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埃塞俄比亚吉马镇公共医疗设施中,在产前诊所就诊的孕妇产后立即使用宫内节育器的情况:意愿与障碍

Immediate postpartum intrauterine contraceptive device use among pregnant women attending antenatal clinics in Jimma town public healthcare facilities, Ethiopia: Intentions and barriers.

作者信息

Terefe Gemechu, Wakjira Diriba, Abebe Fikadu

机构信息

School of Midwifery, Institute of Health, Jimma University, Jimma, Ethiopia.

出版信息

SAGE Open Med. 2023 Mar 3;11:20503121231157212. doi: 10.1177/20503121231157212. eCollection 2023.

Abstract

OBJECTIVE

This study aimed to assess the intention and barriers to the use of immediate postpartum intrauterine contraceptive devices among pregnant women attending antenatal clinics in Jimma town public healthcare facilities, southwest Ethiopia.

METHODS

A facility-based cross-sectional study design was conducted from 1 September to 30 October 2020 by using a systematic sampling technique. Data were entered into Epi-data 3.1 version and exported to Statistical Package for Social Sciences 23 for analysis. A binary logistic regression analysis was done to sort candidate variables for multiple logistic regression, and multivariable logistic regressions were done to identify factors associated with the intention to postpartum intrauterine contraceptive devices. Factors associated with intention to use immediate postpartum intrauterine contraceptive device declared at 95% confidence interval.

RESULTS

This study finding showed that 37.6% (95% confidence interval (31.5, 43.7)) of pregnant women intended to use the immediate postpartum intrauterine contraceptive device after their delivery. The main reason women refused to use immediate postpartum intrauterine contraceptive devices was being satisfied with other methods to use after they gave birth (27.5 %), the concern of health harm (22.2%), and the fear of impaired future fertility (16.4%). The identified factors that were statically significant with the intention to use immediate postpartum intrauterine contraceptive devices among pregnant women were included: attended secondary education (adjusted odd ratio = 2.36;  = 0.03; 95% confidence interval (1.089, 5.128)), attended college and above (adjusted odd ratio = 2.99;  = 0.020; 95% confidence interval (1.189, 7.541)), have high knowledge on immediate postpartum intrauterine contraceptive devices ((adjusted odd ratio = 2.10;  = 0.006; 95% confidence interval (1.236, 3.564)), the previous history of LACM used (adjusted odd ratio = 6.85;  = 0.0001; 95% confidence interval (3.560, 10.021)), parity >4 (adjusted odd ratio = 1.86;  = 0.043; 95% confidence interval (3.99, 8.703)).

CONCLUSION

The intention of pregnant women to use after they gave birth in the study area was low. Maternal educational level, high knowledge, history of previous long-acting contraceptive methods use, and parity were significantly associated with pregnant women's intention to use immediate postpartum intrauterine contraceptive devices. Healthcare providers should focus on delivering crucial information about immediate postpartum intrauterine contraceptive device benefits for postpartum women, particularly concerning reducing barriers during antenatal care follow-up as they plan to use it after their delivery.

摘要

目的

本研究旨在评估埃塞俄比亚西南部吉马镇公共医疗设施中,前往产前诊所就诊的孕妇使用产后即时宫内节育器的意愿及障碍。

方法

2020年9月1日至10月30日采用系统抽样技术进行了一项基于机构的横断面研究设计。数据录入Epi - data 3.1版本,并导出至社会科学统计软件包23进行分析。进行二元逻辑回归分析以筛选多因素逻辑回归的候选变量,并进行多变量逻辑回归以确定与产后宫内节育器使用意愿相关的因素。与使用产后即时宫内节育器意愿相关的因素在95%置信区间内声明。

结果

本研究结果显示,37.6%(95%置信区间(31.5, 43.7))的孕妇打算在分娩后使用产后即时宫内节育器。女性拒绝使用产后即时宫内节育器的主要原因是对产后使用的其他方法感到满意(27.5%)、担心健康危害(22.2%)以及害怕未来生育能力受损(16.4%)。在孕妇中,与使用产后即时宫内节育器意愿具有统计学显著意义的已确定因素包括:接受过中等教育(调整后比值比 = 2.36;P = 0.03;95%置信区间(1.089, 5.128))、接受过大学及以上教育(调整后比值比 = 2.99;P = 0.020;95%置信区间(1.189, 7.541))、对产后即时宫内节育器有较高了解(调整后比值比 = 2.10;P = 0.006;95%置信区间(1.236, 3.564))、既往使用长效可逆避孕方法的历史(调整后比值比 = 6.85;P = 0.0001;95%置信区间(3.560, 10.021))、产次>4(调整后比值比 = 1.86;P = 0.043;95%置信区间(3.99, 8.703))。

结论

研究区域内孕妇产后使用的意愿较低。产妇教育水平、较高的知识水平、既往长效避孕方法使用史以及产次与孕妇使用产后即时宫内节育器的意愿显著相关。医疗服务提供者应专注于为产后女性提供有关产后即时宫内节育器益处的关键信息,特别是在产前保健随访期间,因为她们计划在分娩后使用该节育器时减少障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec79/9989451/0a6243fc2248/10.1177_20503121231157212-fig1.jpg

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