Revitalizing long-acting reversible contraceptives in settings with high unmet need: a multicountry experience matching demand creation and service delivery

Blumenthal, Paul D.; Shah, Nilpa; Jain, Kriti; Saunders, Aleen; Clemente, Corina; Lucas, Brad; Jafa, Krishna; Eber, Maxine

doi:10.1016/j.contraception.2012.10.002

Cited by 36 publications

(36 citation statements)

References 9 publications

(11 reference statements)

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“…According to our prospective FP study, only a handful of women received a long-acting or permanent method of contraception within weeks of delivering their baby. Given that a large proportion of deliveries now take place at health facilities in this area (92%), this provides an opportunity for health care providers to either counsel women on their FP options before they return home (perhaps providing a date by when the woman should return to the health facility to start contraception) or indeed to provide a service such as an implant or intrauterine device (IUD) insertion [18], [19], [20], [21].…”

Section: Discussionmentioning

confidence: 99%

Postpartum uptake of contraception in rural northern Malawi: A prospective study

2016

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ObjectivesCross-sectional estimates of contraceptive use do not provide understanding of time to postpartum uptake. This paper uses a range of Malawian data sources: a prospective study to explore time to uptake of contraception and a cross-sectional survey to assess whether sexually active postpartum women whose fecundity has returned use contraception, and whether abstaining/amenorrheic women report using contraception.Study designA demographic surveillance site (DSS) in Malawi was used to identify 7393 women aged 15–49 years eligible for a 1-year prospective study of contraception using provider-recorded data on patient-held records (2012–2013). This provided a reliable record of time to uptake of postpartum contraception. The average timing of resumption of sexual activities after postpartum abstinence and return of menses was estimated from a population-based sexual behaviour survey in the DSS (2010–2011).ResultsOf 4678 women recruited to the prospective contraception study, 442 delivered an infant during the observation period. Of these, 28.4% used modern contraception within 6 months of delivery. However, at 6–9 months after delivery, only 28.0% women had started menstruation and resumed sexual activities; of these, 77.6% used contraception. Amongst abstaining/amenorrheic women, a quarter reported contraceptive use.ConclusionsThe low uptake of postpartum contraception is likely due to many women abstaining and/or experiencing amenorrhea. Self-reports of contraceptive use amongst abstaining/amenorrheic women bring into question the quality of cross-sectional surveys and demonstrate that contraceptive use by women at low risk of pregnancy could contribute to the Malawi paradox of high contraceptive use and high fertility. Given relatively low risk of pregnancy in the postpartum period in this context, a focus on long-acting/permanent methods may be more effective to avert unintended pregnancies.ImplicationsThere has been increasing interest in the utility of postpartum contraceptive programmes to assist women to space births. Our findings suggest that, although uptake of contraception is low, this is partly due to postpartum abstinence and amenorrhea. Provision of long-acting/permanent methods will be more effective for women after delivery.

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Section: Discussionmentioning

confidence: 99%

Postpartum uptake of contraception in rural northern Malawi: A prospective study

2016

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“…The first household is randomly selected from 1 st three households after geographically leveling the households in the kebeles with local leaders. Finally, any married women available in the household during data collection and fulfilled the inclusion criteria were included [16][17][18][19][20].…”

Section: Sampling Technique or Proceduresmentioning

confidence: 99%

“…In addition, there was no such a study that assessed the determinants of long acting contraceptive at the study area. Therefore, this study aimed to identify to determinants of LACs methods utilization among reproductive age women in study area [16][17][18][19][20][21].…”

Section: Introduction Backgroundmentioning

confidence: 99%

Prevalence and Determinant Factors of Long Acting Contraceptive Utilization among Married Women of Reproductive Age in Adaba Town, West Arsi Zone, Oromia, Ethiopia

Fekadu¹,

Kumera²,

Ea³

et al. 2017

J Women's Health Care

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“…It is established that education influences the uptake of modern contraception among women in Sub-Saharan Africa 14 . This is in line with the findings of this study in which majority (45.1%) had secondary level of education and the lowest percentage (3.5%) were those with college education, this is not surprising considering the report of Gambian Demographic health Survey 2013, the percentage (32.4%) of women who had secondary level of education was three times higher (9.8%) than those with primary level of education.…”

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confidence: 99%

Uptake of long-acting reversible contraceptive devices in Western region of the Gambia

Anyanwu¹,

Alida²

2017

Afr H. Sci.

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Background: The contraceptive method has become an essential factor in the life of most women of reproductive age group; although it varies in different stages of their life course. The use of long acting reversible methods (LARC) is proposed as a strategy to reverse undesirable maternal health consequences in developing countries. Objective: To determine the uptake of long-acting reversible contraceptive in The Gambia. Methods: A community based cross-sectional study of women attending family planning clinic were studied using intervieweradministered questionnaire which included information on socio-demographic factors, reproductive health and contraceptive use of the participants. Results: About 89 % of study participants used long acting reversible contraceptive methods. Of the three commonly available long acting reversible contraceptive methods, Depo Provera was the most commonly used method; 78 of 141 (55.32%); followed by implants (43.3%) and intrauterine contraceptive (1.42%). Being housewives, with 3-4 living children and having secondary level education were associated with high uptake of LARC. Conclusion:The uptake of long acting reversible contraceptive was high; with Depo Provera as the most commonly used contraceptive method in The Gambia. There seemed to be an increase in the uptake of implants; with intrauterine contraceptive device being the least commonly used method.

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Revitalizing long-acting reversible contraceptives in settings with high unmet need: a multicountry experience matching demand creation and service delivery

Cited by 36 publications

References 9 publications

Postpartum uptake of contraception in rural northern Malawi: A prospective study

Postpartum uptake of contraception in rural northern Malawi: A prospective study

Prevalence and Determinant Factors of Long Acting Contraceptive Utilization among Married Women of Reproductive Age in Adaba Town, West Arsi Zone, Oromia, Ethiopia

Uptake of long-acting reversible contraceptive devices in Western region of the Gambia

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