Factors associated with contraceptive use among women in jinja district.
Tamale, Williams S
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BACKGROUND: The contraceptive prevalence rate of Uganda is 24% (UDHS 2006). Eighteen percent of married women use modern methods, while 6% use a traditional method. As expected, current contraceptive use is higher among sexually active, unmarried women (54%) than among married women (24%) and, in turn, among all women (20%). The likely consequences of low CPR include rapid human population growth resulting in overpopulation, poverty, increased incidences of maternal and infant mortality. OBJECTIVES: To identify the factors associated with contraceptive use among women in jinja district so as to design interventions enhancing contraceptive use for better family planning, improve child and maternal health. To explore the individual, community and health service factors associated with contraceptive use among women in jinja district. METHODOLOGY: A Community based, cross sectional study was conducted. The sample size was 600 respondents and these were selected using a multi-stage sampling technique. Quantitative data was collected using a semi-structured questionnaire, while a key informant interview guide and a focus group discussion guide were used to collect qualitative information. The KI’s included four health facility in-charges, four village chair persons and one DHT member. There were four FGD sessions. Each FGD had ten participants who were homogenous with similar ages, residence, education background and socio-economic status. Qualitative data was analyzed manually and presented as text quotes while quantitative data was entered using Epi Data version 3.1 and exported to Excel for storage. The data were then exported to SPSS version 16.0 for analysis. Data was analyzed at univariable, bivariate and multivariable levels. RESULTS: A total of 600 women comprising of 300 women from rural areas and 300 women from urban areas were interviewed and responded to the questionnaire during February and March 2009.Compared to the married women, those who had never married were less likely to use contraceptive (OR 0.61, 95% C1 0.39-0.95). The separated, widowed and divorced women were also less likely to use contraception than the married women (OR 0.37, 95% C1 0.21-0.65). Respondents with an education level of primary were about thirteen times more likely to use contraception than those with no education at all (OR 12.98, 95% C1 6.07-27.76). Women with secondary education level were twice more likely to use contraception than those with no education at all (OR2.00, 95% C1 1.08-3.69). Respondents who had adequate knowledge on at least one contraceptive method were about 1.6 times more likely to use contraception than those whose knowledge on contraception wad inadequate (OR 1.58, 95% C1 1.06-2.36). Respondents who discussed with their partners about family planning were twice likely to use contraceptive methods than those who did not (OR 2.00 95% C1 1.37-2.90). Contraceptive use among women in jinja district was also associated with accessibility, availability, affordability and quality of contraceptive services. CONCLUSIONS: The factors associated with contraceptive services included the following; Among the individual factors, education level of primary and above, having discussed among partners on family planning. The community factors included adequate knowledge on contraceptive methods and a perception that the contraceptive methods are affective. Among health services factors were accessibility, availability, affordability and quality of contraceptive services. RECOMMENDATIONS: Female education through universal primary and secondary education should be encouraged by government paying special attention to family planning and sex education. Regular community sensitizations on family planning using contraceptive methods should be done by the DHT, demystifying the wrong perceptions that people have about contraceptive methods. The DHT should encourage men involvement in contraceptive use by encouraging discussion among couples on family planning issues and further research on the knowledge, attitude and perceptions on contraceptive use among men in jinja district should be done so as to give recommendations on how to further improve the contraceptive prevalence rate. The DHT should strengthen family planning services in health facilities through continuous training of health workers on proper usage of contraceptive methods, timely provision of contraceptive methods.