Tilahun Aklilu, Yoseph Amanuel, Dangisso Mesay Hailu
Adare General Hospital, Maternal and Child Health service case team, Hawassa, Ethiopia.
School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
Contracept Reprod Med. 2020 Jul 6;5:9. doi: 10.1186/s40834-020-00112-x. eCollection 2020.
Long acting reversible contraceptive methods are highly effective, safe and provide uninterrupted protection to women for 3 to 12 years, yet are little used in the Ethiopia. Assessment of the utilization and predictors of long acting reversible contraceptive methods assist health planners to prioritize promotion strategies, and is a fundamental step for intervention. Therefore, this study aimed to assess the utilization and predictors of long acting reversible contraceptives among reproductive age women in Hawassa city, South Ethiopia; 2019.
A community-based cross-sectional study was conducted using a mixed method among the sample of 660 reproductive age women in Hawassa city, South Ethiopia from January 1-30, 2019. We have used a systematic and purposive sampling technique to select the study participants. A structured interview-administrated questionnaire and focus group discussion were used to collect the data. The data were entered using Epi data version 3.1 and analyzed using SPSS version 20. Chi-square (X) test was used to determine the overall association between explanatory and outcome variables. The variables were entered into the multivariable model using the backward stepwise regression approach. Bi-variable and multivariable logistic regression analyses were conducted. The qualitative data were analyzed using a manual thematic analysis technique.
The overall utilization of long acting reversible contraceptive methods was 22% (95% CI = 19.50-25.50%). Among this, 17.5 and 4.5% of women utilized the implants and IUCD, respectively. Good knowledge (AOR = 4.0; 95% CI = 1.66-9.60; = 0.001) and positive attitude (AOR = 7.9; 95% CI = 3.84-16.10; = 0.001) of women about LARC methods were positively associated with utilization of LARC methods. The odds of utilizing LARC methods increased 8.2 times for women who have no desire to have a child (AOR = 8.2, 95% CI = 3.13-21.30) as compared to those who have the desire to have a child. The discussion of women about LARC methods with providers (AOR = 4.1; 95% CI = 1.24-5.24) and husbands (AOR = 2.7; 95% CI =1.02-7.20) were positively associated with utilization of LARC methods. These findings were supported by the individual, institutional and socio-cultural qualitative findings.
The utilization of LARC methods far below the national target (22 V 40%) in the study area. Good knowledge and positive attitude about LARC methods, no desire to have a child, discussion with husbands and providers were major predictors of the LARC methods utilization. Increasing knowledge and positive attitude of the women about LARC methods using various methods of health education should be considered.
长效可逆避孕方法高效、安全，可为女性提供3至12年的持续保护，但在埃塞俄比亚使用率很低。评估长效可逆避孕方法的使用情况及其预测因素有助于卫生规划者确定推广策略的优先级，是干预的基本步骤。因此，本研究旨在评估2019年埃塞俄比亚南部哈瓦萨市育龄妇女长效可逆避孕方法的使用情况及其预测因素。
2019年1月1日至30日，在埃塞俄比亚南部哈瓦萨市660名育龄妇女样本中采用混合方法进行了一项基于社区的横断面研究。我们使用系统抽样和目的抽样技术来选择研究参与者。采用结构化访谈管理问卷和焦点小组讨论收集数据。数据使用Epi data 3.1版本录入，并使用SPSS 20版本进行分析。采用卡方（X）检验来确定解释变量和结果变量之间的总体关联。使用向后逐步回归方法将变量纳入多变量模型。进行了双变量和多变量逻辑回归分析。定性数据采用手工主题分析技术进行分析。
长效可逆避孕方法的总体使用率为22%（95%置信区间=19.50-25.50%）。其中，分别有17.5%和4.5%的女性使用了皮下埋植剂和宫内节育器。女性对长效可逆避孕方法的良好认知（调整后比值比[AOR]=4.0；95%置信区间=1.66-9.60；P=0.001）和积极态度（AOR=7.9；95%置信区间=3.84-16.10；P=0.001）与长效可逆避孕方法的使用呈正相关。与有生育意愿的女性相比，无生育意愿的女性使用长效可逆避孕方法的几率增加了8.2倍（AOR=8.2，95%置信区间=3.13-21.30）。女性与提供者（AOR=4.1；95%置信区间=1.24-5.24）和丈夫（AOR=2.7；95%置信区间=1.02-7.20）就长效可逆避孕方法进行的讨论与长效可逆避孕方法的使用呈正相关。这些发现得到了个人、机构和社会文化定性研究结果的支持。
研究区域内长效可逆避孕方法的使用率远低于国家目标（22%对40%）。对长效可逆避孕方法的良好认知和积极态度、无生育意愿、与丈夫和提供者的讨论是长效可逆避孕方法使用的主要预测因素。应考虑采用各种健康教育方法提高女性对长效可逆避孕方法的认知和积极态度。
