Department of Public Health, Myungsung Medical College/Myungsung Christian Medical Center, Addis Ababa, Ethiopia.
Department of Medicine, Myungsung Medical College/Myungsung Christian Medical Center, Addis Ababa, Ethiopia.
PLoS One. 2020 Feb 18;15(2):e0229071. doi: 10.1371/journal.pone.0229071. eCollection 2020.
Intrauterine Contraceptive Device (IUCD) is a highly effective and reversible modern contraceptive, which is still significantly underutilized in Ethiopia. The aim of this study was to identify factors affecting the use of IUCDs among women of reproductive age group in Addis Ababa.
Facility-based, unmatched case-control study was employed among randomly selected cases and controls in selected health centers in Addis Ababa from August to October 2017. The cases (n = 128) were women of reproductive age group who were IUCD users and controls (n = 256) were women of reproductive age group who were users of oral or injectable contraceptives during the study period. After randomly selecting two health center from each sub-city the number of cases and controls were equally allocated to each of the selected health centers. In each selected health center, all eligible cases were enrolled consecutively until the sample size was achieved. Two consecutive controls were selected for each case. Data was collected face-to-face by trained nurses by using structured questionnaire. Factors associated with IUCD use were identified by multi-variable binary logistic regression models using the backward conditional stepwise method.
In the multi-variable analysis, IUCD use was strongly associated with husbands/partners being supportive of IUCD use (Adjusted OR = 13.24, 95% CI; 5.30-33.02), being literate women (Adjusted OR = 5.31, 95% CI; 1.05-26.93), women having a perception of IUCD does not cause infection (Adjusted OR = 4.38, 95% CI; 1.45-13.26) and the source of information about IUCD being mass-media (Adjusted OR = 3.81, 95% CI; 1.49-9.74).
The findings of the study reinforce the need of husbands/partners involvement in the interventions to enhance utilization of IUCD. Moreover, due attention should also be provided for delivering IUCD-related messages in the public mass-media.
宫内节育器（IUCD）是一种高效、可逆的现代避孕方法，但在埃塞俄比亚的使用率仍然很低。本研究旨在确定影响亚的斯亚贝巴育龄妇女使用 IUCD 的因素。
2017 年 8 月至 10 月，在亚的斯亚贝巴选定的卫生中心，采用基于设施的、不匹配的病例对照研究，对随机选择的病例（n=128）和对照组（n=256）进行研究。病例组为 IUCD 使用者，对照组为研究期间使用口服或注射避孕药的育龄妇女。从每个分区随机选择 2 家卫生中心后，将病例和对照的数量平均分配到每个选定的卫生中心。在每个选定的卫生中心，连续纳入所有符合条件的病例，直到达到样本量。为每个病例选择 2 个连续的对照。由经过培训的护士通过使用结构化问卷进行面对面的数据收集。采用向后条件逐步法的多变量二元逻辑回归模型确定与 IUCD 使用相关的因素。
在多变量分析中，IUCD 使用与丈夫/伴侣支持 IUCD 使用（调整后的比值比=13.24，95%置信区间；5.30-33.02）、妇女识字（调整后的比值比=5.31，95%置信区间；1.05-26.93）、妇女认为 IUCD 不会引起感染（调整后的比值比=4.38，95%置信区间；1.45-13.26）和 IUCD 信息来源为大众媒体（调整后的比值比=3.81，95%置信区间；1.49-9.74）有很强的相关性。
本研究结果强调了需要让丈夫/伴侣参与到干预措施中，以提高 IUCD 的使用率。此外，还应特别注意在大众媒体上传递与 IUCD 相关的信息。
