Prevalence and factors associated with the use of long-acting reversible and permanent contraceptive methods among women who desire no more children in Bangladesh.

Abstract

Background: Long-acting reversible and permanent contraceptive methods (LARC/PM) with high efficacy and continuity of use are highly effective pregnancy prevention methods. However, most sexually active women do not use it and end up with unintended pregnancies and unsafe abortions in Bangladesh. This study aims to assess the prevalence of LARC/PM use and its determinants among sexually active women who desire no more children in Bangladesh.

Methods: The study used Bangladesh Demographic and Health Survey (BDHS) 2017-18 data, which employed a two-stage cluster sampling design. This study extracted 6422 married women of reproductive age who desired no more children. Descriptive statistics were used to present the characteristics of the women. Chi-square and binary logistic regression were also used to identify the factors associated with LARC/PM use.

Results: A total of 20.2% of women use LARC/PM who desire no more children. Women aged 25-34 (aOR = 1.52, 95% CI: 1.10-2.09) and 35 years and above (aOR = 1.99, 95% CI: 1.41-2.81), women from Rangpur (aOR = 2.27, 95% CI = 1.57-3.28), Rajshahi (aOR = 2.15, 95% CI = 1.49-3.11), Khulna (aOR = 2.17, 95% CI = 1.48-3.17), Sylhet (aOR = 1.66, 95% CI = 1.07-2.58) and Dhaka (aOR = 1.97, 95% CI = 1.37-2.83) divisions, who were non-Muslims (aOR = 1.72, 95% CI = 1.40-2.11), having a desired number of children (2+) (aOR = 1.27, 95% CI = 1.08-1.49), whose contraceptive decision solely made by husband (aOR = 3.61, 95% CI = 2.73-1.77) or jointly (aOR = 1.59, 95% CI = 1.32-1.92) were more likely to use LARC/PM. On the other hand, women with primary education (aOR = 0.78, 95% CI = 0.65-0.92), secondary education (aOR = 0.59, 95% CI = 0.47-0.72) and higher education (aOR = 0.64, 95% CI = 0.43-0.95) belonging to richest wealth index (aOR = 0.73, 95% CI = 0.55-0.97), having at least two living children (aOR = 0.62, 95% CI = 0.44-0.85), partner with secondary education (aOR = 0.79 95% CI = 0.65-0.97) and women who were visited by family planning (FP) visitors (aOR = 0.34, 95% CI = 0.29-0.40) were less likely to use LARC/PM.

Conclusion: The LARC/PM use rate among women in Bangladesh is low. It must be increased to meet the targets of the Sustainable Development Goals (SDGs). To increase LARC/PM use in Bangladesh, attention should be given to factors like women's age, education, partner's education, religion, wealth index, division, number of living children, and desired number of children.