Rural women are more likely to use long acting contraceptive in Tigray region, Northern Ethiopia: a comparative community-based cross sectional study

Abstract

BackgroundIn the latest report of Ethiopian Demographic and Health Survey (EDHS) 2011, the maternal mortality ratio (MMR) was estimated at 676/100,000 live births, with total fertility rate at 4.8 and contraceptive prevalence rate at 29 %. Knowledge and utilization of long acting contraceptive in the Tigray region are low. This study aims at comparing and identifying factors related to the utilization of long acting contraceptive in urban versus rural settings of Ethiopia.MethodsA comparative community-based cross-sectional study, comprised of quantitative and qualitative methods, was conducted among 1035 married women in Wukro (urban area) and Kilteawlaelo district (rural area) in March, 2013. Stratified sampling technique was employed to approach the study participants. Data were analyzed using SPSS version 20. Multiple logistic regression analysis was used to identify the respective effect of independent predictors on utilization of long acting contraceptive.ResultsThe proportion of long acting contraceptive use among the respondents was 19.9 % in the town of Wukro and 37.8 % in the district of Kilteawlaelo. Implanon was the most common type of contraceptive used in both districts, urban (75 %) and rural (94 %). The odds of using the long acting contraceptive method were three times higher among married women in the rural areas as compared with the urban women [AOR = 3. 30; 95 %, CI:2.17, 5.04]. No or limited support from male partners was an obstacle to using long acting contraceptive method [AOR = 0. 24, 95 of CI: 0.13, 0.44]. Moreover, married women whose partner did not permit them to use long acting contraceptive [AOR = 0. 47, 95 % of CI: 0.24, 0.92] and women who attended primary education [AOR = 0.24, 95 %, CI: 0.13, 0.44] were significantly associated with long acting contraceptive use.ConclusionOverall, the proportion of long acting contraceptive use has found to be low. Rural women were more likely to use long acting contraceptives as compared to urban women. Moreover, educational status and the partner’s permission to use contraception could influence the utilization of long acting contraceptives.

Family Planning for Women With Severe Mental Illness in Rural Ethiopia: A Qualitative Study

“…Women's lack of adequate knowledge about family planning and fear of side effects played a role in the decision to use contraceptives. This misunderstanding has implications for the uptake and discontinuation of contraception and accords with previous reports from Ethiopia (24,(43)(44)(45)(46). In the present study, a majority of the women were aware of the existence of injectable, pills and implanted contraception.…”

Family Planning for Women with Severe Mental Illness in Rural Ethiopia: A Qualitative Study

“…Women's lack of adequate knowledge about family planning and fear of side effects played a role in the decision to use contraceptives. This misunderstanding has implications for the uptake and discontinuation of contraception and accords with previous reports from Ethiopia [24,[42][43][44][45].In the present study, a majority of the women were aware of the existence of injectable, pills and implanted contraception. Although some of the women knew about the intrauterine contraceptive device and condoms, some related condom use with promiscuity rather than a method used in family planning.…”

Factors influencing post-partum women’s choice of an implantable contraceptive device in a rural district hospital in South Africa

“…Similar results were found in an Ethiopian study where women reported having a negative attitude towards long acting contraceptive methods (LACM) due to allegations of side effects among the community. 31 In this study women who were exposed to positive feedback displayed a favourable attitude towards the Implanon® and were willing to accept the device. This finding is encouraging but contradicts findings in the First World where only 20% of women found that peers influenced their contraceptive choice.…”

“…This is in direct contrast with the study done in Ethiopia where they found a significant reduction in LACM use if the partner did not agree with their choice of contraception and two-thirds of the women obtained permission from their partners before using LARC. 31 The participants in our study had full autonomy in their choice of contraception and did not have to ask permission before choosing their method of contraception. At most, the women admitted that it might be a discussion or shared decision-making process.…”