Utilization and predictors of long acting reversible contraceptive methods among reproductive age women in Hawassa city, South Ethiopia: a community based mixed methods

Abstract

Background Long acting reversible contraceptive methods are highly effective, safe and provide uninterrupted protection to women for 3 to 12 years, yet are little used in the Ethiopia. Assessment of the utilization and predictors of long acting reversible contraceptive methods assist health planners to prioritize promotion strategies, and is a fundamental step for intervention. Therefore, this study aimed to assess the utilization and predictors of long acting reversible contraceptives among reproductive age women in Hawassa city, South Ethiopia; 2019. Methods A community-based cross-sectional study was conducted using a mixed method among the sample of 660 reproductive age women in Hawassa city, South Ethiopia from January 1–30, 2019. We have used a systematic and purposive sampling technique to select the study participants. A structured interview-administrated questionnaire and focus group discussion were used to collect the data. The data were entered using Epi data version 3.1 and analyzed using SPSS version 20. Chi-square (X2) test was used to determine the overall association between explanatory and outcome variables. The variables were entered into the multivariable model using the backward stepwise regression approach. Bi-variable and multivariable logistic regression analyses were conducted. The qualitative data were analyzed using a manual thematic analysis technique. Results The overall utilization of long acting reversible contraceptive methods was 22% (95% CI = 19.50–25.50%). Among this, 17.5 and 4.5% of women utilized the implants and IUCD, respectively. Good knowledge (AOR = 4.0; 95% CI = 1.66–9.60; P = 0.001) and positive attitude (AOR = 7.9; 95% CI = 3.84–16.10; P = 0.001) of women about LARC methods were positively associated with utilization of LARC methods. The odds of utilizing LARC methods increased 8.2 times for women who have no desire to have a child (AOR = 8.2, 95% CI = 3.13–21.30) as compared to those who have the desire to have a child. The discussion of women about LARC methods with providers (AOR = 4.1; 95% CI = 1.24–5.24) and husbands (AOR = 2.7; 95% CI =1.02–7.20) were positively associated with utilization of LARC methods. These findings were supported by the individual, institutional and socio-cultural qualitative findings. Conclusions The utilization of LARC methods far below the national target (22 V 40%) in the study area. Good knowledge and positive attitude about LARC methods, no desire to have a child, discussion with husbands and providers were major predictors of the LARC methods utilization. Increasing knowledge and positive attitude of the women about LARC methods using various methods of health education should be considered.

Level and determinants of long-acting family planning utilization among reproductive age women in Harar, Eastern Ethiopia

“…In our study, the prevalence of LAFP utilization was higher (74.7%), than other similar studies conducted in different parts of Ethiopia, 65.4% in Lay Armachiho, North Gondar, 5 20.9% in Adama, 22 20.4% in Gondar town, 23 and 19.5% in Gojjam. 21 Similarly, studies from Eastern and Southern Ethiopia indicate a prevalence of 38% in Harar, 24 22% in Hawassa, 25 and 7.3% in Jinka, 20 respectively. This difference could be due to the difference in sample size, sample population, and the fact, that our study was conducted at the community level.…”

Prevalence of long-acting reversible contraceptive uses and predictors among Ethiopian women over the past five years. A systematic review and meta-analysis

“…The study subjects in twenty-four investigations were women of reproductive age ( (11, 13-16, 18-33, 35-37), three were about postpartum women (12,28,34), one study was about HIV/AIDS-positive women of reproductive age (20), and one study was about female health professionals of reproductive age (15) . The average age of study participants was ranged from 25 (33) to 36(37) years old, with a range of 15-49 years (17,19). Six studies were done in the Oromia region (12,19,23,24,29,31), nine studies in the Amhara region (13-15, 17, 20, 21, 26, 35, 37)and nine studies in SNNP region (16,18,19,22,27,28,33,34,36), and one study each in the Afar region (11), Harari region (30) ,and Addis Ababa city administration (32).…”

“…The average age of study participants was ranged from 25 (33) to 36(37) years old, with a range of 15-49 years (17,19). Six studies were done in the Oromia region (12,19,23,24,29,31), nine studies in the Amhara region (13-15, 17, 20, 21, 26, 35, 37)and nine studies in SNNP region (16,18,19,22,27,28,33,34,36), and one study each in the Afar region (11), Harari region (30) ,and Addis Ababa city administration (32). Sample size of included studies ranges from 262 (27) to 731(36) and prevalence of LARC users among Ethiopian women over the last ve years ranges from 12.6%(21) to 53.2% (12).…”

Long acting reversible contraceptive utilization and its associated factors among modern contraceptive users in high fertility sub-Saharan Africa countries: a multi-level analysis of recent demographic and health surveys

“…Depending on the type, it can provide 3 to 5 years of protection. The intrauterine contraceptive device (IUCD) is also a reversible long-acting contraceptive, which is a small device placed in the uterus to prevent pregnancy [ 8 ].…”

“…In addition, different predictors have been identified as being associated with LARC methods. These predictors include socio-demographic aspects, behavioral characteristics, and institutional, and service factors [ 8 , 22 ].…”