Preference of source of injectable contraceptives in Uganda

Abstract

Understanding preference of source of contraceptive commodities is an important aspect in the enhancement of delivery of family planning services. This study sought to obtain an understanding of this issue focusing on Depo-Provera (DMPA) contraceptive among rural women in Uganda. The investigation is based on data sourced from the 2008 Save the Children and Family Health International (FHI) study conducted in Uganda’s district of Nakasongola. The data comprises records of 642 women (aged 18 years and above) who were introduced to the contraceptive commodity three years prior to the evaluation. In the investigations, sources of DMPA were assessed using a binary outcome – either a woman preferred private to public sources or vise-versa. Private sources of DMPA comprised predominantly community health worker’s home and woman’s home while the public sources were the routine DMPA provision at government health units. A descriptive summary of users’ preference of source of DMPA and their demographic characteristics was made using frequency distributions. The likelihood of preferring private to public sources of DMPA was modeled in a multivariate analysis using a complementary logistic regression. In the results, about seven-in-every ten women (69.6%) preferred private to public sources of the contraceptive. These findings support community-based distribution programs in enhancing access and utilization of contraceptives in cultural sensitive and friendly ways. Preference to public sources, in a multivariate assessment, was more likely among the older women (30 year and above), those who had never experienced any stock-outs of DMPA, women who were introduced to the contraceptive through private sources and those who had obtained their last injection of the commodity from a private source. Thus, strategies aimed at building capacity for effective service delivery of contraceptive commodities must take into account: variations in characteristics of contraceptive users and their communities; regular supply of contraceptives; and, quality of family planning supply environment and/or services in the various sources.