Practical problems which women encounter with available contraception in Australia

Characteristics and contributory factors for injectable contraceptive usage among women in Kumasi, Ghana

Background

Preferred methods of contraception vary from country to country. Family Planning services have been available on a large scale in Ghana since the 1980’s and their use has contributed to gradual decline in the total fertility rate from 6.4 in 1988 to 4.2 in 2014. Since their introduction in Ghana in the early 1990’s, Injectable contraceptives have seen increasing patronage and are currently the most preferred method of contraception. We set out to identify possible factors contributing to the preference for injectable contraceptives among women in Ghana.

Methods

We conducted a descriptive cross-sectional survey of women accessing contraceptive services at the Family Planning Unit of the Komfo Anokye Teaching Hospital in Kumasi, Ghana. Women who reported for the second dose of their injections were eligible to be selected for participation in the study. Informed consent was obtained from eligible participants. Data was collected using a structured questionnaire in January and February 2011. Data captured included age, marital status, highest level of education completed, religion, ethnicity and employment status, previous contraceptive use, sources of contraceptive information and reasons for choosing injectable contraceptives. Quantitative data was entered into a Microsoft Access Database and analysed using Epi Info Version 7.1.4. Qualitative data was analysed thematically.

Results

A total of 247 respondents participated in the study. One hundred and seventy three (70.0 %) were using Depot Medroxyprogesterone Acetate and 74 (30.0 %) were using NorethisteroneEnanthate/Estradiol Valerate. The mean age for women on Depot Medroxyprogesterone Acetate was higher than those on NorethisteroneEnanthate/Estradiol Valerate (p < 0.001). The effectiveness of method, recommendation from other users, low incidence of forgetfulness and the relatively longer intervals for administration were the commonest reasons for the use of injectables among respondents. The majority of users, 225 (91.1 %), were satisfied with the method and will recommend it to other potential users. Only 10.8 % of the 68 respondents reporting undesirable effects of the injectables intend to change the method.

Conclusion

A high level of satisfaction exists among current users of injectables in Ghana and is influenced by a variety of factors. Strategies to increase the uptake of injectables can go a long way to increase the contraceptive prevalence rate and reduce the unmet need for Family Planning in Ghana.

Emergency contraception: who are the users?

The objective was to describe the demographic and sexual characteristics of clients attending a Sexual Health Clinic for emergency contraception (EC). Information about women attending the Parramatta Sexual Health Clinic (PSHC) who received EC between January 1999 and July 2002 was derived from the clinic database. Age-matched controls were randomly selected. Univariate and logistic regression analysis was performed to establish which factors were associated with use of EC. Two hundred and sixty-seven women requesting EC, and an equal number of controls, were studied. Factors that were independently associated with EC use were being a student, (OR=1.7 [95% CI 1.02-2.69]) and having a regular sexual partner (OR=2.3 [95% CI 1.14-4.73]). Women requiring EC were significantly less likely to have had a sexually transmitted infection (STI) (OR=0.3 [95% CI 0.16-0.60]) or a previous pregnancy (OR=0.2 [95% CI 0.09-0.67]) than controls. We concluded that users of EC are at low-risk for STIs, but need counselling about safer sex.

Contraceptive use in Australia: evidence from the 1995 National Health Survey

This paper analyses the patterns of contraceptive use among Australian women, using data from the 1995 National Health Survey. More than 44% of all women aged 18-49 years reported using a method of contraception. Among users, the 2 most commonly reported methods were the pill (60%) and condom (27%); IUD and natural methods accounted for less than 5% each. Sterilizing operations of the women/partner were the most frequently reported reasons for nonuse of contraception in women aged over 35 years, while among the younger women the most reported reasons were pregnancy or trying to get pregnant and not being sexually active. Among pill-users about a quarter were smokers, 20% overweight and 13% reported heart or circulatory disease. These figures were generally lower than in the general population but indicate a need for regular monitoring. The survey demonstrates the continuing evolution in the use of contraception among Australian women.