Drivers of Uptake of Immediate Postpartum Modern Contraceptives by Postpartum Women in Lira City, Northern Uganda: A Qualitative Inquiry.

Abstract

Introduction: Immediate postpartum modern contraceptive uptake among postpartum women gives over 95% assurance of contraception and reduced chances of short interval pregnancies resulting in improved maternal and child health outcomes. The drivers of its uptake among women are vital in designing interventions aimed at improving and scaling up its uptake. The study therefore explored the drivers of uptake of immediate postpartum modern contraceptives by postpartum women in Lira City, northern Uganda.

Methods: A descriptive qualitative approach was used. A face-to-face key informant interview was used to collect data from 15 key informants (healthcare providers) working in the department of Obstetrics and Gynecology of Lira Regional Referral Hospital. Data were analyzed using Atlas.Ti and thematic analysis was done. The approach enabled an in-depth understanding of the phenomenon from service providers.

Results: The barriers to uptake of immediate postpartum modern contraceptives were health system constraints like commodity unavailability, lack of staff training, and inadequate staffing, knowledge and skills gaps of providers. Limited knowledge, religious and cultural beliefs, male partners objection, inadequate access to information, peer influence and fear of side effects were key barriers from recipients of care. The major facilitators include availability of commodities, improved staffing level, staff training, and timely education and counselling.

Conclusion: This study highlights that the uptake of immediate postpartum modern contraceptives is hindered by both health system and client-related barriers. Presence of trained staff, availability of contraceptive commodities, improved staffing levels, and timely counselling and education were identified as key facilitators. Addressing both health system and individual barriers through strengthening health systems, targeted provider training, male involvement, and enhanced community education may improve the uptake of immediate postpartum modern contraceptives.