Timely initiation of postpartum contraceptive utilization and associated factors among women of child bearing age in Aroressa District, Southern Ethiopia: a community based cross-sectional study

Abstract

BackgroundGlobally, more than 90% of women during the first year of postpartum period want to either delay or avoid future pregnancies. The first year postpartum period is more crucial time to use modern contraceptives that enhance maternal and child health, so more attention should be given on time of initiating modern contraceptive utilization after delivery. Therefore, the aim of this study was to assess the magnitude and associated factors of timely initiation of postpartum contraceptive utilization among women of child bearing age in Aroressa district, Southern Ethiopia.MethodsThe study was conducted in Aroressa district from March 15 to April 15, 2017. A community based cross-sectional study design with interviewer administered structured and pretested questionnaire was used. Multistage sampling technique was employed involving a total of 695 women of child bearing age who delivered a child in the past 12 months prior to the study period. Data were cleaned, coded and entered into Epi data version 3.1, then exported to statistical package for social science version 20 for analysis. Descriptive statistics, Bivariate and Multivariate logistic regression analysis were done. p-value < 0.05 was used to consider significant variables.ResultsThe magnitude of timely initiation of postpartum contraceptive utilization was found to be 31.7% [95% CI (28, 36)]. Antenatal care [AOR = 1.94, 95% CI (1.23, 3.01)], postnatal care [AOR = 1.90, 95%CI (1.23, 2.94)], spousal communication on contraceptive methods [AOR = 1.63, 95% CI (1.09, 2.41)] and resumption of menses after delivery [AOR = 2.6, 95% CI (1.47, 3.81)] were predictors positively associated with timely initiation of postpartum contraceptive utilization.ConclusionThe magnitude of timely initiation of postpartum contraceptive utilization was low. Strengthening integration of family planning information with antenatal and postnatal care follow up and encouraging spousal communication by promoting information, education and communication activities is important to enhance contraceptive use on timely manner.

The role of maternal health care services as predictors of time to modern contraceptive use after childbirth in Northwest Ethiopia: Application of the shared frailty survival analysis

“…These studies showed a dose-response type of relationship between antenatal care and postpartum contraception adoption; that is the likelihood of using postpartum contraception increased when women had frequent antenatal contacts. Our result also demonstrated a significant association between postpartum contraceptive use and early postnatal care, which is in agreement with other studies [20,27].…”

“…The finding is comparable with the finding of the study done in Debre Tabor town, Northwest Ethiopia 63.0% (95% CI: 59%; 67.4%) [26]. This result was, however, higher than the 31.7% prevalence in Southern Ethiopia [20], 45.4% in western Ethiopia [27], and 29.3% in Northern Ethiopia [19], and lower when compared to the studies done in Hosana town (72.9%), Addis Ababa, Ethiopia (80.3%), and 86.3% of Kenya [28][29][30]. The low level of contraceptive use found in this study might reflect the over-reliance of lactating women on breastfeeding and menstruation status.…”

“…Nonetheless, the observed association between prenatal care and contraceptive use is not unique to this study and has been reported in earlier studies from Ethiopia [20,27,32], and other countries [8,16]. These studies showed a dose-response type of relationship between antenatal care and postpartum contraception adoption; that is the likelihood of using postpartum contraception increased when women had frequent antenatal contacts.…”

“…The low level of contraceptive use found in this study might reflect the over-reliance of lactating women on breastfeeding and menstruation status. It is evidenced that these group of women oftentimes do not realize that they are at risk of pregnancy when they are amenorrheic or breastfeeding [15,20,26]. Though breastfeeding is universal in Ethiopia, and exclusive breastfeeding up to 6 months after birth is an important contraceptive method which is highly recommended by the Ministry of Health of Ethiopia, the status of exclusive breastfeeding in the country is less than the global recommendations [31].…”

“…Several studies have been carried out on postpartum contraceptive use in the study area in particular and Ethiopia at large [18][19][20]; yet, most of the earlier studies, if any, have ignored the hierarchical facts. It is, however, evidenced that clustering (frailty) has an effect on modeling the predictors of time to contraception [21].…”