Factors associated with utilization of long acting and permanent contraceptive methods among married women of reproductive age in Mekelle town, Tigray region, north Ethiopia

Abstract

BackgroundEthiopia is the second most populous country in Sub-Saharan Africa. Total Fertility Rate of Ethiopia is 5.4 children per women, population growth rate is estimated to be 2.7% per year and contraceptive prevalence rate is only 15% while the unmet need for family planning is 34%. Overall awareness of Family Planning methods is high, at 87%. The prevalence of long acting and permanent contraceptive methods (LAPMs) in Tigray region was very low which accounts for 0.1% for implants and no users for intra-uterine contraceptive device (IUCD) and female sterilization. Moreover almost all modern contraceptive use in Ethiopia is dependent on short acting contraceptive methods. The objective of this study was to assess factors associated with utilization of long acting and permanent contraceptive methods (LAPM) among married women of reproductive age group in Mekelle town.MethodsA cross sectional community based survey was conducted from March 9-20, 2011. Multistage sample technique was used to select the participants for the quantitative methods whereas purposive sampling was used for the qualitative part of the study. Binary descriptive statistics and multiple variable regressions were done.ResultsThe study consisted of quantitative and qualitative data. From the quantitative part of the study the response rate of the study was 95.6%. Of the qualitative part two FGDs were conducted for each married women and married men. 64% of the married women heard about LAPMs. More than half (53.6%) of the married women had negative attitude towards practicing of LAPMs. The overall prevalence of LAPMs use was 12.3% however; there were no users for female or male sterilization. The main reason cited by the majority of the married women for not using LAPMs was using another method of contraception 360 (93.3%). Mothers who had high knowledge were 8 times more likely to use LAPMs as compared with those who had low knowledge (AOR = 7.9, 95% CI of (3.1, 18.3). Mothers who had two or more pregnancies were 3 times more likely to use LAPM as compared with those who had one pregnancy (AOR = 2.7, 95% CI of (1.4, 5.1).ConclusionA significant amount of the participants had low knowledge on permanent contraceptive particularly vasectomy. More than half (53.6%) of married women had negative attitude towards practicing of LAMPs. Few of married women use female sterilization and none use of female sterilization and or vasectomy. Positive knowledge of LAMPs, women who had two and above pregnancies and women who do not want to have additional child were significantly associated. Information education communication should focus on alleviating factors hinder from practicing of LAPMs.

Acceptance and Positive Attitude Increased Utilization of Long Acting and Permanent Family Planning Methods Among Reproductive Age Group Women from Debre Berhan District, Ethiopia: Quantitative and Qualitative Analysis

“…The major source of LAPMs for the women was a public health facility (80.1%). This finding is consistent with EDHS report of 2011(80%), Butajira (80.8%) and Mekelle 83% and majority of women had got services from public health facility [8,12,15]. IUD were the most extensively used LAPMs around the world but in this study it was the reverse and very low.…”

“…This difference could be as a result of study setting, time of the study, the deployments of urban health extension worker which may supported to bring positive attitude towards LAPMs at community level, currently different Medias were promoting utilization of LAPMs and the government attention towards these methods increased utilization rate. Moreover, this result was consistent with research done in Iran which was 27.7% [12,13]. The majority of the women used implant 117(86.03%) followed by IUD 16(11.76) and only 3(2.21%) of the women were using female sterilization.…”

“…Current utilization of LAPMs found to be higher for implant 117(86.03%). This is in line with study done in Mekelle and Debre Markos; majority of women were used implants among current user of LAPMs which 87% and 81.2% [12,14]. The major source of LAPMs for the women was a public health facility (80.1%).…”

“…These results were similar with research done in Bale and Mekelle which showed that child spacing was 54% and limiting child was 40.6% in Bale. In addition, in Mekelle town it was reported that child spacing (65%) and limiting the number of children (17%) [12,13]. Current utilization of LAPMs found to be higher for implant 117(86.03%).…”

“…The sample size was calculated using the following assumptions; proportion (p) of utilization of long acting and permanent contraceptive methods of Ethiopia is 12.3% [12]. Confidence level of 95%, which means α (alpha) at 0.05 and Z α/2 =1.96 and acceptable difference of 3% (0.03).…”