عنوان

Factors Associated with Type of Method at Contraceptive Debut and Unwanted Pregnancy Among Current Contraceptive Users in Northwest Ethiopia

Number

TL53231

.Language of Text, Soundtrack etc

انگلیسی

Title Proper

Factors Associated with Type of Method at Contraceptive Debut and Unwanted Pregnancy Among Current Contraceptive Users in Northwest Ethiopia

General Material Designation

[Thesis]

First Statement of Responsibility

Tolentino, Lorenzo

Subsequent Statement of Responsibility

Guthrie, Brandon

Name of Publisher, Distributor, etc.

University of Washington

Date of Publication, Distribution, etc.

2020

Text of Note

22 p.

Dissertation or thesis details and type of degree

M.P.H.

Body granting the degree

University of Washington

Text preceding or following the note

2020

Text of Note

Background: Modern contraception prevented over 300 million unintended pregnancies worldwide in 2017. Long-acting, reversible contraception (LARC) is highly effective at pregnancy prevention than other modern reversible methods subject to user error and reduces their unintended pregnancy and adverse maternal and child health outcomes. Yet, there may be gaps in providing a LARC supportive environment in some contexts. Characterizing current contraceptive LARC users could provide insights on how to better support LARC as a contraceptive option among women initiating contraception. We examined correlates of LARC debut among a cohort of current LARC users, as well as risk factors for unwanted pregnancy among all modern, reversible contraceptive users. Methods: we conducted a secondary cross-sectional analysis among 1,124 current modern? contraceptive users seeking family planning services in Northwest Ethiopia. Women were classified as LARC users if they used implants or intrauterine devices or non-LARC users if they used other modern, reversible methods (condoms, injectables, or oral contraceptives), at contraceptive debut. Potential correlates of LARC use at contraceptive debut among current LARC users, and wantedness of prior pregnancy (defined as last pregnancy among women with multiple pregnancies) among other modern contraceptive users, included sociodemographic characteristics, reproductive history, and family planning decision making. Odds ratios adjusted for age, marital status, education, and wealth were reported. Results: Overall, 330 women in the study were currently using LARC; among these 74 (22%) reported LARC was used at contraceptive debut and 118 of 817 (14%) women with a prior pregnancy reported their prior pregnancy was unwanted. Factors associated with using LARC at contraceptive debut were older age (≥35 years) (aOR=3.71; 95% CI: 1.49-9.17), being married before age 18 (aOR=0.46; 95% CI:0.20-0.97), and richest wealth quartile (aOR=3.02; 95% CI: 1.24-8.24).Factors associated with a prior unwanted pregnancy were younger age (15-24 years) (aOR=2.25; 95% CI: 1.39-3.63), being single (aOR=12.74; 95% CI: 7.52-21.88), not using the preferred method of choice (aOR=3.17 95% CI: 1.17-8.21), healthcare provider selecting current method (aOR=4.33; 95% CI: 1.55-11.73) and reporting future fertility desires were "undecided" (aOR=2.61; 95% CI: 1.53-4.36). Conclusion: Factors associated with LARC at contraceptive debut imply an environment supportive of contraceptive choice. Women who debuted with LARC may have been exposed to national programs that focused on expanding LARC access, and sociodemographic characteristics such as age at marriage and wealth could point to a LARC supportive environment. Factors associated with a prior unwanted pregnancy suggest an environment with varying degrees of support for contraceptive choice. Demographic characteristics, provider selected method, and pregnancy ambivalence could point to a nonsupportive environment, whereas fertility intentions and recognizing limitations of prior method point to a supportive environment. Future research is needed to capture the setting and context more accurately at contraceptive debut, and implications of this environment on unwanted pregnancies.

Subject Term

Obstetrics

Subject Term

Public health

Tolentino, Lorenzo

Guthrie, Brandon

University of Washington

Electronic name

p

[Thesis]

276903

a

Y