Predictors of Long Acting Reversible Contraceptive use among Married Women Visiting Health Facilities in Jimma Town

Abstract

Background: A long-acting reversible contraceptive (LARC) method is a birth control method, which provides effective contraception for an extended period of time without requiring user action. The most common methods of these contraceptives are non-hormonal copper intrauterine contraceptive devices (IUCDs) and implantable contraceptive which are safe, effective, convenient and less expensive for the users. Ethiopia is one of the Sub-Saharan African countries with highest maternal mortality rate with 673 maternal deaths per 100,000 live births. The prevalence of family planning in Ethiopia among married women is 29% of these 2% and 3.4% are using IUCD and implant, respectively. There are many factors related to the use of long-acting methods. Despite this, the use of long acting reversible contraceptives is still low in Africa, especially Ethiopia. There is no study that documented use of long acting reversible contraceptive and its predictors in the study area. This study was carried out to fill the gap in information about the practice of long-acting contraceptives use in Jimma Town. Moreover, the study will help the policy makers to design appropriate strategies for encouraging greater use of long-acting contraceptives thereby ensuring further declines in fertility and better reproductive health of couples. Objective: This study was to assess predictors of long acting reversible contraceptives use among married women visiting health facilities in Jimma Town, Southwest Ethiopia. Method: A cross-sectional study was employed from February to March 2012among married women visiting public health facilities in Jimma Town, Southwest Ethiopia. A total of 422 married women were selected using systematic sampling methods. Both quantitative and qualitative data were collected using structured interviewer administered questionnaire and focus group discussion guides, respectively. Multivariable logistic regression model was used to isolate an independent effect of predictors. Results: A total of 418 married women were interviewed giving a response rate of 99.1%. The overall prevalence of long acting reversible contraception use was 16%.Out of 39.8% who intended to use long acting reversible Contraceptives (LARCs), 82.1% preferred to use implant while 17.9% preferred. The main reasons mentioned by the majority of married women for not using LARCs were: rumor (48.1%), husband’s opposition (47.6%), fear of side effects (36.80%), and religious prohibition (34.80%). On multivariable logistic regression analyses, couples discussion, husband’s attitude/ feeling about long acting contraceptives, provider’s discussion with client, myths and beliefs (misconception) and religious prohibition were significant independent predictors of long acting reversible contraceptives use. Conclusions: There is low utilization of LARCs in the study area. The results imply the need for designing appropriate behavior change communication about family planning, especially about LARCs using Health Extension Workers and women’s development army to encourage informed choice and use of long acting reversible contraceptives as a method mix.