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乌干达坎帕拉区卢巴加分区育龄妇女对长效可逆避孕方法的了解与态度

Knowledge and attitudes towards use of long acting reversible contraceptives among women of reproductive age in Lubaga division, Kampala district, Uganda.

作者信息

Anguzu Ronald, Tweheyo Raymond, Sekandi Juliet N, Zalwango Vivian, Muhumuza Christine, Tusiime Suzan, Serwadda David

机构信息

School of Public Health, Makerere University, Kampala, Uganda.

出版信息

BMC Res Notes. 2014 Mar 17;7:153. doi: 10.1186/1756-0500-7-153.

Abstract

BACKGROUND

Uganda has one of the highest total fertility rates globally and in Sub-Saharan Africa. Her high fertility is mainly attributed to the high unmet need for family planning. Use of Long-acting reversible contraceptives (LARC) is low (13%) in Uganda yet they are the most cost-effective contraceptives. This study aimed to assess the reproductive aged women's knowledge, attitudes, and factors associated with use of LARC.

METHODS

A cross-sectional study was conducted involving 565 women (15-49 years) attending private and public health facilities in Lubaga division, Kampala district. Semi-structured questionnaires were used to measure knowledge, attitudes and factors associated with use of LARC; Intra-Uterine Devices, Implants and Injectables. The outcome variable was current use of LARC. A generalized linear regression model was run in STATA version12.0. Prevalence Risk Ratios for associations between current LARC use and independent factors were obtained and regarded significant at 95% CI with p < 0.05.

RESULTS

Mean age (SD) and current use of LARC was 26.34 (5.35) and 31.7% respectively. Factors associated with current use of LARC were; previous use adj.PRR 2.89; (95% CI 2.29, 3.81), knowledge of implant administration site adj.PRR 1.83; (95% CI 1.17, 2.87), and perception that; male partner decisions positively influence their contraceptive choices adj.PRR 1.49; (95% CI 1.18, 1.88). Contrary, perception that LARC should be used by married women was negatively associated with use of LARC adj.PRR 0.63; (95% CI 0.44, 0.90).

CONCLUSION

Knowledge about site of administration, previous use of LARC and women's attitude that male partners' choice influence their contraceptive decisions were positively associated with current use of LARC. Contrary, the attitude that LARC was for married women was negatively associated with its use. This study suggests a need to strengthen client education about LARC to dispel possible myths and to consider integrating male partner's decision making in contraceptive choices for women.

摘要

背景

乌干达的总和生育率在全球及撒哈拉以南非洲地区都处于最高水平之一。其高生育率主要归因于计划生育方面未满足的高需求。长效可逆避孕方法(LARC)在乌干达的使用率较低(13%),然而它们却是最具成本效益的避孕方法。本研究旨在评估育龄妇女对LARC的知识、态度以及与使用LARC相关的因素。

方法

开展了一项横断面研究,纳入了坎帕拉区卢巴加分区公立和私立卫生机构的565名年龄在15 - 49岁的女性。采用半结构化问卷来衡量与使用LARC(宫内节育器、植入剂和注射剂)相关的知识、态度和因素。结果变量为当前LARC的使用情况。在STATA 12.0版本中运行广义线性回归模型。得出当前LARC使用与独立因素之间关联的患病率风险比,在95%置信区间且p < 0.05时被视为具有显著性。

结果

平均年龄(标准差)为26.34(5.35)岁,当前LARC使用率为31.7%。与当前使用LARC相关的因素有:既往使用情况,调整后的患病率风险比为2.89;(95%置信区间为2.29,3.81),对植入剂给药部位的了解,调整后的患病率风险比为1.83;(95%置信区间为1.17,2.87),以及认为男性伴侣的决定对其避孕选择有积极影响,调整后的患病率风险比为1.49;(95%置信区间为1.18,1.88)。相反,认为LARC应由已婚妇女使用的观念与LARC的使用呈负相关,调整后的患病率风险比为0.63;(95%置信区间为0.44,0.90)。

结论

对给药部位的了解、既往LARC使用情况以及女性认为男性伴侣的选择会影响其避孕决定的态度与当前LARC的使用呈正相关。相反,认为LARC适用于已婚妇女的态度与其使用呈负相关。本研究表明有必要加强对客户关于LARC的教育,以消除可能存在的误解,并考虑将男性伴侣纳入女性避孕选择的决策过程。

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