Gbagbo Fred Yao, Kayi Esinam Afi
1University of Education Winneba, Box 25, Winneba, Ghana.
2Regional Institute for Population Studies, University of Ghana, Box LG 96, Accra, Ghana.
Contracept Reprod Med. 2018 Jun 6;3:8. doi: 10.1186/s40834-018-0061-1. eCollection 2018.
The intrauterine contraceptive device is one of the modern long-acting and reversible contraception that is very safe and effective. Yet, less than 2 % of women are using intrauterine devices in Ghana. This study therefore explored the experiences and barriers to intrauterine contraceptive device use and discontinuation in Greater Accra Region, Ghana.
Intrauterine contraceptive device users and providers were purposively selected from eight private family planning clinics in the Greater Accra Region. Semi-structured interview guides were used for in-depth interviews during data collection. The interviews were audio-taped to ascertain accurate accounts of the interviews and recordings replayed for analytical responses. Field assistants transcribed the interviews conducted themselves and read through the transcripts produced twice to increase familiarity with the dataset. A list of code labels was created and a series of categories for the main themes that emerged from the transcripts were developed. The transcribed data was organized, coded and manually thematically analysed in word. Study results were presented in tables and quotes from respondents.
Results showed that key motivations for intrauterine contraceptive device use include effectiveness, benefits, and efficacy of the device, fertility regulation, peace of mind, contraceptive method switching, health provider effects, desire for long-acting contraceptive method, and partner characteristics. Intrauterine contraceptive device discontinuation was due to bleeding irregularities, vaginal infections, desire to increase fertility, physical features of the intrauterine device, and partner disapproval of use. Other reasons in both cases pertained to non-hormonal aspects of the intrauterine device, partner characteristics, and provider encouragement and influence.
Several factors influence the use and discontinuation of intrauterine device in Ghana. Comprehensive contraceptive counselling on the intrauterine device is essential in promoting uptake and knowledge of the intrauterine device at the health facility level. Various targeted messages are also needed to dispel misconceptions at the community level.
宫内节育器是现代长效可逆避孕方法之一,非常安全有效。然而,在加纳,使用宫内节育器的女性不到2%。因此,本研究探讨了加纳大阿克拉地区使用和停用宫内节育器的经历及障碍。
从大阿克拉地区的八家私立计划生育诊所中,有目的地选取了宫内节育器使用者和提供者。在数据收集过程中,使用半结构化访谈指南进行深入访谈。访谈进行了录音,以确保访谈内容准确无误,并回放录音以获取分析性回复。实地助手转录了他们自己进行的访谈,并将转录文本通读两遍,以增加对数据集的熟悉程度。创建了一份代码标签列表,并针对转录文本中出现的主要主题制定了一系列类别。对转录数据进行了整理、编码,并在Word中进行了手动主题分析。研究结果以表格和受访者的引述形式呈现。
结果表明,使用宫内节育器的主要动机包括该装置的有效性、益处、功效、生育调节、安心、避孕方法转换、医疗服务提供者的影响、对长效避孕方法的需求以及伴侣特征。停用宫内节育器的原因包括出血不规律、阴道感染、生育意愿增强、宫内节育器的物理特征以及伴侣不赞成使用。在这两种情况下,其他原因都与宫内节育器的非激素方面、伴侣特征以及提供者的鼓励和影响有关。
在加纳,有几个因素影响宫内节育器的使用和停用。在医疗机构层面,对宫内节育器进行全面的避孕咨询对于促进其使用和了解至关重要。在社区层面也需要各种有针对性的信息来消除误解。