School of Public Health, Collage of Medicine and Health Science, Wachemo University, Hossana, Ethiopia.
College of Medicine and Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA, 5001, Australia.
BMC Womens Health. 2022 Feb 4;22(1):30. doi: 10.1186/s12905-022-01611-6.
Intrauterine devices (IUDs) are one of the long-acting, safe and effective methods of contraception in women across the world. However, this method is underutilised in many countries, including Ethiopia. Several quantitative studies have been used to address this problem and generated a list of factors associated with this problem. However, this list lacks detailed and local contexts that are necessary to inform local solutions. The current study uses a qualitative method to explore determinants of IUDs underutilization among short term modern contraceptive users from the maternal health services in the study setting. The use of a qualitative study design is necessary to obtain and rich contextual details that can inform the development of locally appropriate strategies to increase the IUDs uptake in the study area and improve women's reproductive health outcomes.
A qualitative study was conducted in Hossana town public health facilities, Southern Ethiopia from November 1-30, 2019. A total of thirteen in-depth interviews were conducted including with: 11 short term contraceptive users, one health centre head and one health extension worker. The interview guide comprised semi-structured questions. Interviews were audio recorded, transcribed and collected data analysed thematically.
The main key determinants of IUDs service underutilisation were identified from participants' narratives, including: (1) poor knowledge about the benefits of IUDs, (2) insufficient counselling and ineffective delivery of health information to aid women in decision making, (3) the absence of trained health personals, and shortage of supplies.
Results indicate that the poor utilisation of IUDs services is determined by both the service provider and the consumer related factors. Poor knowledge of short term users of contraception is a critical factor because without knowledge, clients may not use the available services effectively. The shortage of necessary supplies, poor provider-client relationships, and poor counselling by service providers are also service factors that act as barriers to uptake of IUDs. Efforts should be made to increase IUDs utilization by focusing on educating women about the importance of IUDs, improving counselling of mothers and strengthening the health systems, including allocating more resources to increase access to IUDs among the service users.
宫内节育器（IUD）是全球女性使用的一种长效、安全且有效的避孕方法。然而，在许多国家，包括埃塞俄比亚，这种方法的使用率都很低。已经有几项定量研究用于解决这个问题，并列出了与这个问题相关的因素。然而，这个列表缺乏详细和当地的背景信息，这些信息对于提供当地的解决方案是必要的。目前的研究使用定性方法来探讨研究环境中的短期现代避孕使用者中宫内节育器使用率低的决定因素。使用定性研究设计是必要的，以获得丰富的背景细节，为提高研究地区宫内节育器使用率和改善妇女生殖健康结果提供当地适用的策略。
这项定性研究于 2019 年 11 月 1 日至 30 日在埃塞俄比亚南部的 Hossana 镇公共卫生机构进行。共进行了 13 次深入访谈，包括 11 名短期避孕药具使用者、1 名卫生中心主任和 1 名卫生推广员。访谈指南包括半结构化问题。访谈进行了录音、转录和收集数据，并进行了主题分析。
参与者的叙述确定了宫内节育器服务利用率低的主要关键决定因素，包括：（1）对宫内节育器益处的了解不足；（2）咨询不足和未能有效传递健康信息，以帮助妇女做出决策；（3）缺乏经过培训的卫生人员和用品短缺。
结果表明，宫内节育器服务利用率低是由服务提供者和消费者相关因素共同决定的。短期避孕药具使用者知识匮乏是一个关键因素，因为没有知识，客户可能无法有效地利用现有服务。必要用品的短缺、服务提供者与客户之间的不良关系以及服务提供者提供的咨询不足也是服务方面的障碍，阻碍了宫内节育器的使用。应该努力通过教育妇女了解宫内节育器的重要性、改善对母亲的咨询以及加强卫生系统来提高宫内节育器的利用率，包括分配更多资源以增加服务使用者获得宫内节育器的机会。
