Knowledge and use of lactational amenorrhoea as a family planning method among adolescent mothers in Uganda: a secondary analysis of Demographic and Health Surveys between 2006 and 2016

Abstract

ObjectiveTo assess the level of knowledge and use of the lactational amenorrhoea method (LAM) among adolescents in Uganda between 2006 and 2016 using nationally representative data from Demographic and Health Surveys (DHS).DesignCross-sectional design involving analysis of three DHS (2006, 2011, and 2016) in Uganda.SettingThe data collection took place in Uganda. The DHS are nationally representative surveys on a wide range of indicators including contraception knowledge and use.ParticipantsA total of 1948 (2006), 2026 (2011) and 4276 (2016) adolescents (15–19 years) and 1662 (2006), 1666 (2011) and 3782 (2016) young women (20–24 years) were included.Primary outcome measureUse of LAM among adolescents and young women with a live birth within 6 months before each survey.ResultsIn 2016, less than 1.0% (95% CI: 0.2% to 3.5%) of eligible adolescents correctly used LAM, and 56.3% (95% CI: 48.8% to 63.6%) were passively benefitting from LAM. The median duration of postpartum amenorrhoea (PPA) among adolescents in 2016 was 6.9 months, declining from 8.3 months in 2006. Compared with adolescents (56.7%), eligible young women had higher knowledge of LAM (64.1%) and higher median PPA duration (8.0 months) in 2016. The percentage of eligible adolescents who met the LAM criteria irrespective of whether they reported LAM use (were protected by LAM) decreased from 76.4% (95% CI: 66.5% to 84.0%) in 2006 to 57.2% (95% CI: 49.5% to 64.6%) in 2016. More than 50.0% (95% CI: 49.2% to 63.8%) of eligible adolescents were aware of LAM in 2016, increasing from 6.0% (95% CI: 2.5% to 13.8) in 2006.ConclusionDespite increasing awareness of LAM, reported and correct use of LAM was low among adolescents who could benefit from this method in Uganda, and declining over time. Support for adolescents to harness the benefits of correct LAM use should be increased. Additional research is needed to better understand the dynamics of LAM use in adolescents, including the transition to use of other modern contraceptive methods.

Postpartum family planning uptake in Uganda: findings from the lot quality assurance sampling survey

“…Conversely, the present study observed higher odds of PPFP use among mothers who were not breastfeeding which may be attributed to several factors. It is possible that breastfeeding mothers were aware of the benefits of the LAM but had inadequate knowledge or did not fully adhere to the criteria for LAM use [ 35 , 36 ]. Additionally, it is worth noting that only a small percentage (5%) of mothers who reported using PPFP cited LAM as their preferred method [ 2 , 36 , 37 ].…”

“…It is possible that breastfeeding mothers were aware of the benefits of the LAM but had inadequate knowledge or did not fully adhere to the criteria for LAM use [ 35 , 36 ]. Additionally, it is worth noting that only a small percentage (5%) of mothers who reported using PPFP cited LAM as their preferred method [ 2 , 36 , 37 ]. However, it is important to highlight that a significant majority (43%) of mothers who did not use PPFP mentioned breastfeeding as the reason for non-utilization.…”

The more, the better: influence of family planning discussions during the maternal, newborn and child health continuum of care on postpartum contraceptive uptake and method type among young women in Ethiopia

“…A focus on AGYW is pertinent as they often face barriers to access and use of contraception (overall or postpartum) related to social norms around marriage and childbearing 30 – 34 , lack of agency 35 , lack of knowledge 36 , or provider biases 37 , 38 . Further, AGYW are at risk of negative health outcomes for themselves and their children as a result rapid repeat pregnancies 25 – 27 .…”

“…Globally, complications from pregnancy and childbirth are the leading causes of death among AGYW 24 , and AGYW who experience closely spaced births are at risk of negative health outcomes for themselves and their children 25 . Additionally, evidence from Uganda and Nigeria indicates that AGYW who experience a birth have been shown to be at greater risk of another birth within 12 months, which has negative implications for women’s educational attainment, household wealth and fertility 26 , 27 . AGYW face unique challenges to PPFP access and use related to social norms around demonstrating fecundability and community approval of FP use among young people 28 – 32 , lack of agency to use FP 33 , limited information about contraceptive options 34 , and provider bias whereby providers limit access to FP based on parity, marital status or age 35 , 36 .…”

Komunikasi Informasi dan Edukasi (KIE) tentang Kontrasepsi sebagai Upaya Mengatur Jarak Kehamilan yang Sehat pada Ibu Menyusui

“…Kontrasepsi alami yang bisa menjadi pilihan utama ibu yang menyusui bayi secara ekslusif adalah Metode Amenorea Laktasi (MAL). Walaupun pengetahuan dan kesadaran akan amannya MAL pada proses laktasi, namun implementasi MAL sangat rendah dibandingkan kontrasepsi hormonal lain (Birabwa et al, 2022;Mufdlilah et al, 2021). Penggunaan kontrasepsi masa menyusui yang mengandung hormonal harusnya mendapatkan perhatian khusus dari calon akseptor dan tenaga kesehatan karena dapat mempengaruhi produksi ASI.…”