Patient knowledge and intention to use the intrauterine contraceptive device (IUCD) at a tertiary level hospital.

Abstract

Background. The intrauterine contraceptive device (IUCD) is a highly effective and safe method of contraception. Prevention of unwanted pregnancies has made its use a matter of national priority in certain countries. Despite numerous advantages and suitability, the uptake of the IUCD is poor. Patients in South Africa (SA) seem to lack knowledge regarding this contraceptive. Objectives. To determine the quantity and quality of knowledge about the IUCD, and to evaluate its acceptability for future use. Methods. A prospective cross-sectional study was conducted at Pelonomi Tertiary Hospital. A total of 201 consecutive patients were interviewed using structured questionnaires: of these, 193 formed the final study group. Results. Almost half (49.2%, n=95) of our patients were aware of the existence of the IUCD. Its use was very low, with only one patient having used it before. Overall qualitative knowledge was poor, even among those aware of the existence of the IUCD. There was a significant association between level of education and knowledge, with patients having passed grade 12 or higher significantly more likely to have knowledge of the IUCD than those at lower levels (relative risk 1.57, 95% confidence interval 1.18 -2.08). Forty-five percent (n=86) of patients indicated a desire for future IUCD use. Conclusion. Despite the availability of the IUCD in SA clinics and hospitals, its uptake is poor. Awareness of this method seems to have improved over the past few years, but the qualitative knowledge is still considerably lacking. Education plays a major role in the knowledge of contraception. Better educational aids at all facilities will increase its use and reduce unwanted pregnancies. The intrauterine contraceptive device (IUCD), a long-acting re versible contraceptive (LARC), has been shown to be one of the most reliable contraceptive methods, which can be considered as effective as tubal ligation.[1] Advantages of the IUCD include reversibility, long-term efficacy and confidentiality.[2] It is also considered safe and effective for use in selected HIV-infected patients. [3] Worldwide there is a high prevalence of teenage and unwanted pregnancies with an increasing incidence every year, [4] and abortion rates in SA remaining virtually unchanged.[5] In a study performed in the USA, 42% of adolescents reported having been sexually active at least once in their lives. The methods of contraception used by this group, however, were mostly those with a relatively high failure rate with typical use, such as withdrawal, oral contraception or condom use. [6] Unintended pregnancies have been reported as being a result of low use of LARCs. These methods have been suggested to lower the rate of unwanted pregnancies, and the use of the IUCD has been made a national priority in the USA since 2009. [7] Currently the IUCD is the best method of contraception for high-risk obstetric patients. This group includes patients with previous venous thrombo-embolism, ovarian cancer, valvular heart disease, and those with chronic diseas...

Knowledge and Attitude concerning use of Intrauterine Contraceptive Device among Women attending Family Planning at Makambako RCH in Njombe-Tanzania

“…[2] Study done in primary care family planning clinics in Cape Town showed that the knowledge of the IUCD as the contraceptive method was very poor, despite its availability it was underused and not a preferred method to prevent pregnancy, shows that 41% of women had heard about this method but that only 4% had ever used it. [3] The study done in South Africa showed that there was lack of knowledge among the participants in the study regarding IUCD; therefore, despite the availability of the IUCD in SA clinics and hospitals, its uptake was poor. Awareness of this method seemed to have improved over the past few years but the knowledge was considerably lacking.…”

Barriers and Enablers Influencing Women's Adoption and Continuation of Vaginally Inserted Contraceptive Methods: A Literature Review

“…2018; Callahan et al. 2019; Van Der Westhuizen and Hanekom 2016; Ndegwa et al. 2014; Jairaj and Dayyala 2016; Eva et al.…”

“…2016; Scavuzzi, Souza, and Amorim 2016; Mahlalela and Maharaj 2015; Jairaj and Dayyala 2016; Hayes and Kilbourne‐Brook 2016b; Kyamwanga et al. 2014; Mathenjwa and Maharaj 2012; Van Der Westhuizen and Hanekom 2016). Many women saw the ability to use a method while breastfeeding as a positive factor (Huber‐Krum et al.…”

“…2015; Huber‐Krum et al. 2019; Van Der Westhuizen and Hanekom 2016; Jairaj and Dayyala 2016; Danna et al. 2019; Todd et al.…”

Are myths surrounding long-acting reversible contraception the reason for a huge unmet need for spacing pregnancies?

“…In African countries, knowledge of IUCD ranged from 24% to 84% in various studies. [ 12 13 14 ] This implies that promotion and awareness campaigns of family planning methods needs to be upscaled by the health department.…”