Prevalence and factors associated with contraceptive uptake among adolescents receiving post abortion care services at Kawempe National Referral Hospital.

Abstract

In Uganda Adolescent girls face many challenges and barriers to access and utilization of contraceptives leading to the unwanted pregnancies which terminate as abortions. The immediate post-abortion period is a great opportunity to provide contraception to adolescents. Pregnancy can occur as early as within two weeks after termination of pregnancy, providing contraception to adolescents during this period reduces the risk of unintended pregnancy and related complications. The aim of this study was to determine the prevalence and factors associated with contraceptive uptake among adolescents receiving postabortion care at Kawempe National Referral Hospital. Methods: This was a cross sectional study conducted at Kawempe National Referral Hospital among 179 consecutively sampled adolescents who had received post abortion care services. Data was collected using a structured interviewer administered questionnaire on bio data and factors that could influence post abortion contraceptive uptake. Uptake was calculated as the proportion of study participants who took up a contraceptive method. Factors associated to contraceptive uptake were determined by multivariate logistic regression. Results: The mean age of the participants was 18.4 years ± 0.85 years and more than half were aged 19 years, 57.0% (102/179). The prevalence of contraceptive uptake in this study was 70.9%, (95%CI 63.71 – 77.48). Majority of the participants who accepted contraceptives opted for Depo-Provera at 47%. The factors that were independently associated with uptake were having one child, having educated guardians and not having heard about contraceptives. The prevalence of contraceptive uptake was 42% higher among the participants who had one child when compared to participants who had no children (aPR = 1.42, 95%CI 1.17 - 1.73, P value <0.001). In addition, participants who had never heard about contraceptives had a 50% higher prevalence of contraceptive uptake compared to participants who had ever heard about contraceptives (a PR = 1.50, 95%CI 1.16 - 1.95, P value = 0.002). Lastly, participants whose guardians had completed a secondary level of education had a 30% less prevalence of contraceptive uptake compared to those whose participants had no formal education (aPR = 0.70, 95%CI 0.52 - 0.94, p value = 0.017). employment status and guardian’s marital status had no association to uptake of contraceptives. Conclusion The study revealed a high (70.9%) contraceptive uptake among adolescents receiving post abortion care at Kawempe National Referral Hospital. Prior contraceptive knowledge, having a child and guardian’s education level was strongly associated to the uptake.