Prevalence and factors associated with uptake of long-acting reversible contraceptives in Kiambu Level Five Hospital Kiambu County

Abstract

Background: Postpartum long-acting reversible contraceptive (LARC) methods provide effective contraception. However, little is known about the socio-demographic and reproductive factors associated with postpartum, its uptake and barriers to the use of postpartum LARC. Objective: To determine the prevalence of, socio-demographic and reproductive factors associated with uptake of, and barriers to the use of postpartum LARCs among women seeking FP services at Kiambu Level Five Hospital, Kiambu County, Kenya. Methods: A cross-sectional study was employed from May to June 2019 among women visiting Kiambu Level Five Hospital in Kiambu County, Kenya. A total of 172 married women were selected using systematic random sampling method and interviewed about their postpartum contraceptive use. Data was collected using semi-structured interviewer-administered questionnaire. Descriptive statistics were used to estimate the prevalence of LARC, chi-square statistic was used for comparisons. Univariable and Multivariable logistic regression were used to isolate associations/effect of postpartum LARC predictors with the outcome. Results: The prevalence of postpartum LARC was 31.4% (95% CI: 22.7, 41.4%). The women in age group 25–34 years old [COR: 0.346; 95% CI=0.236, 0.952, p<0.05] and 35+ years old [COR: 5.08; 95% CI=1.26, 20.46] were less likely and more likely respectively to take up postpartum LARC than those in 15–24 years’ age group. Women who ever used LARC [COR: 26.81; 95% CI=3.31, 217.35, p=0.002] were also more likely to currently use LARC than those who didn’t. Women whose spouses/partners completed secondary school [AOR: 0.06; 95% CI=0.001, 0.97] and tertiary [AOR: 0.05; 95% CI=0.001, 0.87] were less likely to currently use LARC than those who completed primary school. The postpartum women who had resumed menstruation [AOR: 0.34; 95% CI=0.12, 0.98] were less likely to use LARC than their counterparts who hadn’t resumed their menses. Resumption of menstruation (p<0.05) and sexual activity (p<0.001) had statistically significant differences in women using and those not using contraceptive since delivery. Significant differences in proportions of both sexual intercourse and menstrual resumption (p<0.05) in postpartum any contraceptive users and non-users were found. The major barrier to lack of uptake was side effects. Conclusions: Nearly ⅓ of women utilized LARC during the postpartum period. Age group, ever used LARC, highest level of education completed by partner and resumption of menstruation were all associated with the current use of postpartum LARC. The major barriers to lack uptake were side effects, lack of knowledge of postpartum family planning. Recommendations: Increasing access through counseling would be a highly effective strategy to meet the unmet needs of postpartum LARC.