Factors associated with utilization of long acting and permanent contraceptive methods among married women of reproductive age in Mekelle town, Tigray region, north Ethiopia
Ethiopia is the second most populous country in Sub-Saharan Africa. Total Fertility Rate of Ethiopia is 5.4 children per women, population growth rate is estimated to be 2.7% per year and contraceptive prevalence rate is only 15% while the unmet need for family planning is 34%. Overall awareness of Family Planning methods is high, at 87%. The prevalence of long acting and permanent contraceptive methods (LAPMs) in Tigray region was very low which accounts for 0.1% for implants and no users for intra-uterine contraceptive device (IUCD) and female sterilization. Moreover almost all modern contraceptive use in Ethiopia is dependent on short acting contraceptive methods. The objective of this study was to assess factors associated with utilization of long acting and permanent contraceptive methods (LAPM) among married women of reproductive age group in Mekelle town.
A cross sectional community based survey was conducted from March 9-20, 2011. Multistage sample technique was used to select the participants for the quantitative methods whereas purposive sampling was used for the qualitative part of the study. Binary descriptive statistics and multiple variable regressions were done.
The study consisted of quantitative and qualitative data. From the quantitative part of the study the response rate of the study was 95.6%. Of the qualitative part two FGDs were conducted for each married women and married men. 64% of the married women heard about LAPMs. More than half (53.6%) of the married women had negative attitude towards practicing of LAPMs. The overall prevalence of LAPMs use was 12.3% however; there were no users for female or male sterilization. The main reason cited by the majority of the married women for not using LAPMs was using another method of contraception 360 (93.3%). Mothers who had high knowledge were 8 times more likely to use LAPMs as compared with those who had low knowledge (AOR = 7.9, 95% CI of (3.1, 18.3). Mothers who had two or more pregnancies were 3 times more likely to use LAPM as compared with those who had one pregnancy (AOR = 2.7, 95% CI of (1.4, 5.1).
A significant amount of the participants had low knowledge on permanent contraceptive particularly vasectomy. More than half (53.6%) of married women had negative attitude towards practicing of LAMPs. Few of married women use female sterilization and none use of female sterilization and or vasectomy. Positive knowledge of LAMPs, women who had two and above pregnancies and women who do not want to have additional child were significantly associated. Information education communication should focus on alleviating factors hinder from practicing of LAPMs.
- World Health Organization: Trends in Maternal Mortality, 1990 to 2008 Estimates developed by WHO, UNICEF, UNFPA and The World Bank, Geneva. 2010.
- Jacob R, Bakamjian L, Pile M: Threatened and still greatly needed Family planning programs in Sub-Saharan Africa. New York: The ACQUIRE Project/Engender Health; 2008.
- United States Agency for International Development (USAID: The case for long acting and permanent methods. FHI 2007.
- Acquire project: acquiring knowledge, acquire knowledge applying lessons learned to strengthen fp/rh services [http://www.acquireproject.org/archive/files/3.0_program_effectively/3.2_resources/3.2.1_project_briefs/acquire_knowledge_IUD_final.pdf] New York; 2008, 14. Accessed on August 24, 2011
- Ali M, Cleland J: Determinants of contraceptive discontinuation in six developing countries. J Biosoc Sci 1999, 31:343–60. CrossRef
- Son field A: Working to eliminate the world's unmet need for contraception. Guttmacher Policy Rev 2006, 9:10–13.
- United States Agency for International Development (USAID): Long-Acting and Permanent Methods of contraception: Meeting Clients' Needs. In Issue Brief. Washington, DC: USAID; 2006.
- Ross JA, Winfrey W: Contraceptive use, intention to use and unmet need during the extended postpartum period. International Family Planning Perspective 2001, 27:20–27. CrossRef
- United States Agency for International Development (USAID): Long-Acting and Permanent Methods of Contraception: Without them, a Country's Development Will Be Low and Slow, the acquire project. 2008.
- Planning and Programming Department, Ministry of Health Of Ethiopia: Health and health related indicators. Addis Ababa 2007.
- Central Statistical Agency, Ethiopia and ORC Macro: Ethiopia Demographic and Health Survey (EDHS) 2005. Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ORC Macro; 2006.
- USAID Health Policy Initiative: The contribution of family planning, achieving MDGs in Ethiopia. Ethiopia 2009.
- Mekelle Health Bureau (TRHB): profile on health and health related condition of Mekelle town. 2009.
- Osei I, Birungi H, Addico G, Askew I, Gyapong JO: What happened to the IUD in Ghana. Afr J Reprod Health 2005,9(2):76–91. CrossRef
- Karen R, Katz M, Johnson B, José MC: Reasons for the Low Level of IUD Use in El Salvador. International Family Planning Perspectivesm 2002.,28(1):
- Kang W, Tan KH: Implant contraception in Singaporean women, one decade of experience in KK Women's and Children's Hospital. Singapore Med J 2004, 45:482.
- Chigbu B, Onwere S, Aluka C, Kamanu C, Okoro O, Feyi-Waboso P: Contraceptive choices of women in rural Southeastern Nigeria. Niger J Clin Pract 2010, 13:195–9.
- Juan S: Contraceptive Use among the Poor in Indonesia, International Family Planning Perspectives. 2005, 31:106–114.
- Sahin HA, Sahin HG: Reasons for not using family planning methods in Eastern Turkey. Eur J Contracept Reprod Health Care 2003, 8:11–6.
- Ko S, You A, Kim S, Lee W, Kim S, Kim M, Nam J, Lee K: Family planning practice and related factors of married women in Ethiopia. International Nursing Review 2010, 7:377–382. CrossRef
- Barbara J, Rebecca G, Conrad O: commercial sectors roles in providing long acting and permanent methods, USAID, USA. 2006.
- Jennifer B, Cynthia B: Constrained Contraceptive Choice, IUD Prevalence in Uzbekistan International Family Planning Perspectives. 2007, 33:50–57.
- Kane R, Irving G, Brown S, Parkes N, Walling M, Killick S: Long-acting, reversible and permanent methods of contraception: insight into women's choice of method Qual Prim Care. 2009, 17:107–14.
- Amare D, Dehab B: Reasons for the low use of IUCD. 2003.
- The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2393/12/6/prepub
- Factors associated with utilization of long acting and permanent contraceptive methods among married women of reproductive age in Mekelle town, Tigray region, north Ethiopia
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
BMC Pregnancy and Childbirth
- Online Date
- January 2012
- Online ISSN
- BioMed Central
- Additional Links