784
Views & Citations10
Likes & Shares
Introduction: Long acting
reversible contraceptive (LARC) allows women to prevent pregnancy for many
years at time, offering young women in particular a valuable opportunity to
post pone childbearing safely and effectively. However, use of LARC method
remains relatively low across the developing world, especially among young
women.
Objective: To assess
prevalence of long acting reversible contraceptive methods among women of
reproductive age group in Debre Tabor Town, North West Ethiopia, 2017.
Methods: The study was conducted
in Debre Tabor Town, South Gondar zone, Amhara region, Ethiopia. Debre Tabor is
the zonal town in north central Ethiopia located approximately 100 km from
Bahir Dar and 666 km north east Addis Ababa. Institutional based cross
sectional study design was conducted. Here in the study 223 subjects was
sampled with systematic sampling technique. The data was collected through
structured questionnaires. The collected data was analyzed manually using
scientific calculator after it was edited, stored, organized and checked for
completeness.
Results: The response rate
of this study was 98.7%. Most of the respondent’s age was from 18-35 years 197
(89.5%). The median and the mean age with the standard deviation (SD) of the
participants was 28 and 29.03 ± 5.8 years, respectively. Majority of the
respondents were orthodox 211 (95.9%), Amhara 214 (97.2%) and Married 170
(77.3%). Most of respondents 130 (59.1%) were use injectable contraceptive
family planning. Majority of respondents 198 (90%) were satisfied with they
used FP and 117 (53.2%) were use of first choice FP.
Conclusion and
recommendation: The overall prevalence of long acting reversible contraceptives among
reproductive age group women in Debre Tabor Town was 60 (27.3%). Debre Tabor
Town health institution staffs shall give health education for reproductive age
group women about family planning especially on long acting family planning.
Researchers shall conduct additional research which will investigate associated
factors to show the gaps for Debre Tabor Town health institution to reduce the
factors.
Keywords: Contraceptive, Reproductive
age group, Long acting reversible contraceptive (LARC), Young women
INTRODUCTION
The family planning and
reproductive health needs of young people in sub-Sahara Africa remains under
studied and insufficiently understood. As growing numbers girl’s age in to
adulthood, sustained efforts are needed to ensure that all receive access to
the family planning counseling and services they want and need [1].
Long acting reversible
contraceptive (LARC) allows women to prevent pregnancy for many years at time,
offering young women in particular a valuable opportunity to post pone
childbearing safely and effectively. However, use of LARC method remains
relatively low across the developing world, especially among young women [2].
In Ethiopia, young women often begin
sexual activity many years before marriage or child bearing is desired, highlighting
the need for safe and effective ways of delaying pregnancy for relatively long period
of time.
However,
Demand for family planning satisfied with modern methods” has emerged
as a key indicator of contraceptive availability and use. The indicator
measures the population of women who want to delay or limit child bearing and
who are using modern methods of contraceptive. Family planning experts have
urged countries to strive for meeting at least 75% of demand with modern
methods. Over the past two decades, a significant number of less developed
countries have seen increases in the share of demand satisfied with modern
methods, but many countries remain far below the proposed 75% benchmark. They
will need to accelerate progress over the coming decades, so that increased
contraceptive use can translate in to improve maternal and child health, slower
population growth, increased economic well-being and environmental
sustainability [6].
STATEMENT OF THE PROBLEM
Currently, the world population growth is increasing through time to
time in fastest manner. Such kinds of problems are much significant in
developing countries like that of Ethiopia. This is true because currently
Ethiopia is one of the most populated countries in Africa [1].The world
population in the year 1987 GC was 5 billion and it became 6 billion in year
2000 GC. Thus, it is increasing by 1.4% per year approximately. Therefore, if
this rate of growth continues in such manner, the population will be 10 billion
in 2035 [2]. If the population growth continues in this rate in such manner, it
will result economically, socially and health crisis throughout the world.
Unable to use modern contraceptives leads to unwanted pregnancy which
intern results economic and social problem in the family. If the mother is
giving birth frequently without enough gaps in between, she is stayed at home
rearing her children. This problem prevents her from being active participant
in the country and she will draw from social activity, it causes famine and
makes the ecosystem unfavorable [3]. In terms of Health crisis unplanned
pregnancy is known to represent a serious problem in Ethiopia today although
only limited empirical data are correctly available. But the 2005district
hospital finding show more than 20-40% death of mothers is due to the
complication of unsafe abortion. Most victim of unplanned pregnancy was
adolescent. Giving birth at extreme age, i.e., at early adult hood age and near
to Menopause periods has health burden for both the mother and the neonate [4].
Demographic health survey conducted in Sub Saharan African countries
from 2003-2005 showed that more than 20% of women in 9 of 11 countries surveyed
do not want any more children. However, in each of the 9 countries less than 7%
of women are using long acting methods [5]. Though the CPR near doubled from
15% in 2004/2005 to 29% in 2010/2011, it is still very low [7]. According to
the 2011 EDHS report, modern contraceptive use which is dominated by short-term
methods among married women was reported as 29%. Similarly, the overall
prevalence of long acting and permanent contraceptive methods (LAPMs) in
Ethiopia was 12.3% [8].
There was limited and no recently done research in the study area. This
research project used for the concerned body to create awareness of family
planning, increasing family planning service provision and again reducing the
cost of family planning service by showing the prevalence of LAFP. To assess
prevalence of long acting reversible contraceptive methods among women of
reproductive age group in Debre Tabor Town, North West Ethiopia, 2017.
OBJECTIVE
To determine utilization of long acting family
planning method.
MATERIALS AND METHODS
Study area
The study was conducted in Debre Tabor Town
Health facilities. Debre Tabor is the capital of South Gondar Zone which is
located 666 km north-west of Addis Ababa, the capital city of Ethiopia and 103
km South-West of the Capital city of Amhara National Regional state, Bahir Dar.
As the information obtained from South Gondar Zone department, Debre Tabor has
a total population of 87,627 from these 45670 are females and 41957 are male
(2010 EFY). Total reproductive age group women are 14462. The town is divided
by 6 kebeles and has 3 Health Posts, 3 Private Clinics and has 3 Governmental
Health Center and 1 Governmental General Hospital.
Study design and
period
Institutional based cross-sectional study
design was conducted from October 2017-January 2018.
Population
Source of population: All reproductive age group women
who were visit family planning unit of health facilities found in Debre Tabor
Town.
Study population: All reproductive age group women
who were visit family planning unit of health facilities found in Debre Tabor
Town during the study period.
Study unit: Individual reproductive age group
woman from FP user who were interviewee.
Inclusion criteria
All reproductive age group women who were visit
family planning unit of health facilities found in Debre Tabor Town.
Exclusion criteria
Women who lived less than six months in Debre
Tabor Town.
Sample size
determination
The Sample size was determined by using single
population proportion formula by assuming, confidence/Z-level of 95%, marginal
error of 5%, proportion of LARCs from previous study (p=0.156) [12].
n=Z2p (1-p) / d2
Where;
d=Error of margin which is 5%/0.05
n=sample size for Long acting reversible family
planning
z=is confidence level of 95% (1.96)
N=total population of reproductive age group
women in Debre Tabor Town=14462
Then
the sample size was:
Then adding 10% nonresponse rate
Therefore, the final sample size was 223.
Sampling procedure
Systematic sampling technique was used for 223
FP use women in Debre Tabor Town health facility institution. Both public and
private health facilities were providing family planning services in the town.
The study participants were selected by using systematic random sampling method
from family planning service users who visit the health institutions during the
data collection period every kth value (K=N/n=14462/223=65) (K=N/n=14462/223=65).
The first client in each health facility was selected by lottery method. All
subjects shall listen and understand the Amharic language. The interview
questionnaires and the subject number were recorded on each page to insure
proper data tabulation.
Study variables
Dependent variables: Long acting family planning
utilization.
Independent variables: Demographic and socioeconomic
variables: Age, marital status, ethnicity, educational status, occupational and
religion of the respondents, family monthly income, occupation and educational
status of husband, distance of house from the health center.
Variable related with reproductive history: Number
of pregnancies, history of birth, plan and plan for future fertility.
Operational definition
Family planning: The use of birth control to
determine the number of children there will be in a family and when those
children will be born.
Long acting reversible
family planning: A
family panning that used for three to twelve years’ birth control and return to
birth when last the duration of birth control or remove from the body.
Data collection
procedure and instruments
Data was collected through face to face
interview with structured questionnaires. The questionnaires were included
Socio demographic characteristics, educational status. Interview was conducted
after participants took contraceptive method at the service delivery units. As
the study was conducted at all health institution in town which found at
different kebele the principal investigator recruited four health profession
female data collectors and two health profession supervisors to facilitate the
data collection process. In order to collect data, the data collectors were use
structured questionnaire, pencil, pen and paper.
Data quality control
measures
First structured English questionnaire
translate to local language which, was Amharic to facilitate communication and
avoid confusion. The Amharic language questionnaires translated back to English
to check the consistency of the translations.
Furthermore, researcher also gives attention on
the supervisor repeated check up on the data collection process to increase the
validity of the research. Questionnaire was checked manually for their
completeness and consistency when end each interview immediately.
The data collectors were had an hour training
how to collect and handle data as well as how to interview. In addition, the
questionnaire was pre-tested at FinoteSelam Town with 5% of the sample size.
Data processing and
analysis
The collected data was analyzed manually using
scientific calculator after it was edited, stored, organized and checked for
completeness. The data was analyzed using descriptive statistics to describe
frequencies and percentages. Tables, pie chart, graph and other necessary
methods were used to describe the result.
Ethical considerations
The support or cooperation letter was obtained
from DTU, College of health Sciences, and Department of nursing. Then the
respective administrative organization was writing the respective permission
letter to Debre Tabor Town health institutions administrative organ. Oral
consent was obtained from subjects. During data collection the data collectors
was assured about the confidentiality and respect the cultural and social
values of the community under study. Participants was also had informed that
they had full right to discontinue or refuse to participate in the study.
Plan for dissemination
of findings
The results of the study will be shared to
Debre Tabor University, College of Health Science, Department of Nursing and
Debre Tabor Town Health Institutions.
RESULTS
Socio-demographic
variables of respondents
A total of respondents were participated with a
response rate of 98.7%. Most of the respondent’s age was from 18-35 years 197
(89.5%). The mean age with the standard deviation (SD) of the participants was
29.03 ± 5.8 years. Variance age of the respondents was 33.68 years with range
of 22 years. Most of 211 (95.9%) of the respondents were orthodox Christian in
religion. Almost all 214 (97.2%) of participants were Amhara in ethnicity and
majority 179 (81.4%) Of respondents were married. Most of respondent’s 115
(52%) of family monthly income was greater than 2500ETB (Table 1).
Obstetric related
condition
Almost all 200
(97.6%) of respondents’ the age of first marriage was between 18 and 35 years.
And also, majority 142 (64.5%) of mothers were gave their first baby by the age
of 18-35 years (Table 2).
Majority
of respondents 130 (59.1%) were use injectable contraceptive family planning (Figure 1).
Family planning use of respondents
Majority of respondents 108 (49.1%) were use contraceptive 1-3 years duration. Most of respondents 198 (90%) were satisfied with they used FP and 117 (53.2%) were use of first choice FP. 150 (68.2%) of respondents first choice were depo contraceptive (Table 3).
DISCUSSION
This study revealed that utilization of long
acting reversible family planning is 27.3%. The finding of this study is higher
than studies done in different countries like Mini EDHS-2014, 4.2% [10], in
Mekelle City 16.4% [12], in Adigrat town, Tigray Region, 19.5% [13], in Jimma
town, 16% [14], in Arba Minch Town, 13.1% [15], in Debre Markos Town 19.5%
[16], in Fartaworeda, 76 (15.6%) [19] and in Debre Tabor Town 9.2% [20]. This
difference may be due to the gap of the study period and socio-economic variation.
The result of this study is similar with studies done in Debre Berhan Town
27.3% [18]. However; this finding is lower than studies done in different
countries like Lubaga division, Kampala district, Uganda 31.7% [9], in Addis
Ababa 34.8% [11], and in Debre Markos town 33.3% [17].The possible reason for
this discrepancy may be the result of the geographical land and cultural
variation.
The strength of this study is data collectors
were well trained and health profession and one of the limitation of this study
was that did not assess the potential or associated factors that risk factor
for not use of long acting reversible family planning.
CONCLUSION
The overall prevalence of long acting
reversible contraceptives among reproductive age group women in Debre Tabor
Town was60 (27.3%).This coverage is low even if it is better when compare to
the majority of previous study.
RECOMMENDATIONS
·
Amhara regional health bureau shall support the health institution to
give attention for family planning.
·
Debre Tabor Town health office shall give training for health profession
about family planning.
·
Debre Tabor Town health institution staffs shall give health education
for reproductive age group women about family planning especially on long
acting family planning.
·
Researchers shall conduct additional research which will investigate
associated factors to show the gaps for Debre Tabor Town health institution to
reduce the factors.
1. Eke AC, Alabi-Isama L (2011) Long-acting reversible
contraceptive (LARC) use among adolescent females in secondary institutional in
Newi, Nigeria. J Obstet Gynecol 31: 164-168.
2. Hubacher D, Vilchez R, Gmach R, Jarquin C, Medrano J,
et al. (2006) The impact of clinician education on IUD up take, knowledge and
attitudes: Result of a randomized trial. Contraception 73: 628-633.
3. Wesson J1, Olawo A, Bukusi V, Solomon M, Pierre-Louis
B, et al. (2008) Reaching providers is not enough to increase IUD use: A
factorial experiment of ‘academic detailing’ in Kenya. J Biosoc Sci 40: 69-82.
4. Hong R, Montana L, Mishra V (2006) Family planning
services quality as a determination of use of IUD in Egypt. BMC Health Serv Res
6: 79.
5. Neukom J, Chilambwe J, Mkandawire J, Mbewe RK,
Hubacher D (2011) Dedicated providers of long acting reversible contraception:
New approach in Zambia. Contraception 83: 447-452.
6. (2015) Global Health Report.
7. Family Health international (2015) Addressing unmet
need for FP in Africa.
8. Federal Democratic Republic of Ethiopia Ministry of
Health (FMOH) (2011) National Guidelines for family planning services in
Ethiopia, p: 23.
9. Anguzu R, Tweheyo R, Sekandi JN, Zalwango V, Muhumuza
C, et al. (2014) Knowledge and attitudes towards use of long acting reversible
contraceptives among women of reproductive age in Lubaga division, Kampala district,
Uganda. BMC Res Notes 7: 153.
10. Ethiopia Mini Democratic and Health survey (2014)
Utilization of long acting permanent FP methods among women of reproductive
age. EDHS.
11. Tizta D (2015) To assess utilization of LARCMs and its
associated factors among married reproductive age women in Addis Ababa,
Ethiopia. Addis Ababa University.
12. Hailay G (2014) Acceptance of long-acting
contraceptive methods and associated factors among women in Mekelle city,
northern Ethiopia. Sci J Public Health 2: 349-355.
13. Addis AG, Astede FA, Kahsu GG, Woldegebriel GE,
Weldegebriel GK, et al. (2015) Assessment of factor Affecting long acting of FP
Utilization in Adigrat Town, Tigray, North East Ethiopia. Am J Health Res 3:
239-247.
14. Taye A, Woldie M, Sinaga M (2014) Predictors of long
acting reversible contraceptive use among married women visiting health
facilities in Jimma town. J Womens Health Care 4: 217.
15. Shegaw G, Mohamed AA, Nadew K, Tamrat K, Zeru G, et
al. (2014) Long acting contraceptive method utilization and associated factors
among reproductive age women in Arba Minch Town, Ethiopia. Greener J Epidemiol
Public Health 2: 23-31.
16. Bulto GA, Zewdie TA, Beyen TK (2014) Demand for long
acting and permanent contraceptive methods and associated factors among married
women of reproductive age group in Debre Markos Town, North West Ethiopia. BMC
Womens Health 14: 46.
17. Shemels W (2013) Assessment of factors affecting the
use of LARC method among married women of reproductive age in Markos district
North West Ethiopia.
18. Wondwosen A (2014) Utilization of long acting and
permanent FP methods among women of reproductive age group in Debre Birhan Town
North Shewa Ethiopia.
19. Kassa TB, Degu G, Birhanu Z (2014) Assessment of
modern contraceptive practice and associated factors among current married
women age 15-49 years in Farta district, South Gondar Zone, North West Ethiopia.
Sci J Public Health 2: 507-512.
20. Yalew SA, Zeleke BM, Teferra AS (2015) Demand for long
acting contraceptive methods and associated factors among family planning
service users, Northwest Ethiopia: A health facility based cross sectional
study. BMC Res Notes 8: 29.
QUICK LINKS
- SUBMIT MANUSCRIPT
- RECOMMEND THE JOURNAL
-
SUBSCRIBE FOR ALERTS
RELATED JOURNALS
- Proteomics and Bioinformatics (ISSN:2641-7561)
- Journal of Genetics and Cell Biology (ISSN:2639-3360)
- Journal of Agriculture and Forest Meteorology Research (ISSN:2642-0449)
- Advances in Nanomedicine and Nanotechnology Research (ISSN: 2688-5476)
- Food and Nutrition-Current Research (ISSN:2638-1095)
- Journal of Microbiology and Microbial Infections (ISSN: 2689-7660)
- Journal of Astronomy and Space Research