregnancy intention of most recent pregnancy and subsequent postpartum contraceptive use using multinomial logistic regression models. We also explored whether this association differed by women's HIV status. Finally, we examined the association between pregnancy intention and changes in contraception from the pre- to postpartum periods.ResultsFindings suggest that women who reported that their pregnancy was unintended adopted less modern (all non-traditional) contraceptive methods overall, but adopted long-acting reversible contraception (LARC) more frequently than women reporting an intended pregnancy (OR 1.41; CI 1.18, 1.68). Among HIV-positive women, this relationship was particularly strong (OR 3.12; CI 1.96, 4.97). However, when examining changes in contraceptive use from the pre-pregnancy to the postpartum period, women who had an unintended pregnancy had lower odds of changing to a more effective method postpartum overall (OR 0.71; CI 0.64, 0.79).ConclusionsWe did not find evidence of higher modern method adoption in the postpartum period among women with an unintended pregnancy. However, women who were already on a method in the pre-pregnancy period were catalyzed to move to more effective methods (such as LARC) postpartum. This study provides evidence of low modern (non-traditional) method adoption in general in the postpartum period among a vulnerable sub-population in Zimbabwe (women who experience unintended pregnancy). Simultaneously, however, it shows a relatively greater portion specifically of LARC use among women with an unintended pregnancy. Further research is needed to more closely examine the motivations behind these contraceptive decisions in order to better inform distribution and counseling programs.

Project description:ObjectivesThe utilization of long-acting reversible contraceptive methods is one of the key factors in protecting women and couples against unwanted pregnancies. The study aimed to assess the determinants of long-acting reversible contraceptive use among women in Northwest Ethiopia.MethodsA community-based unmatched case-control study was conducted from 1 February to 8 March 2017 in Northwest Ethiopia. The cases were women who used long-acting reversible contraceptive methods, and the controls were women who used short-acting contraceptives. Both of them were selected using a systematic sampling method. An interviewer-administered questionnaire was used to collect the data. Epi info and SPSS version 23 were used for data entry and analysis, respectively. Descriptive statistics and association measures were done and presented in texts, tables, and figures.ResultsA total of 882 women were interviewed, with a response rate of 99.3%. Women who were between 15 and 24 years old were two times more likely to use long-acting reversible contraceptive methods than those whose age was ⩾35 (adjusted odds ratio = 2, 95% confidence interval: (1.20, 3.50)). A good level of knowledge about long-acting reversible contraceptive methods (adjusted odds ratio = 11.6, 95% confidence interval: (5.42, 24.80)), a negative attitude toward long-acting reversible contraceptive methods (adjusted odds ratio = 0.31, 95% confidence interval: (0.21, 0.46)), membership in the health development army (adjusted odds ratio = 2.8, 95% confidence interval: (2.12, 3.78)), no discussion with a partner about long-acting reversible contraceptive methods (adjusted odds ratio = 2.3, 95% confidence interval: (1.54, 3.49)), and more than 2 years of desire to wait before another pregnancy (adjusted odds ratio = 23.7, 95% confidence interval: (11.63, 48.55)) were determinants of long-acting reversible contraceptive methods use.ConclusionThis study revealed that attitude toward long-acting reversible contraceptive method use, being a member of the women's health development army, and the desire to space children were determinants of long-acting reversible contraceptive method use. More actions should be taken to increase the utilization of long-acting reversible contraceptive methods by promoting discussion between partners about modern contraceptives and increasing women's participation in being a member of the health development army.

Dataset Information

Knowledge and factors influencing long acting reversible contraceptive use among women of reproductive age in Nigeria.

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Knowledge and factors influencing long-acting reversible contraceptives use among women of reproductive age in Nigeria.

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