Factors associated with long acting and permanent contraceptive methods use in Ethiopia

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Abstract

Background

Long acting and permanent contraceptives methods are more effective, save cost and enable women to control their reproductive lives better. Although the Ethiopian government is promoting its use through various mechanisms, the level of use is low. Therefore, this study was designed to identify factors associated with long acting and permanent contraceptive methods use in Ethiopia.

Methods

Four Ethiopian demographic and health survey data were used to examine trends of long acting and permanent contraceptive methods use. To identify factors associated with long acting and permanent contraceptive methods use, the 2016 Ethiopian demographic and health survey data was used. The data was accessed from the demographic and health survey program data base. Data analysis was done using Stata 15.1. Descriptive analysis was used to describe socio-economic and other variables of the study participants. Data were weighted and design effect was considered during analysis. Multicollinearity was assessed using variance inflation factor. Finally, multinomial logistic regression model was used to identify factors associated with long acting and permanent contraceptive methods use.

Results

Long acting and permanent contraceptive methods use increased significantly from 0.6% in 2000 to 11.6% in 2016. The odds of long acting and permanent contraceptive methods use was higher among richer women (AOR 2.6; 95%CI 1.2–5.4), women who were sales workers (AOR 2.1; 95%CI 1.1–3.9) and women whose ideal number of children was high (AOR; 4.2, 95%CI 1.4–13.0). But the odds of long acting and permanent contraceptive methods use was lower among female headed households (AOR 0.2: 95%CI 0.1–0.5) and women who had history of abortion (AOR 0.2: 95%CI 0.1–0.5).

Conclusion

Long acting and permanent contraceptive methods use increased significantly in Ethiopia. Wealth index, women’s occupation, ideal number of children, sex of head of the household and history of abortion were factors associated with long acting and permanent contraceptive methods use in Ethiopia. Improving economic status of women may help improve long acting and permanent contraceptive methods use in Ethiopia.

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Most cited references 11

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Strategies to prevent unintended pregnancy: increasing use of long-acting reversible contraception.

P Blumenthal, A Voedisch, K. Gemzell-Danielsson (2015)

Despite increasing contraceptive availability, unintended pregnancy remains a global problem, representing as many as 30% of all known pregnancies. Various strategies have been proposed to reverse this disturbing trend, especially increased use of long-acting reversible contraceptive (LARC) methods. In this review we aim to discuss the role of LARC methods and importance of contraceptive counseling in reducing unintended pregnancy rates. References/resources cited were identified based on searches of medical literature (MEDLINE, 1990-2009), bibliographies of relevant publications and the Internet. LARC methods-copper intrauterine devices (IUDs), progestogen-releasing intrauterine system and injectable and implantable contraceptives-are safe and effective contraceptive options (unintended pregnancy rates with typical versus perfect use: 0.05-3.0 versus 0.05-0.6%) that are appropriate for a wide range of women seeking to limit or space childbearing. Despite their safety and efficacy records, these methods remain underutilized; injectable and implantable methods are used by an estimated 3.4% and intrauterine methods by 15.5% of women worldwide. LARC methods require no daily or coital adherence and avoid the adverse events and health risks of estrogen-containing contraceptives. The copper IUD and progestin-only injections and implants have been shown to be more cost-effective than more commonly used methods, such as condoms and the pill (5-year savings: $13,373-$14,122, LARC; $12,239, condoms; $12,879, pill). Women who are considering use of LARC methods should receive comprehensive contraceptive counseling, as women who receive counseling before use demonstrate higher rates of after-use method satisfaction, continuation and acceptance than those who do not.

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Knowledge and attitudes towards use of long acting reversible contraceptives among women of reproductive age in Lubaga division, Kampala district, Uganda

Ronald Anguzu, Raymond Tweheyo, Juliet Sekandi … (2014)

Background Uganda has one of the highest total fertility rates globally and in Sub-Saharan Africa. Her high fertility is mainly attributed to the high unmet need for family planning. Use of Long-acting reversible contraceptives (LARC) is low (13%) in Uganda yet they are the most cost-effective contraceptives. This study aimed to assess the reproductive aged women’s knowledge, attitudes, and factors associated with use of LARC. Methods A cross-sectional study was conducted involving 565 women (15–49 years) attending private and public health facilities in Lubaga division, Kampala district. Semi-structured questionnaires were used to measure knowledge, attitudes and factors associated with use of LARC; Intra-Uterine Devices, Implants and Injectables. The outcome variable was current use of LARC. A generalized linear regression model was run in STATA version12.0. Prevalence Risk Ratios for associations between current LARC use and independent factors were obtained and regarded significant at 95% CI with p < 0.05. Results Mean age (SD) and current use of LARC was 26.34 (5.35) and 31.7% respectively. Factors associated with current use of LARC were; previous use adj.PRR 2.89; (95% CI 2.29, 3.81), knowledge of implant administration site adj.PRR 1.83; (95% CI 1.17, 2.87), and perception that; male partner decisions positively influence their contraceptive choices adj.PRR 1.49; (95% CI 1.18, 1.88). Contrary, perception that LARC should be used by married women was negatively associated with use of LARC adj.PRR 0.63; (95% CI 0.44, 0.90). Conclusion Knowledge about site of administration, previous use of LARC and women’s attitude that male partners’ choice influence their contraceptive decisions were positively associated with current use of LARC. Contrary, the attitude that LARC was for married women was negatively associated with its use. This study suggests a need to strengthen client education about LARC to dispel possible myths and to consider integrating male partner’s decision making in contraceptive choices for women.

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The public costs of births resulting from unintended pregnancies: national and state-level estimates.

Kathryn Kost, Adam Sonfield, Joshua Gold … (2011)

Births resulting from unintended pregnancies are associated with substantial maternity and infant care costs to the federal and state governments; these costs have never been estimated at the national and state levels. The proportions of births paid for by public insurance programs in 2006 were estimated, by pregnancy intention status, using data from the Pregnancy Risk Assessment Monitoring System and similar state surveys, or were predicted by multivariate linear regression. Public costs were calculated using state-level estimates of the number of births, by intention status, and of the cost of a publicly funded birth. In 2006, 64% of births resulting from unintended pregnancies were publicly funded, compared with 48% of all births and 35% of births resulting from intended pregnancies. The proportion of births resulting from unintended pregnancies that were publicly funded varied by state, from 42% to 81%. Of the 2.0 million publicly funded births, 51% resulted from unintended pregnancies, accounting for $11.1 billion in costs-half of the total public expenditures on births. In seven states, the costs for births from unintended pregnancies exceeded a half billion dollars. Public insurance programs are central in assisting American families in affording pregnancy and childbirth; however, they pay for a disproportionately high number of births resulting from unintended pregnancy. The resulting budgetary impact warrants increased public efforts to reduce unintended pregnancy. Copyright © 2011 by the Guttmacher Institute.

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Author and article information

Contributors

Gedefaw Abeje Fekadu: abejegedefaw@gmail.com

Akinyinka O. Omigbodun: omigbodun@yahoo.com

Olumuyiwa A. Roberts: omigbodun@yahoo.com

Alemayehu Worku Yalew: alemayehuwy@yahoo.com

Journal

Journal ID (nlm-ta): Contracept Reprod Med

Journal ID (iso-abbrev): Contracept Reprod Med

Title: Contraception and Reproductive Medicine

Publisher: BioMed Central (London )

ISSN (Electronic): 2055-7426

Publication date (Electronic): 1 August 2019

Publication date PMC-release: 1 August 2019

Publication date Collection: 2019

Volume: 4

Electronic Location Identifier: 9

Affiliations

[1 ]ISNI 0000 0004 1794 5983, GRID grid.9582.6, Pan African University, Institute of Life and Earth Sciences (including health and Agriculture), , University of Ibadan, ; Ibadan, Nigeria

[2 ]ISNI 0000 0004 0439 5951, GRID grid.442845.b, College of Medicine and Health Sciences, School of Public Health, , Bahir Dar University, ; Bahir Dar, Ethiopia

[3 ]ISNI 0000 0004 1794 5983, GRID grid.9582.6, University College Hospital, , University of Ibadan, ; Ibadan, Nigeria

[4 ]ISNI 0000 0001 1250 5688, GRID grid.7123.7, School of Public health, College of Medicine, , Addis Ababa University, ; Addis Ababa, Ethiopia

Article

Publisher ID: 91

DOI: 10.1186/s40834-019-0091-3

PMC ID: 6670188

PubMed ID: 31388440

SO-VID: 3e266205-5e0b-48c2-a054-267a228858da

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 26 November 2018

Date accepted : 26 May 2019

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Keywords: ethiopia,long acting and permanent contraceptives,demographic and health survey

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Keywords: ethiopia, long acting and permanent contraceptives, demographic and health survey

Factors associated with long acting and permanent contraceptive methods use in Ethiopia

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Most cited references 11

Strategies to prevent unintended pregnancy: increasing use of long-acting reversible contraception.

Knowledge and attitudes towards use of long acting reversible contraceptives among women of reproductive age in Lubaga division, Kampala district, Uganda

The public costs of births resulting from unintended pregnancies: national and state-level estimates.

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