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Eristu T, Mekis A, Abdo RA. Determinants of postpartum long-acting reversible contraceptives in the extended postpartum period in Shashago district, Central Ethiopia: a cross-sectional study conducted in the community. Contracept Reprod Med 2024; 9:21. [PMID: 38730446 PMCID: PMC11084074 DOI: 10.1186/s40834-024-00284-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 04/16/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Women who fail to initiate contraceptive use within the first year after childbirth face an increased likelihood of experiencing unintended pregnancies in close succession. In regions with limited resources, the use of postpartum contraceptives, particularly long-acting reversible contraceptives, remains notably low. Consequently, this study sought to assess the prevalence and determinants of postpartum long acting reversible contraceptives in the extended postpartum period in the Shashago district, Central Ethiopia. METHODS This study employed a community-based cross-sectional design, conducted between March 1, 2021, and April 15, 2021, involving a total of 617 women of reproductive age. The selection of study participants was performed using a multistage stratified sampling technique. Data collection was carried out through the use of a structured interviewer-administered questionnaire. Subsequently, the collected data were entered into Epi-data version 3.1 and exported to SPSS version 25 for further analysis. Bivariate and multivariable logistic regression analyses were conducted, and statistical significance was determined using a P value of 0.05, along with adjusted odds ratios (AORs) and their corresponding 95% confidence interval (CI). RESULTS A total of 224(36.3%) women used long-acting contraceptives after giving birth. Among these women, 31.1% used Implanon, while 5.2% used an intrauterine device (IUD). Factors significantly associated with the use of long-acting contraceptives after childbirth included age 25-29 years (AOR: 1.8, 95% CI: 1.1-3.0), age ≥ 35 years (AOR = 8.7, 95% CI: 3.6-21.5), primary education (AOR = 3.3, 95% CI: 1.6-6.7), secondary education and above (AOR = 3.5, 95% CI: 1.5-8.3), and history of abortion (AOR = 2.7, 95% CI: 1.3-5.4). Additionally, having good knowledge of long-acting contraceptives after childbirth (AOR: 2.4, 95% CI: 1.5-3.9) was significantly associated with their use. CONCLUSION This study revealed that a small number of women opt for long-acting contraceptives after childbirth, with Implanon being more popular than IUDs. Factors such as age, education level, abortion history, pregnancy counseling, and knowledge about long-acting contraceptives were linked to their usage. Integrating contraceptive counseling into routine antenatal and postnatal care is essential for ensuring access to postpartum contraception. Tailored interventions based on age and education level could also help promote long-acting contraceptive use. More research and targeted interventions are needed to overcome these barriers and improve access to these methods for postpartum women.
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Affiliation(s)
- Tesfaye Eristu
- Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
| | - Abera Mekis
- Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
| | - Ritbano Ahmed Abdo
- Department of Midwifery, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia.
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Steiner ML, Mendes JL, Strufaldi R, Carneiro M, Giovanelli SA, da Silva MH. Epidemiological profile and effectiveness of immediate postpartum contraception in Brazilian women. Front Glob Womens Health 2023; 4:1052224. [PMID: 37637759 PMCID: PMC10450033 DOI: 10.3389/fgwh.2023.1052224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 07/31/2023] [Indexed: 08/29/2023] Open
Abstract
Purpose To determine the epidemiological profile of women who inserted copper intrauterine device (Cu-IUD), subdermal etonogestrel implant (ENG), tubal ligation (TL), depot medroxyprogesterone acetate (DMPA) or did not choose a contraceptive method (NCM) in the immediate postpartum period and compare the contraceptive effectiveness of Cu-IUD and DPMA with non-MAC. Methods We analyzed the epidemiological profile of women who inserted copper intrauterine device (Cu-IUD), subdermal etonogestrel implant (ENG), tubal ligation (TL), depot medroxyprogesterone acetate (DMPA) or did not choose a contraceptive method (NCM) in the immediate postpartum. The data was collected by electronic medical records of postpartum women assisted at the University Hospital of São Bernardo do Campo (HMU-SBC) from January 2016 to December 2020. Also, we compared the contraceptive effectiveness of Cu-IUD and DPMA with non-MAC by identifying women who returned for second delivery during the study period and analyzing the contraceptive method chosen in the first hospitalization. Then the pregnancies interval and the sociodemographic characteristics were analyzed according to contraceptive method type. Results Data from 20,896 women were collected, of which 8,183 (39%) opted for Cu-IUD, 559 (2.5%) DPMA, and 10,989 (52.5%) chose not to use contraception at the time of hospital discharge. When comparing these groups, women in the DPMA were younger (26.5 ± 7.3, p < 0.05), and NCM showed women with a lower number of pregnancies (2.2 ± 1.3, p < 0.05). Subjects in the TL group (4.6%) had the higher number of pregnancies (3.8 ± 1.2, p < 0.05), and ENG group, the highest number of miscarriages (1.6 ± 1.3, p < 0.05). Of those women who returned pregnant, 5.5% belonged to the DPMA group, 6% to the NCM group, and 2.3% to the Cu-IUD. Conclusions Women who opted for Cu-IUD insertion were younger, had more pregnancies and vaginal delivery when compared to those who did not choose a method. Of those women who returned, the minority opted for Cu-IUD compared to those that opted for DPMA or no method.
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Affiliation(s)
- Marcelo Luis Steiner
- Department of Gynecology and Obstetrics, Faculdade de Medicina do ABC, Santo André, Brazil
| | - Julia Lorenzini Mendes
- Department of Gynecology and Obstetrics, Faculdade de Medicina do ABC, Santo André, Brazil
| | - Rodolfo Strufaldi
- Department of Gynecology and Obstetrics, Faculdade de Medicina do ABC, Santo André, Brazil
| | - Monica Carneiro
- Department of Gynecology and Obstetrics, Hospital Municipal Universitário de São Bernardo, São Bernardo do Campo, Brazil
| | - Silvana Aparecida Giovanelli
- Department of Gynecology and Obstetrics, Hospital Municipal Universitário de São Bernardo, São Bernardo do Campo, Brazil
| | - Mariliza Henrique da Silva
- Department of Gynecology and Obstetrics, Hospital Municipal Universitário de São Bernardo, São Bernardo do Campo, Brazil
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Mukherjee S, Swain D. Barriers and Acceptance of Intrauterine Contraceptive Devices (IUCD) Among Married Women of Reproductive Age in Odisha, India. Cureus 2023; 15:e40919. [PMID: 37496531 PMCID: PMC10367123 DOI: 10.7759/cureus.40919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2023] [Indexed: 07/28/2023] Open
Abstract
INTRODUCTION The Copper-T (Cu T-380 A), an intrauterine contraceptive device (IUCD), is widely available and is a highly effective, safe, long-term, and reversible method of contraception. Despite this fact, there is low utilization of IUCDs in India. Hence, this study focused on determining the rate of acceptability of IUCDs, identifying barriers to acceptance of IUCDs, and finding out the cause of IUCD discontinuation. METHODS A hospital-based cross-sectional study was conducted among 720 married women in the Khordha district, Odisha, India, via a questionnaire and a structured interview schedule. A systematic random sampling method was applied to select the participants. A multivariate logistic regression test was used to determine the factors associated with the acceptance of IUCDs. RESULTS This study revealed that only 20.97% of the potential users were currently using IUCDs, 73.75% had never used n IUCD as a contraceptive, and 20.1% of women had discontinued it. Multiple socio-demographic, obstetrical, and family planning behaviours and a lack of awareness were identified to be linked to IUCD acceptability. Fear of adverse effects, family members' objections, availability of other modern contraceptive methods, husband's disagreement, and lack of awareness about the benefits of IUCDs were the most stated reasons for refusal of IUCDs. The most common reason for discontinuing an IUCD was the desire for another child. CONCLUSION The rate of acceptability of IUCDs was quite low in Odisha as compared to other parts of India and, therefore, this study recommends imparting counselling on effective methods of family planning to increase the acceptance of IUCD use.
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Affiliation(s)
- Sangita Mukherjee
- College of Nursing, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Dharitri Swain
- Obstetrics and Gynaecological Nursing, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
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Nalini N, Singh B, Jha S, Singh AV. Acceptance, safety and efficacy of postpartum intrauterine contraceptive device. J Family Med Prim Care 2023; 12:868-873. [PMID: 37448945 PMCID: PMC10336930 DOI: 10.4103/jfmpc.jfmpc_1392_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 07/11/2022] [Accepted: 07/25/2022] [Indexed: 07/18/2023] Open
Abstract
Background Postpartum intrauterine contraceptive device (PPIUCD) is safe method of contraception, but with low acceptability rate. Factors that govern acceptability needs to be addressed for increasing its rate. This study was done to assess the acceptance, efficiency, and complications of PPIUCD in tertiary centre of Jharkhand, India. Methods This prospective study included antenatal women >34 weeks of gestational age who attended antenatal women in the department of Obstetrics and Gynaecology between 1st January 2020 to 1st September 2020. Details related to age, parity, education, awareness of PPIUCD, reasons for acceptance/refusal of PPIUCD were recorded. The types of insertion were postplacental, postcaesarean, and postabortal. Postinsertion counselling was done for PPIUCD, and women were followed-up at 6 weeks and 10 weeks for assessing complications. Results The overall acceptance rate was 36.23% (n = 100). The main reasons for rejecting the use of PPIUCD included fear of pain, bleeding, and other complications (59.09%) and COVID-19 (10.23%). In majority (80%), type of insertion was postplacental with postcaesarean in 18% and postabortal in 2%. Complications were present in 14% women that included abdominal pain (8%), heavy menstrual bleeding (6%), infection (4%), thread not visible (1%), and IUCD not located by USG or X-ray (1%). At 6 months, expulsion occurred in 2 women. There was no significant association of age (P = 0.312), religion (P = 1), tribal/non-tribal (P = 1), education level (P = 0.628), and type of insertion (P = 0.356) with complications. At 1 year of follow up, none of the women conceived again showing the efficacy to be 100% as a contraceptive. Conclusion In spite of limited awareness, PPIUCD proved to be an effective and safe method of long-acting reversible contraception. However, it had low rate of acceptability. PPIUCD was related to lesser complications as expulsion occurred in only 2 women at 6 months. Factors such as age, religion, tribal/non-tribal, education level, and type of insertion were not associated with acceptability rate. PPIUCD was 100% effective as a contraceptive.
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Affiliation(s)
- Neelam Nalini
- Departments of Obstetrics and Gynaecology, RIMS, Ranchi, Jharkhand, India
| | - Bijeta Singh
- Medini Rai Medical College, Palamu, Jharkhand, India
| | - Saumaya Jha
- Departments of Obstetrics and Gynaecology, RIMS, Ranchi, Jharkhand, India
| | - Aditya V. Singh
- Department of Medicine, Lakshmi Chandravanshi Medical College, Garhwa, Jharkhand, India
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Dorairajan G, Ashok VM, Veena P. Effect of the timing of insertion of postpartum intrauterine contraceptive device (PPIUCD) copper T380A on expulsion rates. Indian J Med Res 2023; 157:322-329. [PMID: 37282395 PMCID: PMC10438408 DOI: 10.4103/ijmr.ijmr_1485_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Indexed: 06/08/2023] Open
Abstract
Background & objectives Postpartum intrauterine contraceptive device (PPIUCD) is well accepted and recommended for contraception. However, anxiety at the time of delivery may restrict the acceptance of a PPIUCD for its immediate insertion. So far there is limited evidence to conclude anything concrete on the association between the expulsion rates and the timing of insertion following a vaginal delivery. Thus, this study was undertaken to compare the expulsion rates in immediate and early insertions and their safety and complications. Methods This prospective comparative study was carried out over 17 months on women delivering vaginally in a tertiary care teaching hospital in South India. A copper device (CuT380A) was inserted using Kelly's placental forceps either within 10 min of placental delivery (immediate group, n=160) or between 10 min upto 48 h postpartum (early group, n=160). Ultrasound was done before discharge from the hospital. The expulsion rates and any other complications at six-week and three-month follow up were studied. Chi-square test was used to compare the difference in expulsion rates. Results The expulsion rate was five per cent in the immediate compared to 3.7 per cent in the early group (no significant difference). In ten cases, the device was found to be in the lower uterus upon ultrasound before discharge. These were repositioned. There was no case with perforation, irregular bleeding or infection up to the three-month follow up. Higher age, higher parity, lack of satisfaction and motivation to continue were predictors of expulsion. Interpretation & conclusions In the present study PPIUCD was found to be safe with overall expulsion in 4.3 per cent. It was marginally, though not significantly, higher in the immediate group.
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Affiliation(s)
- Gowri Dorairajan
- Department of Obstetrics & Gynecology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
| | - Venkatesh M. Ashok
- Department of Obstetrics & Gynecology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
| | - P. Veena
- Department of Obstetrics & Gynecology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
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Gupta S, Bansal R, Shergill HK, Sharma P, Garg P. Correlates of post-partum intra-uterine copper-T devices (PPIUCD) acceptance and retention: an observational study from North India. Contracept Reprod Med 2023; 8:25. [PMID: 36978137 PMCID: PMC10045498 DOI: 10.1186/s40834-023-00222-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 03/18/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Postpartum intrauterine contraceptives device (PPIUCD) offers an effective means of providing contraceptive services to women in countries with high rates of unmet needs for family planning services. However, scientific literature estimating the long-term retention rates is scarce. We estimate the factors affecting acceptance and retention of PPIUCD and explore the risk factors against PPIUCD Discontinuation at six months". MATERIAL AND METHOD This prospective observational study was conducted between 2018 and 20 at a tertiary care institute in North India. PPIUCD was inserted following a detailed counseling session and consent. The women were followed up for six months. Bivariate analysis was done to depict the association between socio-demographic characteristics and acceptance. Logistic regression, cox regression, and Kaplan Meier analysis were applied to explore factors affecting acceptance and retention of PPIUCD. RESULTS Of the 300 women counseled for PPIUCD, 60% accepted them. The majority of these women were between 25 and 30 years (40.6%), primigravida (61.7%), educated (86.1%), and from urban areas (61.7%). Retention rates at six months were about 65.6%, while 13.9% and 5.6% were either removed or expelled. Women declined PPIUCD due to refusal by spouses, partial knowledge, inclination towards other methods, non-willingness, religious beliefs, and fear of pain and heavy bleeding. Adjusted logistic regression depicted that higher education, housewife status, lower-middle and richest SES, Hinduism, and counseling in early pregnancy promoted acceptance of PPIUCD. The most common reasons for removal were AUB, infection, and family pressure (23.1%). Adjusted hazard ratio depicted religion other than Hinduism, counseling in late stages of pregnancy, and normal vaginal delivery were significant predictors for early removal or expulsion. While education, higher socio-economic status favoured retention. CONCLUSION PPIUCD is a safe, highly effective, low-cost, long-acting, and feasible method of contraception. Skill enhancement of healthcare personnel for insertion techniques, adequate antenatal counseling, and advocacy of PPIUCD can help increase the acceptance of PPIUCD.
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Affiliation(s)
- Sneha Gupta
- Department of Obstetrics and Gynaecology, Adesh Institute of Medical Sciences and Research, 151001, Bathinda, India
| | - Romi Bansal
- Department of Obstetrics and Gynaecology, Adesh Institute of Medical Sciences and Research, 151001, Bathinda, India
| | - Harbhajan Kaur Shergill
- Department of Obstetrics and Gynaecology, Adesh Institute of Medical Sciences and Research, 151001, Bathinda, India
| | - Pradeep Sharma
- Department of Obstetrics and Gynaecology, Adesh Institute of Medical Sciences and Research, 151001, Bathinda, India
| | - Priyanka Garg
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, 151001, Bathinda, Punjab, India.
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Shiferaw Y, Jisso M, Fantahun S, Eshetu B, Assefa AA, Gebretsadik A. Acceptance, utilization, and factors associated with immediate postpartum intrauterine contraceptive device among mothers delivered at public health facilities in Hawassa city, Ethiopia: Institution-based study. Reprod Health 2023; 20:39. [PMID: 36890509 PMCID: PMC9996894 DOI: 10.1186/s12978-023-01586-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 02/16/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Immediate postpartum intra-uterine contraceptive device (IPPIUCD) placement within 10 min after the expulsion of the placenta following vaginal delivery is a safe and effective method when provided after comprehensive counseling. Studies on its acceptance and utilization are scarce in the study area. This study aims to assess the acceptance and utilization of IPPIUCD. METHODS A cross-sectional study was conducted from January 1st up to February 31st, 2020, among 392 mothers who delivered at public health facilities in Hawassa city. EPI-Data version 7.2 was used for data entry and STATA 14 for analysis. Data were collected using an interviewer administered structured questionnaire. A binary logistic regression and a multivariable logistic regression model were used to assess association. Statistical significance was determined at a p-value of less than 0.05 with a 95% confidence interval. RESULTS Of the 392 mothers enrolled, 16.3% (95% CI: 12.7-20.0) of them accepted immediate post-partum IUCD. However, only 10% (95%CI: 7.0, 12.9) utilized immediate post-partum IUCD. Counseling about IPPIUCD, Attitude, plan to have another child, and birth intervals were associated with acceptance of immediate PPIUCD while husband support for family planning use, delivery time, and the number of children had a significant association with utilization of immediate PPIUCD. CONCLUSIONS The study found a relatively low proportion of acceptors and utilizers of immediate post-partum IUCD in the study area. To improve the acceptance and utilization of immediate PPIUCD among mothers, all stakeholders concerned with family planning need to mitigate and promote the challenges and facilitating factors, respectively.
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Affiliation(s)
- Yemisrach Shiferaw
- Hawassa University College of Medicine and Health Science School of Public Health, Hawassa, Ethiopia.
| | - Meskerem Jisso
- Hawassa University College of Medicine and Health Science School of Public Health, Hawassa, Ethiopia
| | - Selam Fantahun
- Hawassa University College of Medicine and Health Science School of Public Health, Hawassa, Ethiopia
| | - Betelhem Eshetu
- Hawassa University College of Medicine and Health Science School of Public Health, Hawassa, Ethiopia
| | - Abiyu Ayalew Assefa
- Department of Public Health, Hawassa College of Health Science, P. O. Box: 84, Hawassa, Ethiopia
| | - Achamyelesh Gebretsadik
- Hawassa University College of Medicine and Health Science School of Public Health, Hawassa, Ethiopia
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Cherie N, Abera M, Tura G. Mapping evidence on postpartum modern family planning service uptake among women in Ethiopia: A scoping review. Front Glob Womens Health 2022; 3:1043034. [PMID: 36619592 PMCID: PMC9816789 DOI: 10.3389/fgwh.2022.1043034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/24/2022] [Indexed: 12/25/2022] Open
Abstract
Background In Ethiopia, different fragmented studies have been conducted to assess the determinants and uptake of postpartum modern family planning services. There is discrepancy and inconsistency among reported studies on postpartum modern family planning service uptake. The scoping review aimed to collect evidence on postnatal birth control service use and supply a chance to spot key ideas and gaps to research, policy revision, and changes in strategies. Methods There were different process steps in this scoping review which included analysis questions, distinctive relevant studies, study choice, charting the information, and eventually collating, summarizing, and reporting the results. A search was conducted through scientific databases like PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Hinari, and Google Scholar. The first outcome of this scoping review was postpartum family planning service uptake after childbirth in Ethiopia. The Preferable Reporting Information in Systematic Review and Meta-Analysis (PRISMA) flow diagram was used to select and summarize the selection procedure of the articles. The information of the chosen studies was sorted using the subsequent categories: authors, year of publication, study location, main study objective, and method employed for information analyses. Results A total of 1,607 records were reclaimed from the database searches and reference list review. A total of 596 articles were identified in PubMed, 375 in CINAHL, 576 in Hinari, and 60 records in Google Scholar. A total of 1,607 literature studies were checked for replication, and 840 records were excluded. The bulk of articles (n = 420) were excluded because they did not focus on postpartum family planning service, and 322 articles were excluded due to study setting discrepancy. The remaining 28 full-text articles were read in full using the preidentified inclusion criteria and included in the scoping review for analysis. Conclusion Generally, this scoping review identified different fragmented and inconsistent research findings on the uptake of postpartum modern family planning in Ethiopia. Almost all studies were observational studies that lack interventional study designs to provide evidence-based interventions to improve postpartum family planning uptake. There is a definite need for further interventional and qualitative research to improve early postpartum family planning service uptake that improves maternal and child health.
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Affiliation(s)
- Niguss Cherie
- Reproductive and Family Health Department, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia,Correspondence: Niguss Cherie
| | - Mulumebet Abera
- Population and Family Health Department, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Gurmesa Tura
- Population and Family Health Department, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
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Aemro E, Abdo M, Deksisa A, Alemayehu A, Mulatu T, Ahmed Hassen T, Molla A, Teji Roba K. Immediate postpartum intrauterine contraceptive device utilization and associated factors among women who gave birth in public health facilities of Adama town, Ethiopia. SAGE Open Med 2022; 10:20503121221142412. [PMID: 36568343 PMCID: PMC9768822 DOI: 10.1177/20503121221142412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 11/14/2022] [Indexed: 12/23/2022] Open
Abstract
Objectives The evidence on utilization of immediate postpartum intrauterine contraceptive devices (IPPIUCDs) and its associated factors are limited in Ethiopia. Hence, this study intended to assess IPPIUCD utilization and related factors among women who gave birth in Adama town public hospitals, Ethiopia. Method A facility-based cross-sectional study was done among 493 postpartum mothers at selected government health facilities in Adama town from January 20 to February 20, 2021. All women who gave birth in selected government health facilities and within 48 h of postpartum were included in the study. Data were collected using an interviewer-administered questionnaire. Logistic regression models were used to identify the factors associated with IPPIUCD utilization. Adjusted odds ratios (AORs) with 95% confidence interval (CI) were calculated to measure the strength of association and statistical significance was declared at p < 0.05. Result In this study, 22.1% (95% CI: 17.3-25.2) of the mothers used IPPIUCDs within 48 h of giving birth. Having three or more children (AOR = 4.18, 95% CI: 1.79-9.79), having no desire to have another child (AOR = 3.9, 95% CI: 1.86-8.17), counseling after delivery (AOR = 3.1 95% CI: 1.52-6.34), and having good knowledge about PPIUCD (AOR = 3.82, 95% CI: 1.94-7.49) were significantly associated with IPPIUCD utilization. Conclusion The utilization of IPPIUCD in this study was low. Strategies to raise pregnant mothers' awareness of IPPIUCD through mass media, and integrating standard counseling on immediate postpartum intrauterine device (IPPIUD) during antenatal care, and the immediate postpartum period are required to improve IPPIUD utilization.
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Affiliation(s)
| | - Meyrema Abdo
- Department of Public Health, Adama Hospital Medical College, Adama, Ethiopia
| | - Alem Deksisa
- Department of Public Health, Adama Hospital Medical College, Adama, Ethiopia
| | - Afework Alemayehu
- School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia,Afework Alemayehu, School of Nursing and Midwifery, College of Health and Medical science, Haramaya University, P.O. Box 235, Harar, Ethiopia.
| | - Teshale Mulatu
- School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Tahir Ahmed Hassen
- School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Alemayehu Molla
- College of Health and Medical Science, Diredawa University, Diredawa, Ethiopia
| | - Kedir Teji Roba
- School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
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Geda YF, Berhe TM. A systematic review and meta-analysis of immediate postpartal intrauterine contraceptive device use in Ethiopia. Heliyon 2022; 8:e11657. [DOI: 10.1016/j.heliyon.2022.e11657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 06/28/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022] Open
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Arero WD, Teka WG, Hebo HJ, Woyo T, Amare B. Prevalence of long-acting reversible contraceptive methods utilization and associated factors among counseled mothers in immediate postpartum period at Jimma University medical center, Ethiopia. Contracept Reprod Med 2022; 7:17. [PMID: 36050794 PMCID: PMC9438260 DOI: 10.1186/s40834-022-00184-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 08/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background Postpartum family planning is defined as the prevention of unintended pregnancy and closely spaced pregnancies through the first twelve months following childbirth. The immediate postpartum period is particularly favorable time to provide long-acting reversible contraception methods; and postpartum provision is safe and effective. Despite the advantages of long acting reversible contraception methods, they may be infrequently used in Ethiopia. Objective This study assessed the prevalence and associated factors of long-acting reversible contraceptive methods utilization among counseled mothers in immediate postpartum period. Methods A cross-sectional study was conducted on 393 women who gave birth at Jimma University Medical Centre from 12 November 2016 to 21 January 2017, Ethiopia. Data were collected by face-to-face interview using pre-tested structured questionnaire and by record reviewing using data compiling form; and analyzed using SPSS version 20. Logistic regression was used to identify associated factors for long acting contraceptive methods use. P-value less than 0.05 at 95% confidence level was taken as significance level. Results Prevalence of reversible long acting contraceptive methods utilization among immediate postpartum mothers was 53.2% (209/393) and more than three-fourths (78.0%) of participants used implanon. The most common reported reason for not using reversible long acting contraceptive methods was preference of other contraceptive methods like short acting contraceptives (25.5%). Having more than four alive kids (AOR 2.6, 95% CI: 1.15,5.95), high monthly income (≥1000 ETB) (AOR 2.4, 95% CI: 1.08,7.20), planning to delay next pregnancy by more than 2 years (AOR 4.0, 95% CI: 1.60,9.28), mothers with no fertility desire (AOR 2.0, 95% CI: 1.12,3.15), prior use of reversible long acting contraceptive methods (AOR 3.0, 95% CI: 1.30,7.20) and receiving counseling during antenatal care follow-up and before delivery (AOR 2.0, 95% CI: 1.01, 4.73) were associated with immediate postpartum reversible long acting contraceptive methods use. Conclusion and recommendations Although the prevalence of reversible long acting contraceptive methods utilization in immediate postpartum was high, counseling mothers during ANC follow-up and before delivery can further increase its utilization. Therefore, the need for providing counseling during ANC follow up and before delivery to increase utilization of immediate postpartum reversible long acting contraceptive methods use is emphasized.
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Affiliation(s)
- Wariyo D Arero
- Department of Gynecology and Obstetrics, Medical Science Faculty, Institute of Health, Jimma University, P.O.Box 378, Jimma, Ethiopia
| | - Woubishet G Teka
- Department of Gynecology and Obstetrics, Medical Science Faculty, Institute of Health, Jimma University, P.O.Box 378, Jimma, Ethiopia
| | - Habtemu J Hebo
- Department of Epidemiology, Public Health Faculty, Institute of Health, Jimma University, P.O.Box 378, Jimma, Ethiopia
| | - Terefe Woyo
- Department of Midwifery, College of Medicine and Health Sciences, Hawassa University, P.O.Box 1560, Hawassa, Ethiopia
| | - Belay Amare
- Department of Midwifery, College of Medicine and Health Sciences, Hawassa University, P.O.Box 1560, Hawassa, Ethiopia.
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Ferreira PB, Utiyama RY, Tamanaha S, Fukunaga ET. Immediate Postpartum Copper IUD: A Comparative Analysis between Profiles of Women who Accept and who Refuse it. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRICIA : REVISTA DA FEDERACAO BRASILEIRA DAS SOCIEDADES DE GINECOLOGIA E OBSTETRICIA 2022; 44:154-160. [PMID: 35213913 PMCID: PMC9948272 DOI: 10.1055/s-0041-1741452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To analyze the profiles of women who accepted and who refused the insertion of the copper intrauterine device (IUD) postpartum and to learn the motivations related to the refusal of the method. METHODS Cross-sectional study with 299 pregnant women. The women were informed about the possibility of inserting a copper IUD postpartum and were questioned about their interest in adopting or not this contraceptive. All participants answered a questionnaire with information relevant to the proposals of the present study. The sample size was limited to the number of devices available for the present study. RESULTS A total of 560 women were invited to join the present study and 299 accepted. Out of the 299 women included in the present study, 175 accepted the copper IUD and 124 refused. As the number of pregnancies increased, the IUD acceptance rate raised (p = 0.002), especially between the groups with 1 and with ≥ 4 pregnancies (p = 0.013). Regarding the desire to have more children, the women who planned to have more children were more likely to refuse the method than the ones who did not (p < 0,001). CONCLUSION Women with multiple pregnancies and desire to not have more children were more likely to accept the copper IUD. The profile of those who refused was first pregnancy and desire to have more children. Among the three most frequent reasons reported for copper IUD rejection, two responses stood out: no specific justification and desire to have more children.
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Affiliation(s)
| | - Raul Yao Utiyama
- Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brazil
| | - Sonia Tamanaha
- Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brazil
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Usso AA, Adem HA, Dessie Y, Tura AK. Utilization of Immediate Postpartum Long Acting Reversible Contraceptives among Women Who Gave Birth in Public Health Facilities in Eastern Ethiopia: A Cross-Sectional Study. Int J Reprod Med 2021; 2021:1307305. [PMID: 34805394 PMCID: PMC8598333 DOI: 10.1155/2021/1307305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 11/02/2021] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Although importance of postpartum family planning is essential and immediate postpartum insertion of long acting and reversible contraceptives (LARC) is recommended, evidence on its uptake and associated factors is limited in Ethiopia. This study was conducted to assess utilization of immediate postpartum LARC among women who gave birth in selected public health facilities in eastern Ethiopia. METHOD An institution-based cross-sectional study was conducted among randomly selected women who gave birth in selected public health facilities in eastern Ethiopia from 10 March to 09 April 2020. At discharge, all eligible women who gave birth in the facilities were interviewed using a pretested structured questionnaire. Data were entered using EpiData 3.1 and analyzed using SPSS 24. Bivariable and multivariable logistic regression analyses were conducted to identify factors associated with utilization of immediate postpartum LARC. Adjusted odds ratio (aOR) with 95% confidence interval was used to report association, and significance was declared at p value < 0.05. RESULTS From a total of 546 women invited to the study, 530 (97.1%) participated in the study and 98 (18.5%; 95% CI: 15.1%, 22.0%) reported starting long acting reversible contraceptives. Women who reported discussing about contraceptives with partners (aOR = 6.69, 95% CI: 3.54, 12.61) and receiving postpartum counselling on contraceptives (aOR = 5.37, 95% CI: 3.00, 9.63) were more likely to using contraception. However, women who live >30-minute walking distance from the nearest health facility (aOR = 0.47, 95% CI: 0.26, 0.85) and reported disrespect and abuse during childbirth (aOR = 0.22, 95% CI: 0.12, 0.40) were less likely to start LARC. CONCLUSIONS Almost one in five women delivering in public health facilities in eastern Ethiopia started using LARC. Provision of respectful maternity care including counselling on the importance of immediate postpartum family planning is essential for increasing its uptake.
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Affiliation(s)
- Ahmedin Aliyi Usso
- School of Nursing and Midwifery, College of Health and Medical Sciences, Jijjiga University, Jijjiga, Ethiopia
| | - Hassen Abdi Adem
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abera Kenay Tura
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Department of Obstetrics and Gynaecology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
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Gebremedhin M, Alemayehu A, Yihune M, Dessu S, Melis T, Nurahmed N. Acceptability and Factors Associated with Immediate Postpartum Intrauterine Contraceptive Device Use Among Women Who Gave Birth at Government Hospitals of Gamo Zone, Southern Ethiopia, 2019. Open Access J Contracept 2021; 12:93-101. [PMID: 33790665 PMCID: PMC8009030 DOI: 10.2147/oajc.s291749] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 03/11/2021] [Indexed: 11/23/2022] Open
Abstract
Background An intrauterine contraceptive device is suitable for women of all reproductive age groups for preventing unwanted pregnancies. Immediate postpartum family planning (PPFP) services need to be emphasized when the woman leaves the hospital. Despite the accepted demand for PPFP, many women do not access the services. Therefore, this study aimed to assess acceptability and factors associated with immediate postpartum intrauterine contraceptive device use among women who gave birth at government hospitals of Gamo Zone, Southern Ethiopia. Methods A cross-sectional study was conducted from March 1 to 30, 2019 with 452 participants studied using systematic random sampling technique. Data was collected using a pretested interviewer-administered questionnaire from March 1 to 30, 2019. The data were coded, cleaned and entered into Epi-data manager version 4.2.2.1 and exported to SPSS version 23 for advanced analysis. Binary logistic regression was performed to identify associated factors of immediate PPIUCD acceptability. Results This study revealed that about 161 (35.6%) in 95% CI (31.0, 39.6) of the study participants accepted immediate PPIUCD. Multiparty (AOR = 2.33, 95% CI, (1.29, 4.20)), completed antenatal follow up (AOR = 3.65, 95% CI, (2.22, 5.99)), counselling (AOR= 8.38, 95% CI, (4.85, 14.48)) and prior discussion (AOR=2.57, 95% CI, (1.51, 4.36)) were statistically significant. Conclusion and Recommendation Even though 58% of the mothers were counselled about PPIUCD during the important cascade of pregnancy and 53% of the mothers completed antenatal service, efforts need to improve antenatal care services and integrate counselling services through the whole cascade of pregnancy.
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Affiliation(s)
- Mesfin Gebremedhin
- Arba Minch University, College of Medicine & Health Sciences, Department of Public Health, Arba Minch, Ethiopia
| | - Addisu Alemayehu
- Dilla University, College of Medicine & Health Sciences, Department of Public Health, Dilla, Ethiopia
| | - Manaye Yihune
- Arba Minch University, College of Medicine & Health Sciences, Department of Public Health, Arba Minch, Ethiopia
| | - Samuel Dessu
- Wolkite University, College of Medicine & Health Sciences, Department of Public Health, Wolkite, Ethiopia
| | - Tamirat Melis
- Wachamo University, College of Medicine & Health Sciences, Department of Public Health, Hosanna, Ethiopia
| | - Negash Nurahmed
- Paster Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Determinants of Postpartum Intrauterine Contraceptive Device Uptake among Women Delivering in Public Hospitals of South Gondar Zone, Northwest Ethiopia, 2019: An Unmatched Case-Control Study. Obstet Gynecol Int 2021; 2021:1757401. [PMID: 33688350 PMCID: PMC7920734 DOI: 10.1155/2021/1757401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 01/31/2021] [Accepted: 02/06/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Integrated use of postpartum intrauterine contraceptive devices with delivery service during the immediate postpartum period is ideal for both women and health-care providers. However, utilization of intrauterine contraceptive devices during the postpartum period was rare and in Ethiopia, with information regarding uptake of postpartum intrauterine contraceptive devices limited. Objective Identify determinants of postpartum intrauterine contraceptive devices uptake among women delivering in public hospitals of South Gondar zone, Northwest Ethiopia, 2019. Methods An unmatched case-control study was conducted in public hospitals of South Gondar, Ethiopia, from August 1, 2019, to November 10, 2019. A total of 140 cases and 280 controls have actively participated in the study. Five hospitals were selected by simple random sampling. Cases were selected consecutively, whereas two controls for each case were recruited by the lottery method. Pretested questionnaires were used to collect data and it was entered into Epidata version 4.4.2. Logistic regression analysis was used to identify variables associated with the use of outcome and adjusted odds ratio with a 95% confidence interval was used to determine the association between independent and outcome variables. Results Completing secondary education (AOR = 4.5, 95%CI 2.3-8.85), having a total number of children of 3-4 (AOR = 3.6, 95%CI 1.25-10.2), having ≥ 5 (AOR = 4.7, 95%CI 1.5-15.3), attending 3 antenatal care (AOR = 2.8, 95%CI 1.44-5.6), ever hearing about postpartum IUCD (AOR = 6.6, 95%CI 2.7-16.1), and having counseling from health-care provider about a postpartum intrauterine contraceptive device (AOR = 6.2, 95%CI 2.99-12.8) were significantly associated with uptake of the postpartum intrauterine contraceptive. Conclusion and Recommendation. Completing secondary education, having 3-4 and ≥5 children, attending three antenatal care, ever hearing about postpartum IUCD, and having counseling from health-care providers about the postpartum intrauterine contraceptive device among women were significantly associated with uptake of an intrauterine contraceptive device after birth. Therefore, it is better to advise women to strictly follow their antenatal care, access to information, and provide counseling.
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Geda YF, Nejaga SM, Belete MA, Lemlem SB, Adamu AF. Immediate postpartum intrauterine contraceptive device utilization and influencing factors in Addis Ababa public hospitals: a cross-sectional study. Contracept Reprod Med 2021; 6:4. [PMID: 33526103 PMCID: PMC7851919 DOI: 10.1186/s40834-021-00148-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 01/06/2021] [Indexed: 11/10/2022] Open
Abstract
Background Postpartum intrauterine device (PPIUCD) utilization remains very low in Ethiopia beside high levels of unmet need for postpartum family planning even if nongovernmental organizations efforts to promote its use. This study investigates immediate PPIUCD utilization and influencing factors. Methods Institution based cross-sectional study was conducted on public hospitals of Addis Ababa city. All public hospitals which have PPIUCD service were included and systematic random sampling technique was used to select 286 participants. Data were entered using Epi Data and exported to SPSS for analysis. Bivariate and multivariate logistic regression analysis was used to determine the effect of independent variables on immediate PPIUCD utilization. Variables which have P-value< 0.2 on bivariate analysis were candidate for multivariate analysis. Variables which have P-value ≤0.05 on multivariate analysis was considered as statistically significant. Results Utilization of immediate PPIUCD among participants who gave birth in Addis Ababa public hospitals was 26.6% (95%CI: 21.3, 31.8). Eighty one percent respondents occupation was housewife were (AOR = 0.19, 95%CI: 0.06, 0.67) less likely to utilize PPIUCD compared to those who have personal job. In the other hand respondents who have discuss about PPFP with their partner were 1.21times (AOR = 1.21, 95%CI: 1.14, 25.67) more likely to utilize PPIUCD compared to those who never discuss. Contrarily 81% of respondents who need partner approval were (AOR = 0.19, 95%CI: 0.05, 0.79) less likely to utilize PPIUCD compared to those who doesn’t need approval. Respondents who have been counseled about PPIUCD were 1.13 times (AOR = 1.13, 95%CI: 1.10, 2.21) more likely to utilize PPIUCD compared to those who were not counseled. Similarly respondents who have good knowledge about PPIUCD were 7.50 times (AOR = 7.50, 95%CI: 4.06, 9.31) more likely to utilize PPIUCD compared to those who have poor knowledge. Conclusion This study verifies that immediate PPIUCD utilization is high compared to other studies. Having a housewife occupation and necessity of partner approval to utilize PPIUCD have negative influences, whereas spousal discussion about PPIUCD, counseled during pregnancy and having good knowledge have positive influences on PPIUCD utilization. Therefor empowering women by the government and other organizations working on maternal health will advance immediate PPIUCD utilization.
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Affiliation(s)
| | - Seid Mohammed Nejaga
- College of Health Science, Black Lion Specialized Hospital, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Mesfin Abebe Belete
- School of Nursing and Midwifery, Addis Ababa University, Addis Ababa, Ethiopia
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Utilization of immediate postpartum intrauterine contraceptive device and associated factors among mothers who gave birth at selected hospitals in west Gojjam zone, Ethiopia, multi-level facility-based study, 2019. Heliyon 2021; 7:e06034. [PMID: 33521367 PMCID: PMC7820927 DOI: 10.1016/j.heliyon.2021.e06034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 12/12/2020] [Accepted: 01/15/2021] [Indexed: 11/23/2022] Open
Abstract
Background Intrauterine contraceptive device (IUCD) prevents unwanted pregnancy. An immediate postpartum period is a good opportunity to place IUCD for women who want to delay pregnancy. However, in Sub-Saharan Africa mainly in Ethiopia, this procedure is not widely used. This study aimed to determine the utilization and factors associated with an immediate postpartum intrauterine contraceptive device (IPPIUCD). Methods Multi-level facility-based cross-sectional study was conducted from Januarey12 to March 12/2019GC on 423 women who delivered at selected hospitals of the west Gojjam zone. A systematic random sampling technique was applied to select study participants. Proportional allocations of samples were done based on the delivery caseload of each hospital. Data were entered in Epi info version 7.1 software and exported to SPSS version 23 for editing, cleaning, and analysis. Bivariable and multivariable logistic regression analysis were performed to determine factors associated with the utilization of IPPIUCD. Result The utilization of IPPIUCD was 4.02 % (95% CI: 1.65, 5.24). The following factors were significantly associated with IPPIUCD utilization; Being age 35–49 (AOR: 2.98; 1.31, 4.68), College and above education (5.01; 2.21, 7.90), Being counseled about IPPIUD (2.76: 1.79, 7.58), and needing of birth spacing >36 months (2.01: 1.52, 10.12). Conclusion The utilization of IPPIUCD was low in selected hospitals of west Gojjam zone. According to this finding; age between 35–49 years, having college and above education, being counseled about IPPIUCD, and needing above 36 months birth spacing were significant factors for utilization of IPPIUCD. Encouraging women's education and informing health professionals of the importance of IPPIUCD may enhance IPPIUCD utilization. This finding may be useful in both reproductive health promotion at an individual level and policy-making regarding this issue.
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Kanakuze CA, Kaye DK, Musabirema P, Nkubito P, Mbalinda SN. Factors associated with the uptake of immediate postpartum intrauterine contraceptive devices (PPIUCD) in Rwanda: a mixed methods study. BMC Pregnancy Childbirth 2020; 20:650. [PMID: 33109097 PMCID: PMC7590736 DOI: 10.1186/s12884-020-03337-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 10/14/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Rwanda has a high unmet need for family planning which could be reduced by improving access to postpartum intrauterine contraceptives device (PPIUCD) insertion. The objective of the study was to assess the prevalence and factors associated with the uptake of PPIUCD among postpartum women in Muhima Hospital. METHODS A concurrent mixed-method study was used. Three hundred eight three (383) immediate postpartum mothers, and 10 health services providers were interviewed using a structured questionnaire and in-depth interviews respectively. Logistics regression was done to assess for factors associated with PPIUCD uptake and thematic analysis was used for qualitative data. RESULTS The prevalence for PPIUCD use was 28.1%, women who had spontaneous vaginal delivery were more likely to take up PPIUCD (Adjusted Odds Ratio (AOR) 2.623, 95% CI = 2.017-6.507 compared to those who had cesarean section; women who received PPIUCD counselling during the antenatal period were more likely to use PPIUCD ((AOR 2.072, 95% CI = 1.018-4.218) as compared to those who didn't receive any form of counselling; mothers who received spouse approval were more likely to use PPIUCD (AOR 2.591,95% CI = 1.485-4.492); as compared to those who didn't receive any spousal approval; women who had more than one child were more likely to use PPIUCD (AOR =2.265, 95% CI = 1.472-3.163) as compared to prime gravida; Mothers with birth to pregnancy interval less than two years were more likely to use PPIUCD (AOR =2.123, CI =1.477-2.706) as compared to those who had birth to pregnancy interval more than 2 years. From the qualitative findings, health education of mothers and partners on PPIUCD, training of health care providers, and availability of supplies to provide PPIUCD influenced the use of PPIUCD. CONCLUSION The acceptability to use for PPIUCD was high in this population. PPIUCD uptake was associated with normal birth, PPIUCD counselling, spousal approval, parity, birth interval, level of education. Health education of mothers and partners on PPIUCD, training of health providers, and availability of supplies to provide PPIUCD influenced uptake of PPIUCD.
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Grants
- D43 TW010132 FIC NIH HHS
- R25 TW011213 FIC NIH HHS
- D43TW010132 by Office of the Director, National Institutes of Health (OD), National Institute Of Dental & Craniofacial Research (NIDCR), National Institute Of Neurological Disorders And Stroke (NINDS), National Heart, Lung, And Blood Institute (NHLBI), Fogarty Interna
- 1R25TW011213. Fogarty International Center of the National Institutes of Health.
- by Office of the Director, National Institutes of Health (OD), National Institute Of Dental & Craniofacial Research (NIDCR), National Institute Of Neurological Disorders And Stroke (NINDS), National Heart, Lung, And Blood Institute (NHLBI), Fogarty Interna
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Affiliation(s)
- Chris Adrien Kanakuze
- Faculty of Health Sciences, Kibogora Polytechnic, P.O. Box: 31, Rusizi, Rwanda
- Department of Nursing, Makerere University, College of Health Sciences, School of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Dan Kabonge Kaye
- Department of Obstetrics and Gynecology, Makerere University, College of Health Sciences, School of Medicine, Kampala, Uganda
| | - Priscilla Musabirema
- Midwifery department, Faculty of Nursing Science, University of Rwanda, Kigali, Rwanda
| | - Pascal Nkubito
- Department of Obstetrics and Gynecology, Muhima Hospital, Kigali, Rwanda
| | - Scovia Nalugo Mbalinda
- Department of Nursing, Makerere University, College of Health Sciences, School of Health Sciences, P.O. Box 7072, Kampala, Uganda
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Jemal Mohammed S, Gebretsadik Kelbore W, Endashaw Yesera G, Shegaze Shimbre M, Assfa Mossa K, Nuriye Metebo K, Yesgat YM. Determinants of Postpartum IUCD Utilization Among Mothers Who Gave Birth in Gamo Zone Public Health Facilities, Southern Ethiopia: a Case-Control Study. Open Access J Contracept 2020; 11:125-133. [PMID: 33061684 PMCID: PMC7533218 DOI: 10.2147/oajc.s257762] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 08/19/2020] [Indexed: 11/23/2022] Open
Abstract
Background The postpartum intrauterine contraceptive device (PPIUCD) is an effective, reliable, safe and recommended contraceptive method for the postpartum women. However, only a small proportion of women who gave birth at health facilities in the world have used it. There are limited studies about determinants of PPIUCD utilization. Therefore, this study aimed to assess determinants of postpartum IUCD utilization among mothers who gave birth in Gamo zone health facilities, southern Ethiopia. Methods A facility based unmatched case-control study was done at Gamo zone public health facilities, southern Ethiopia. Data were collected using a pretested interviewer-administered questionnaire from March 1 to April 15, 2019. The data were coded, cleaned and entered into Epi-Info version 3.5.1 and exported to SPSS version 25 for advanced analysis. Binary logistic regression was performed to identify the determinants of PPIUCD utilization. Results A total of 510 (175 cases and 335 controls) participants were involved in the study yielding a response rate of 95.1%. Partner support for IUCD insertion (AOR [95% CI]: 10 [4.03, 24.3]), birth interval (AOR [95% CI]: 9.7 [1.7, 55.1]), fertility plan (AOR [95% CI]: 4 [1.44, 10.84]), and timing of counseling (AOR [95% CI]:1.25 [0.034, 0.46]) are the determinant factors for postpartum IUCD. Conclusion and Recommendation Birth interval, fertility plan, timing of counseling, pregnancy plan and partner support were the determinant factors identified in this study. Therefore, counseling of both partners during antenatal follow-up, delivery and immediately after delivery by health professionals are recommended.
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Affiliation(s)
- Seid Jemal Mohammed
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | | | - Gesila Endashaw Yesera
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Mulugeta Shegaze Shimbre
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Kenzudin Assfa Mossa
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Keyredin Nuriye Metebo
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Yibeltal Mesfin Yesgat
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
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