Utilization of Immediate Postpartum Long Acting Reversible Contraceptives among Women Who Gave Birth in Public Health Facilities in Eastern Ethiopia: A Cross-Sectional Study

Abstract

Objective. Although importance of postpartum family planning is essential and immediate postpartum insertion of long acting and reversible contraceptives (LARC) is recommended, evidence on its uptake and associated factors is limited in Ethiopia. This study was conducted to assess utilization of immediate postpartum LARC among women who gave birth in selected public health facilities in eastern Ethiopia. Method. An institution-based cross-sectional study was conducted among randomly selected women who gave birth in selected public health facilities in eastern Ethiopia from 10 March to 09 April 2020. At discharge, all eligible women who gave birth in the facilities were interviewed using a pretested structured questionnaire. Data were entered using EpiData 3.1 and analyzed using SPSS 24. Bivariable and multivariable logistic regression analyses were conducted to identify factors associated with utilization of immediate postpartum LARC. Adjusted odds ratio (aOR) with 95% confidence interval was used to report association, and significance was declared at p value < 0.05. Results. From a total of 546 women invited to the study, 530 (97.1%) participated in the study and 98 (18.5%; 95% CI: 15.1%, 22.0%) reported starting long acting reversible contraceptives. Women who reported discussing about contraceptives with partners ( aOR = 6.69 , 95% CI: 3.54, 12.61) and receiving postpartum counselling on contraceptives ( aOR = 5.37 , 95% CI: 3.00, 9.63) were more likely to using contraception. However, women who live >30-minute walking distance from the nearest health facility ( aOR = 0.47 , 95% CI: 0.26, 0.85) and reported disrespect and abuse during childbirth ( aOR = 0.22 , 95% CI: 0.12, 0.40) were less likely to start LARC. Conclusions. Almost one in five women delivering in public health facilities in eastern Ethiopia started using LARC. Provision of respectful maternity care including counselling on the importance of immediate postpartum family planning is essential for increasing its uptake.

Postpartum long-acting reversible contraceptives use in sub-Saharan Africa. Evidence from recent demographic and health surveys data

“…This is lower than the previous studies conducted in Kenya 38.3% [ 27 ], Rwanda 28.1% [ 28 ], and Ghana 28.6% [ 29 ]. Furthermore, it is lower than studies done in Ethiopia [ 6 , 14 , 30 – 32 ]. The possible justification might be due to the difference in the study setting.…”

“…Family planning is one of the four pillars of safe motherhood initiatives and aims at preventing and reducing maternal mortality rates in developing countries, including SSA, through the control of the number of births a woman may have [ 12 ]. Any maternal and neonatal deaths are largely preventable in developing countries by expanding the use of postpartum LARC methods [ 5 , 13 , 14 ].…”

Immediate postpartum family planning utilization and its associated factors among postpartum women in Ethiopia: a systematic review and meta-analysis

“…Fifteen primary studies were included in this systematic review and meta-analysis, of which 13 were cross-sectional studies, while two were case–control studies with a sample size ranging from 182 to 884 ( 30 , 31 ). Regarding the region in which the study was conducted, four articles were from Amhara ( 31 – 34 ), five from SNNP ( 35 – 39 ), four from Addis Ababa ( 31 , 40 – 42 ), and two from the Oromia ( 43 , 44 ) region with the year of study ranging from 2016 to 2020. The highest prevalence of IPPFP utilization was reported by Arero et al (53.2%) ( 44 ), which was done in the Oromia region, while the lowest IPPFP utilization was reported in the Amhara region by Hagos et al (3.3%) ( 30 ) ( Table 1 ).…”

Determinants of short birth interval among married multiparous women in Chinaksen district, eastern Ethiopia: a case-control study

“…It is worrisome that young women were more likely to be affected by short birth intervals. Encouraging and empowering young women to utilize reproductive health services is essential for reducing and preventing short birth intervals ( 32 ).…”

“…This could be because the use of postpartum contraception can reduce and prevent the chances of unwanted pregnancy, lowering fertility and lengthening the birth interval ( 36 ). The mechanisms should established in place to increase women's intentions to utilize immediate postpartum contraception ( 32 ).…”