Postpartum Use of Long-Acting Reversible Contraception in a Military Treatment Facility

Dahlke, Joshua D.; Ramseyer, Abigail M; Terpstra, Eric R.; Doherty, Dorota; Keeler, Sean; Magann, Everett F.

doi:10.1089/jwh.2011.2845

Cited by 11 publications

(6 citation statements)

References 10 publications

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“…The relationship between the wealth status indicator and PPFP utilization to a greater extent is related to both financial autonomy and access to resources necessary to purchase the required health inputs [7, 26]. Further in Rwanda, an equity analysis of performance based financing in Rwanda, showed increased utilization of services at health facilities across wealth status [20, 27, 28, 29]. Among the few studies conducted in both countries, one showed wealth status as a significant factor in influencing pregnancy history and current use of contraception in Rwanda and Burundi [30].…”

Section: Discussionmentioning

confidence: 99%

Postpartum family planning utilization in Burundi and Rwanda: a comparative analysis of population based cross-sectional data

Rutaremwa¹,

Kabagenyi²

2018

Pan Afr Med J

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IntroductionPromotion of modern family planning is a major policy action for Africa to harness the demographic dividend. Family planning is an important public health intervention for maternal and child health.MethodsAnalysis was based on data from Demographic and Health Surveys conducted in 2010 on samples of women from Burundi (3396) and Rwanda (4670). Descriptive and multivariate logistic regression analyses to examine the contribution and comparison of the various predictors of uptake of modern contraceptives during the postpartum period (PPFP) in the two countries were carried out using STATA statistical software.ResultsDescriptive findings show only 20% of the samples of women in Burundi used while more than half of the women (51%) were using PPFP. Utilization of PPFP was significantly associated with primary (OR = 1.3, 95% CI = 1.1-1.6) and higher education (OR = 2.2, 95% CI = 1.6-3.1) in Burundi. Similarly in Rwanda increased use of PPFP in primary was (OR = 1.4, 95% CI = 1.2-1.6) while secondary education (OR = 1.6, 95% CI = 1.2-2.1). Protestant women were less likely to use PPFP in both Burundi (OR = 0.75, 95% CI = 0.6-0.9) and Rwanda (OR = 0.69, 95% CI = 0.6-0.8). Other significant variables in the regression models of both countries included wealth status, age of woman, number of living children and exposure to media. Professional birth delivery assistance was significant only in Rwanda.ConclusionEnhancing postpartum contraceptive use should target women with low education, low wealth status, and that the media has an important role to play in this transformation. Policies and programs must be put in place to ensure that the rural urban differences are eradicated.

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Section: Discussionmentioning

confidence: 99%

Postpartum family planning utilization in Burundi and Rwanda: a comparative analysis of population based cross-sectional data

Rutaremwa¹,

Kabagenyi²

2018

Pan Afr Med J

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“…This implies that PPFP was higher among the younger women compared to the older women. In a study on use of long active reversible contraceptives at a military facility in the US, the study revealed that younger women <25 years were more likely to use these methods [ 33 ]. Similar results were also reported concerning current contraceptive use in Malawi, where younger women were more likely to use contraceptives compared to older women [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Predictors of modern contraceptive use during the postpartum period among women in Uganda: a population-based cross sectional study

et al. 2015

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BackgroundThe rationale for promotion of family planning (FP) to delay conception after a recent birth is a best practice that can lead to optimal maternal and child health outcomes. Uptake of postpartum family planning (PPFP) remains low in sub-Saharan Africa. However, little is known about how pregnant women arrive at their decisions to adopt PPFP.MethodsWe used 3298 women of reproductive ages 15–49 from the 2011 UDHS dataset, who had a birth in the 5 years preceding the survey. We then applied both descriptive analyses comprising Pearson’s chi-square test and later a binary logistic regression model to analyze the relative contribution of the various predictors of uptake of modern contraceptives during the postpartum period.ResultsMore than a quarter (28%) of the women used modern family planning during the postpartum period in Uganda. PPFP was significantly associated with primary or higher education (OR=1.96; 95% CI=1.43-2.68; OR=2.73; 95% CI=1.88-3.97 respectively); richest wealth status (OR=2.64; 95% CI=1.81-3.86); protestant religion (OR=1.27; 95% CI=1.05-1.54) and age of woman (OR=0.97, 95% CI=0.95-0.99). In addition, PPFP was associated with number of surviving children (OR=1.09; 95 % CI=1.03-1.16); exposure to media (OR=1.30; 95% CI=1.05-1.61); skilled birth attendance (OR=1.39; 95% CI=1.12-1.17); and 1–2 days timing of post-delivery care (OR=1.68; 95% CI=1.14-2.47).ConclusionsIncreasing reproductive health education and information among postpartum women especially those who are disadvantaged, those with no education and the poor would significantly improve PPFP in Uganda.

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“…This prospective study is important because it is one of the few published studies to describe patterns of contraceptive uptake and discontinuation among postpartum women with 1 year of follow-up in sub-Saharan Africa. Other studies among postpartum women have only been able to assess contraceptive uptake at hospital discharge or within the first 3 months postpartum [ 24 , 25 ]. We were able to describe baseline characteristics of women who used LARC over 1 year and the timing of use and discontinuation.…”

Section: Discussionmentioning

confidence: 99%

Association between contraceptive implant knowledge and intent with implant uptake among postpartum Malawian women: a prospective cohort study

Tang

Kopp²,

Stuart

et al. 2016

Contracept Reprod Med

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BackgroundLong-acting reversible contraception (LARC) can assist women with birth spacing and reduce unintended pregnancies. Sub-Saharan Africa has low uptake of the two available methods of LARC, the subdermal implant and intrauterine contraception (IUC). Our primary objectives were to: 1) calculate the incidence of LARC use among postpartum Malawian women, and 2) assess if LARC knowledge and intent to use LARC were associated with LARC uptake.MethodsThis study was a prospective cohort study of 634 postpartum women who were recruited from the postpartum ward of Bwaila Hospital in Lilongwe, Malawi. Study participants completed a baseline survey in the postpartum ward. Follow-up telephone surveys about contraceptive use were conducted at 3, 6, and 12 months postpartum. Cox proportional hazards regression analysis was performed to evaluate if implant knowledge and intent to use implant were associated with implant uptake.ResultsOne hundred thirty-seven implant and 10 IUC placements were reported over 12 months of follow-up; given the low rate of IUC uptake, further analysis was only done for implant uptake. The incidence rate for implant uptake was 35.6 per 100 person-years (95 % CI 30.0, 42.2). Correct implant knowledge (adjusted HR = 1.69; 95 % CI 1.06, 2.68) and intent to use implant (adjusted HR 1.95; 95 % CI 1.28, 2.98) were both associated with implant uptake.ConclusionsMore women reported implant use than IUC use in our study. Correct implant knowledge and intent to use implant were both associated with implant uptake, with a stronger association for intent. Interventions to increase LARC uptake should focus on improving LARC knowledge and removing barriers to LARC.Trial registrationClinical Trial Registration #: NCT01893021

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Postpartum Use of Long-Acting Reversible Contraception in a Military Treatment Facility

Abstract: In our institution, LARC is highly desired and utilized within 12 weeks postpartum with African-American ethnicity and age <25 years predictive of use.

Cited by 11 publications

References 10 publications

Postpartum family planning utilization in Burundi and Rwanda: a comparative analysis of population based cross-sectional data

Postpartum family planning utilization in Burundi and Rwanda: a comparative analysis of population based cross-sectional data

Predictors of modern contraceptive use during the postpartum period among women in Uganda: a population-based cross sectional study

Association between contraceptive implant knowledge and intent with implant uptake among postpartum Malawian women: a prospective cohort study

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