Factors associated with intention to use long-acting reversible contraceptive methods among mothers 15-49 years admitted on postnatal ward in Kawempe National Referral Hospital, Kampala, Uganda

Abstract

Introduction: Globally, 1.1 billion women of reproductive age needed contraceptive services in the year 2020. Out of these, 172 million women used no contraceptive method at all, despite their desire to avoid pregnancy. The contraceptive prevalence rate of all women of reproductive age using long-acting contraceptive methods (implants and IUCDs) in Uganda is very low which predisposes women to unwanted pregnancies, unsafe abortions and avoidable mortalities. This study sought to determine the prevalence and factors associated with intention to use LARCs among postpartum women at Kawempe National Referral Hospital. Methods: This was a cross-sectional study with a quantitative research approach conducted among postnatal mothers in Kawempe National Referral Hospital found in Uganda. A total of 190 participants were selected by simple random sampling technique and interviewed using a face-to-face interviewer administered questionnaire. The data collected was analyzed at three levels: univariate, bivariate, and multivariate level using SPSS V20. Prior to data collection, ethical approval was obtained from IRB Makerere university school of public health and Kawempe National Referral Hospital. A written informed consent was obtained and participation in the study was voluntary. Results: A total of 190 postnatal mothers participated in the study. The average age was 26.1±3.3 years, majority were married 162 (85.3%) and residents of Kampala district 114 (60.0%). Most mothers 158 (83.2%) intended to use postpartum family planning of which 79 (42%) intended to use LARCs, 71(37%) intended to use other methods while 8 (4%) had not decided on the contraceptive method to use. Specifically, 60 (38.0%) mothers intended to use implants, 42 (26.6%) injectables, 23 (14.6%) pills and 19 (12.0%) IUCDs. The intention to use LARCs was significantly associated with having a baby boy (aOR=4.442, 95% CI 2.194 - 8.994 and women who had ever used LARCs (aOR= 3.477, 95% CI 1.426 - 8.481). Conclusion: The intention to use LARCs in the study area was low with prior use of LARCs and sex of the newborn baby acting as positive predictors of postpartum LARCs use. There is need for continued sensitization of pregnant mothers during antenatal care on different family planning options, their advantages and side effects. Mothers on family planning should be encouraged to share their positive family planning experiences to other mothers in order to address negative attitudes and beliefs towards some family planning methods.