Contraceptive methods continuation and its determinants among acceptors on repeat visits to a Nigerian University Teaching Hospital: a 10-year review
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20241169Keywords:
Family planning, Continuation, Determinants, ContraceptivesAbstract
Background: Family planning is a known reproductive health modality for reducing the high maternal mortality in Nigeria. Contraceptive use and continuation is thus necessary to achieve its benefits. The study aimed to determine the contraceptive options and the factors associated with the continuation of contraceptive choices among women on repeat visits.
Methods: This was a 10-year retrospective study of the family planning clinic register of all clients who presented for a repeat visit for contraceptive method continuation at the University of Uyo Teaching Hospital.
Results: There were 6939 contraceptive acceptors on repeat visits aged between 14 and 50 years (mean 31.6 years, SD 5.4). The majority were 26 to 30 years (32.9%), had secondary education (54.6%), were multiparous (90.9%) and chose the subdermal implant (34.9%) and the intrauterine contraceptive devices (27.7%) for continuation. There was a significant association between the women`s age (Df=3, F=10.81, p<0.0001), their educational status (Df=6, Χ2=38.5583, p<0.0001), their parity (Df= 15, Χ2 =76.8644, p<0.0001) and the contraceptive method continued.
Conclusions: An interest in long-acting reversible contraceptives for continuation was found, and this is significantly associated with their sociodemographic and obstetric characteristics; however, we recommend cross-sectional and focus-group inquiries among clients in the different contraceptive-specific categories for further information on the reasons for their choices at subsequent visits.
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References
World Health Organization. Trends in Maternal Mortality: 1990 to 2015: Estimates Developed by WHO, UNICEF, UNFPA, World Bank Group, and the United Nations Population Division. Available at: https://reliefweb.int/report/world/trends-maternal-mortality-1990-2015-estimates-who-unicef-unfpa-world-bank-group-and. Accessed on 3 January 2024.
World Health Organization. Sexual and Reproductive Health. Maternal Health in Nigeria: Generating Information for Action. Available at: https://www.who.int/reproductivehealth/maternal-health-nigeria/en/ Accessed on 3 January 2024.
Mba CI, Obi SN, Ozumba BC. The impact of health education on reproductive health knowledge among adolescents in a rural Nigerian community. J Obstet Gynaecol. 2007;27(5):513-7.
Utomo B, Sucahya PK, Romadlona NA, Robertson AS, Aryanty RI, Magnani RJ. The impact of family planning on maternal mortality in Indonesia: What future contribution can be expected? Population Health Metrics. 2021;19(1):1-3.
Hellwig F, Coll CV, Ewerling F, et al Time trends in demand for family planning satisfied: analysis of 73 countries using National health surveys over 24 years. J Glob Health. 2019;9:020423.
Alkema L, Kantorova V, Menozzi C, Biddlecom A. National, regional, and global rates and trends in contraceptive prevalence and unmet need for family planning between 1990 and 2015: a systematic and comprehensive analysis. Lancet. 2013;381:1642-52
National Population Commission (NPC) [Nigeria] and ICF. 2019. Nigeria Demographic and Health Survey 2018. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF.
United Nations, Department of Economic and Social Affairs, Population Division (2019). Contraceptive Use by Method 2019: Data Booklet (ST/ESA/SER.A/435). Available at: https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/files/documents/2020/Jan/un_2019_contraceptiveusebymethod_databooklet.pdf. Accessed on 3 January 2024.
Weisberg E. Contraceptive options for women in selected circumstances. Best Pract Res Clin Obstetr Gynaecol. 2010;24(5):593-604.
Alihonou E, Carre N, Capochichi V, Thonneau P. Contraceptive continuation and its determinants in Benin. Contraception. 1997;55(2):97-101.
Akhter HH, Ahmed S. Determinants of contraceptive continuation in rural Bangladesh. J Biosocial Sci. 1992;24(2):261-8.
Kopp DM, Rosenberg NE, Stuart GS, Miller WC, Hosseinipour MC, Bonongwe P, et al. Patterns of contraceptive adoption, continuation, and switching after delivery among Malawian women. PLoS One. 2017;12(1):e0170284.
Abah MG, Bassey EB, Ekwere TA, Motilewa OO, Edu BE, Abah IG, et al. Contraceptive Preferences and Trends Among New Acceptors in a Southern Nigerian Tertiary Hospital: An Eight-year Review. Tropical J Obstetr Gynaecol. 2023;39(3):434-41.
US. Issue Brief Washington, DC: USAID; Agency for International Development Long-Acting and Permanent Methods: Addressing Unmet Need for Family Planning in Africa. Available at: https://pdf.usaid.gov/pdf_docs/Pnadl371.pdf. Accessed on 21 October 2023.
Unumeri G, Ishaku S, Ahonsi B, Oginni A. Contraceptive Use and Its Socio-economic Determinants among Women in North-East and North-West Regions of Nigeria: A Comparative Analysis. African Population Studies. 2015;29(2):1851-67.
Adeyemi A, Olugbenga-Bello AI, Adeoye O, Salawu M, Aderinoye A, Agbaje M. Contraceptive prevalence and determinants among women of reproductive age groups in Ogbomoso, Oyo State, Nigeria. Open Access J. Contracept. 2016;7:33-41.
Melka AS, Tekelab T, Wirtu D. Determinants of long-acting and permanent contraceptive methods utilization among married women of reproductive age groups in western Ethiopia: a cross-sectional study. Pan Afr Med J. 2015;21:246.
Habtamu A, Tesfa M, Kassahun M, Animen S. Determinants of long-acting contraceptive utilization among married women of reproductive age in Aneded district, Ethiopia: a case-control study. BMC Res Notes. 2019;12:433.
Adanu RM, Seffah JD, Hill AG, Darko R, Duda RB, Anarfi JK. Contraceptive use by women in Accra, Ghana: Results from the 2003 Accra women's health survey. Afr J Reprod Health. 2009;13(1):123-33.
Mturi A, Joshua K. Falling fertility and increase in use of contraception in Zimbabwe. Afr J Reprod Health. 2011;15(2):31.
Dompere KK. Information and Knowledge in Decision-Choice Rationality. In: Fuzzy Rationality. Studies in Fuzziness and Soft Computing, Springer, Berlin, Heidelberg. 2009;235.
Budu E, Okyere J, Osei MD, Seidu AA, Ahinkorah BO. Determinants of contraceptive continuation among women in sub-Saharan Africa. BMC Women's Health. 2023;23:447.
Rosenstock JR, Peipert JF, Madden T, Zhao Q, Secura GM. Continuation of reversible contraception in teenagers and young women. Obstet Gynecol. 2012;120(6):1298-305.
Scott A, Glasier A. Evidence-based contraceptive choices. Best Pract Res Clin Obstetr Gynaecol. 2006;20(5):665-80.
Njoku O, Abah MG, Ocheche US, Inyangetoh EC, Etuk MS. Discontinuation Patterns Among Women Using Jadelle Contraceptive Devices in a Tertiary Hospital in South-South Nigeria. Euro J Clin Biomed Sci. 2023:9(2):22-7.
