Prevalence and factors associated with post-abortion contraceptive uptake at Mbagala Hospital, Temeke, Dar Es Salaam, Tanzania.

Abstract

Background: The uptake of modern contraceptives post-abortion care bridges the gap of unmet need for modern contraceptives which can reduce the rate of unintended pregnancies and recurrent abortion, thus improving women's health. Studies have demonstrated variations in the uptake of modern contraceptives, even within the same country.

Objective: To assess the factors associated with the uptake of modern contraceptive methods among women who received care at a comprehensive post-abortion care (cPAC) unit at Mbagala Hospital in Temeke, Dar es Salaam.

Methodology: A cross-sectional analytical study involving 234 post-abortion women was conducted at Mbagala Hospital in Temeke, Dar es Salaam, from October 2020 to March 2021. The convenient sampling technique was employed to collect data using a pretested structured questionnaire. Subsequently, the data was cleaned and analyzed using SPSS Version 23. A Chi-square test with a significance level set at P-value < 0.2 was used to test associations, and multivariable analysis was employed to identify independent factors associated with the uptake of modern contraceptives, with a P-value of less than 0.05 being significant.

Results: The uptake of modern contraceptives post-abortion was 67% among 234 post-abortion women, with the most commonly used method being injectable (35.9%). Higher uptake of modern contraceptives was observed in those aged 15 to 19 years with an Adjusted Odds Ratio (AOR) of 5.97 (95% CI 1.24-28.58), and in those aged 20 to 24 years, with an AOR of 3.55 (95%CI 1.54-8.18). Self-employed individuals also showed higher uptake with an AOR of 2.59 (95%CI 1.13-5.91). On the other hand, nulliparous and primiparous women were less likely to use modern contraceptives, with AORs of 0.12 (95%CI 0.02-0.60) and 0.22 (95% CI 0.16-1.70), respectively.

Conclusion and recommendation: All the women who attended the clinic for post-abortion care received counseling on contraceptive methods, and two-thirds of the women (67%) received modern contraceptives as part of post-abortion care. However, there was a missed opportunity to prevent unwanted pregnancies in 33% of the women who received care. Greater efforts should be made to reach out to women (aged 25 years or older), self-employed, and women with four or more children in order to increase the uptake rate.