Factors associated with uptake of long acting reversible contraceptives (LARCS) among immediate post-partum mothers at Kawempe National Referral Hospital

Abstract

Background: Long-acting reversible contraceptives (LARCs) are essential to women’s empowerment, promotion of economic growth and improvement of child survival. Thus, LARCs use in the post-partum is recommended for improving maternal health and child survival in countries with high rates of unintended pregnancies like Uganda. This study aimed to determine the level of uptake of immediate post-partum LARCs and its associated factors among post-partum mothers. Methods: This was a hospital-based cross-sectional study conducted among post-partum mothers at Kawempe National Referral Hospital. Mothers were enrolled from the postnatal wards, health educated on LARCs and offered an option to have LARCs. For those who agreed to have IUDs or Implants inserted, these were sent to trained midwives who inserted the IUDs or implants and were considered to have taken up LARCs. A structured questionnaire was used to collect participant data and record the uptake of LARCs. Results: The study involved 421 post-partum mothers with an average age of 27.8 (±6.0) years, ranging from 15 to 45 years. Majority were aware of LARCs 329 (78.1%) with health facilities 289 (87.8%) as the main source of information about LARCs. The level of uptake of LARCs was 32.1% [95% CI: 27.6% – 36.5%] for which 48.9% used IUDs while 51.1% used implants. For mothers who had not used any family planning method post-partum, only 76 (27.6%) reported having intentions to use family planning at a later stage. The uptake of LARCs was more likely in women who were salary employed (aOR=2.6 [1.289 - 5.212], p=0.008), who had attended ANC for eight or more times (aOR=6.4 [2.132 - 19.019], p=0.001), women who had ever used LARCs (aOR=2.8 [1.539 - 4.927], p=0.001) and women whose spouses approves use of family planning (aOR=2.0 [1.079 - 3.645], p=0.027). Uptake of LARCs was however less likely in women who desired to have more children in a period of less than 2 years (aOR=0.5 [0.288 - 0.821], p=0.007). Conclusion: Uptake of LARCs is high with patient education and availability of the services. It is recommended that all post-partum women be given clear information about LARCs, encouraged to consider using them, and ensure easy access to these services.

Key words: Post-partum period, LARCs, Family planning, Uptake