Dataset Information

Postpartum intrauterine contraceptive device use and its associated factors in Ethiopia: systematic review and meta-analysis.

ABSTRACT:

Background

The intrauterine contraceptive device, a type of long-acting reversible contraception, is one of the most effective and safe contraceptive methods. In Ethiopia, intrauterine contraceptive device is little known and practised to delay pregnancy. Therefore, this study aimed to assess post-partum intrauterine contraceptive device utilisation and its associated factors among women in Ethiopia.

Method

In the current meta-analysis, variables were searched from different electronic database systems, including PubMed, Google Scholar, EMBASE, HINAR, Scopus, Web of Sciences, and Grey literature. Data were extracted using a standardised data collection measurement tool. The data were also analysed by using STATA 16 statistical software. I² tests assessed heterogeneity between the studies. A random-effect model was used to forecast the pooled utilisation of postpartum intrauterine contraceptive device.

Results

Twelve full-article studies were included. The pooled prevalence of post-partum intrauterine contraceptive device among women in Ethiopia was 21.63%. Occupation (OR = 4.44, 95% CI, 2.24-8.81), educational level of college and above (OR = 5.93, 95% CI, 2.55-13.8), antenatal care (OR = 2.09, 95% CI, 1.4-3.12), age (OR = 4.8, 95% CI, 2.3-10.04), good knowledge (OR = 4.16, 95% CI, 1.65-10.49), counseling (OR = 3.05, 95%CI, 1.41-6.63), husband support (OR = 11.48, 95% CI, 6.05-21.79) and awareness about IUCD (OR = 3.86, 95% CI, 1.46-10.2) were positively associated with utilization of postpartum intrauterine contraception device.

Conclusions

Utilisation of post-partum intrauterine contraceptive device was significantly low. Scaling up women's educational status and ANC use has paramount importance in increasing post-partum IUD use, which further improves maternal and child health in general. This finding may be useful in both reproductive health promotion at an individual level and policy-making regarding this issue.

SUBMITTER: Kassa BG

PROVIDER: S-EPMC8590214 | biostudies-literature | 2021 Nov

REPOSITORIES: biostudies-literature

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Publications

Postpartum intrauterine contraceptive device use and its associated factors in Ethiopia: systematic review and meta-analysis.

Kassa Bekalu Getnet BG Ayele Alemu Degu AD Belay Habtamu Gebrehana HG Tefera Adanech Getie AG Tiruneh Gebrehiwot Ayalew GA Ayenew Netsanet Temesgen NT Mihiretie Gedefaye Nibret GN Tenaw Lebeza Alemu LA Semahegn Abenezer Melkie AM Worku Mulugeta Dilie MD

Reproductive health 20211113 1

<h4>Background</h4>The intrauterine contraceptive device, a type of long-acting reversible contraception, is one of the most effective and safe contraceptive methods. In Ethiopia, intrauterine contraceptive device is little known and practised to delay pregnancy. Therefore, this study aimed to assess post-partum intrauterine contraceptive device utilisation and its associated factors among women in Ethiopia.<h4>Method</h4>In the current meta-analysis, variables were searched from different elect ...[more]

PMID: 34774058

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Project description:BackgroundPostpartum contraceptive use is defined as the avoidance of short spaced pregnancies and unintended pregnancy through the first 12 months after delivery. In Ethiopia, different studies have been conducted to assess the prevalence of postpartum contraceptive use and associated factors. The findings of these studies were inconsistent and characterized by great variability. Therefore, the aim of this systematic review and meta-analysis was to estimate the pooled prevalence of postpartum contraceptive use and determinants in Ethiopia using the accessible studies.MethodsThe articles were identified through electronic search of reputable databases (MEDLINE through PubMed, EMBASE, HINARI, Science Direct, and Cochrane Library) and the hand search of reference listed in previous prevalence studies to retrieve more. 18 articles are included based on a comprehensive list of inclusion and exclusion criteria. Two authors independently extracted all necessary data using a standardized data extraction format. STATA 14 statistical software was used to analyze the data. The Cochrane Q and I 2 test were used to assess the heterogeneity between the studies. A random effects model was calculated to estimate the pooled prevalence of postpartum contraceptive use. Moreover, the determinants for family planning use were reviewed.ResultsThe pooled prevalence of family planning use among mothers during the postpartum period in Ethiopia was 48.11% (95% CI: 36.96, 59.27). Besides, subgroup analysis revealed that the highest family planning use prevalence among postpartum mothers was observed in Addis Ababa, 65.41 (95% CI: 48.71, 82.11). Resumed sexual activity: 7.91 (95% CI: 4.62, 13.55), antenatal care: 4.98 (95% CI: 2.34, 10.21), secondary school and above level of maternal education: 3.53 (95% CI: 1.67, 7.45), postnatal care: 3.16 (95% CI: 1.7, 5.88), menses resumption: 3.12 (95% CI: 1.52, 6.39), and ≥6 months of postpartum period: 2.78 (95% CI: 1.97, 3.93) have shown a positive association with the use of family planning among mothers in the postpartum epoch.ConclusionsIn this study, family planning use among mothers of the postpartum period in Ethiopia was significantly low compared to the existing global commendation on postpartum contraceptive use. Resumed sexual activity, antenatal care, secondary and above level of maternal education, postnatal care, menses resumption, and postpartum period ≥ 6 months were found to be significantly associated with postpartum contraceptive use.

Project description:IntroductionPostpartum intrauterine contraceptive devices (PP-IUCD) are one type of post-partum family planning method, which can be provided to a post-partum woman starting from the placental delivery time (within 10 minutes), or within the first 48 hours of postpartum period. In most developing countries, delivery time is the primary opportunity for women to access post-partum family planning methods, especially for those living in remote areas. Hence, this study assesses providers' knowledge on postpartum intrauterine contraceptive device service provision.MethodsA facility-based cross-sectional study was conducted in Amhara region health center and hospitals. Health providers surveyed included obstetricians, gynecologists, general practitioners, emergency surgical officers, health officers, midwives and nurses from September 18, 2015 to December18, 2016. Simple random sampling was used to select 864 subjects. Data were collected by using a structured self-administered questionnaire and observing the facility. Multilevel analysis was done to see factors associated with outcome.ResultsA total of 197 health facilities and 864 providers are included in the final analysis. Of the total providers 524 (60.6%) were from a health center. The mean age (±SD) of participants was 27.8 years (±5.4). The number of providers with good knowledge accounted for 253 of those surveyed (29.3%). The proportion of good knowledge among trained PP-IUCD providers was 35.7% (those who scored above average), and 27.9% was untrained about PP-IUCD. A considerable heterogeneity was observed between health facilities for each indicator of provider's knowledge. Gender differences were observed as the mean knowledge score deference on PP-IUCD by 0.4 points (β = -0.41; -0.72, -0.10) when the participant was female. Having experience of regular counseling of pregnant women increases PP-IUCD knowledge score by 0.97. (β = 0.97; 95% CI: 0.48, 1.47). Where the health facility requested clients to purchase the IUCD themselves, the mean knowledge score decreased by 0.47 points compared with free of charge at the facility level (β = -0.47; 95%CI: -0.87, -0.07).ConclusionOur findings showed that providers' knowledge about postpartum IUCD was low in the Amhara region public health facility. The lowest knowledge score was noted among nurses, health Officers, midwives, and general practice professionals. Factors associated with providers' knowledge on PP-IUCD are the status of health facility, female sex, training on PP-IUCD, regular counseling of pregnant women, and unavailability of IUCD service.

Project description:ObjectiveThis study aimed to assess the intention and barriers to the use of immediate postpartum intrauterine contraceptive devices among pregnant women attending antenatal clinics in Jimma town public healthcare facilities, southwest Ethiopia.MethodsA facility-based cross-sectional study design was conducted from 1 September to 30 October 2020 by using a systematic sampling technique. Data were entered into Epi-data 3.1 version and exported to Statistical Package for Social Sciences 23 for analysis. A binary logistic regression analysis was done to sort candidate variables for multiple logistic regression, and multivariable logistic regressions were done to identify factors associated with the intention to postpartum intrauterine contraceptive devices. Factors associated with intention to use immediate postpartum intrauterine contraceptive device declared at 95% confidence interval.ResultsThis study finding showed that 37.6% (95% confidence interval (31.5, 43.7)) of pregnant women intended to use the immediate postpartum intrauterine contraceptive device after their delivery. The main reason women refused to use immediate postpartum intrauterine contraceptive devices was being satisfied with other methods to use after they gave birth (27.5 %), the concern of health harm (22.2%), and the fear of impaired future fertility (16.4%). The identified factors that were statically significant with the intention to use immediate postpartum intrauterine contraceptive devices among pregnant women were included: attended secondary education (adjusted odd ratio = 2.36; p = 0.03; 95% confidence interval (1.089, 5.128)), attended college and above (adjusted odd ratio = 2.99; p = 0.020; 95% confidence interval (1.189, 7.541)), have high knowledge on immediate postpartum intrauterine contraceptive devices ((adjusted odd ratio = 2.10; p = 0.006; 95% confidence interval (1.236, 3.564)), the previous history of LACM used (adjusted odd ratio = 6.85; p = 0.0001; 95% confidence interval (3.560, 10.021)), parity >4 (adjusted odd ratio = 1.86; p = 0.043; 95% confidence interval (3.99, 8.703)).ConclusionThe intention of pregnant women to use after they gave birth in the study area was low. Maternal educational level, high knowledge, history of previous long-acting contraceptive methods use, and parity were significantly associated with pregnant women's intention to use immediate postpartum intrauterine contraceptive devices. Healthcare providers should focus on delivering crucial information about immediate postpartum intrauterine contraceptive device benefits for postpartum women, particularly concerning reducing barriers during antenatal care follow-up as they plan to use it after their delivery.

Project description:The postpartum period is a crucial starting point for the delivery of family planning services. To date, there are numerous primary studies in Ethiopia on postpartum contraceptive use and related factors. However, the results of key variables are inconsistent, making it difficult to use the results to advance the service dimensions of postpartum contraceptive use in the country. Therefore, this systematic review and meta-analysis was required to summarize this inconsistency and compile the best available evidence on the impact of maternal educational status, antenatal care and menstrual resumption on postpartum contraceptive use in Ethiopia. PubMed, Google Scholar, Scopus, Science Direct, and the repositories of online research institutes were searched. Data were extracted with Microsoft Excel and analyzed with the statistical software STATA (version 14). Data on the study area, design, population, sample size, and observed frequency were extracted using the Joanna Briggs Institute tool. To obtain the pooled effect size, a meta-analysis was performed using a weighted inverse variance random effects model. Cochran's Q X2 test, and I2 statistics were used to test for heterogeneity, estimate the total quantity, and measure the variability attributed to heterogeneity. A mixed-effects meta-regression analysis was performed to identify possible sources of heterogeneity. To examine publication bias, the Eggers regression test and the Beggs correlation test were used at a p-value threshold of 0.001. Of the 654 articles reviewed, 18 studies met the inclusion criteria and were included in this meta-analysis. Overall, the final analysis includes 11,263 study participants. In Ethiopia, postpartum contraceptive use correlated significantly with maternal educational status (OR = 3.121:95% CI 2.127-4.115), antenatal care follow-up (OR = 3.286; 95% CI 2.353-4.220), and return of the mother's menses (OR = 3.492; 95% CI 1.843-6.615). A uniform meta-regression was performed based on publication year (p = 0.821), sample size (p = 0.989), and city of residence (p = 0.104), which revealed that none of these factors are significant. The use of postpartum contraceptives was found to be better among mothers who are educated, attended antenatal appointments, and resumed their menstrual cycle. Based on our research, we strongly recommended that antenatal care use and maternal educational accessibility need to improve. For family planning professionals, removing barriers to menstruation resumption should be a key priority.

Project description:BackgroundThe postpartum period is a critical moment for the delivery of family planning services. However, the utilization of family planning among women in sub-Saharan Africa is not optimal. Therefore, the current study aims to assess the intention to use postpartum contraception and its related determinants in the sub-Saharan African setting.MethodsThis study utilized a comprehensive search strategy that involved searching several databases, including PubMed, Scopus, EMBASE, Science Direct, Google Scholar, and online research institutional repository homes. Data extraction was performed using Microsoft Excel, and statistical analysis was conducted using STATA software (version 14). To assess publication bias, a forest plot, Begg's rank test, and Egger's regression test were employed. Heterogeneity was evaluated using the I2 statistic, and an overall estimated analysis was conducted. In addition, sensitivity analysis was performed to examine the impact of each study on the overall estimate. Meta-regression analysis was conducted to identify potential sources of heterogeneity. Finally, the pooled odds ratio (OR) for associated factors was calculated.ResultAfter reviewing 1,321 articles, 14 studies were deemed eligible for inclusion in this meta-analysis. The final analysis comprised a total of 39,936 study participants. The overall intention to use postpartum contraception in sub-Saharan Africa was found to be 62.21% (95% confidence interval [CI]: 55.532-68.875). In subgroup analysis, the highest prevalence of intention was observed in Ethiopia (66.71%; 95% CI: 50.36-83.05), while the lowest prevalence was reported in Ghana (59.39%; 95% CI: 50.22-68.57). The intention to use contraception was found to be 67.22% (95% CI: 62.37-72.07) and 54.53% (95% CI: 46.61-62.45) for institutional and community-based studies, respectively. Maternal educational status (OR = 1.22; 95% CI: 1.09-1.38) and husbands' approval of contraceptive use (OR = 2.395; 95% CI: 1.256-4.567) were identified as predictors of intention to use postpartum contraception.ConclusionIn conclusion, the results of our study show a comparatively low intention toward the use of postpartum contraception, in contrast to findings reported in other countries. As such, we recommend that stakeholders prioritize maternal education and encourage male partner involvement in family planning decisions.

Dataset Information

Postpartum intrauterine contraceptive device use and its associated factors in Ethiopia: systematic review and meta-analysis.

Background

Method

Results

Conclusions

Publications

Postpartum intrauterine contraceptive device use and its associated factors in Ethiopia: systematic review and meta-analysis.

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