Utilization of dual protection methods of modern family planning by women aged 15-49 years attending early infant diagnosis clinics in Jinja District, Eastern Uganda

Abstract

Introduction: Globally, approximately 37 million people are living with Human Immunodeficiency Virus /Acquired Immune Deficiency Syndrome. About 92% of pregnant women living with HIV are in Sub-Saharan Africa. In Uganda, 1.3 million adults are living with HIV of whom 770,000 (59.23%) are women (UNAIDS, 2018). Dual protection is one of the World Health Organization’s recommended strategies to prevent unwanted pregnancies and mother-to-child transmission among HIV-infected women. Objective: To investigate the factors associated with utilization of dual protection among women aged 15-49 years attending Early Infant Diagnosis clinic in Jinja district. Methods: This was a mixed study design conducted in Jinja district. The study employed both qualitative and quantitative methods of data collection. A total of 364 women aged 15-49 years attending Early Infant Diagnosis clinics in health centre IVs of Jinja district, women who delivered in the past 18 months and those who wished to delay child bearing in the near future were selected and interviewed. Five Focus Group Discussion were conducted on women aged 15-49 years attending EID clinics and six key informant interviews were conducted with health workers who were in contact with women attending EID clinics. Analysis was done using Stata v.14. Descriptive, bivariate and multivariate analyses for quantitative data were conducted where frequencies, mean, and multivariable modified Poisson that gives prevalence ratios and P. values respectively were calculated and qualitative data were analyzed using Atlas Ti. Presented in themes and quotations. Results: The study found that 10.2% of women aged 15-49 who attended EID clinics from five public health center IV’s of Jinja district had utilized dual protection methods. The factors significantly associated with dual protection were; - level of Education -Secondary (APR=0.08; 95%CI (0.01-0.85), Religion –Muslim (APR=0.1; 95%CI (0.00-0.53) and Number of children-<4 children (APR=0.05; 95%CI (0.00-0.85). All (6/6) KIIs and (5/5)FGD groups re-counted that the available dual protection methods were :-use of any effective modern methods of family planning such as intrauterine device (IUD), self-injectable, implants together with a male condom only. Conclusions and recommendations. The study revealed that 1 in 10 women aged 15-49 attending EID clinics in the health center IVs of Jinja used dual protection. The key factors significantly associated with dual protection were level of education, religion and number of children-(<4children). There is need for health care providers to further embrace provider-initiated counseling approaches in order to promote utilization of dual protection methods to all couples attending EID clinics during post-test counselling whether they are seroconcordant or serodiscordant respectively. Keywords: Dual protection, Unwanted pregnancy, Sexually Transmitted Infection, Condoms