Potential user interest in new long-acting contraceptives: Results from a mixed methods study in Burkina Faso and Uganda
Potential user interest in new long-acting contraceptives: Results from a mixed methods study in Burkina Faso and Uganda
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DOI：
10.1371/journal.pone.0217333
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发表时间：
2019-05-28
期刊：
影响因子：
3.7
通讯作者：
Makumbi, Fredrick
中科院分区：
文献类型：
--
作者：
Callahan, Rebecca L.;Brunie, Aurelie;Makumbi, Fredrick
与方法有关的关切是不使用和停止使用避孕药具的一个重要原因。在设计新的避孕技术时必须考虑到使用者的偏好，以确保产品成功并改善计划生育成果。我们评估了布基纳法索和乌干达的潜在使用者对目前正在开发或准备引入的六种避孕方法的偏好：新的铜宫内节育器（IUD），左炔诺孕酮宫内节育器系统，新的单杆植入物，可生物降解的植入物，长效注射剂和非手术永久避孕方法。在具有全国代表性的PMA 2020家庭调查中增加了问题，分别询问了布基纳法索和乌干达的2 743名和2 403名妇女，她们对使用每种新方法的兴趣。我们通过多变量逻辑回归模型评估了与兴趣相关的因素。我们进行了定性访谈和焦点小组与398名妇女，78名男子，和52个计划生育服务提供者和关键的线人，以探讨感知的优势和劣势的方法。受访者表示有兴趣使用所有新的方法，最感兴趣的是长效注射剂（布基纳法索77%，乌干达61%），其次是新的单杆植入物。最不感兴趣的是新的铜宫内节育器（布基纳法索26%，乌干达15%）。在这两个国家，受教育程度较低的女性对长效注射剂的兴趣更高。对大多数新方法的兴趣与希望持续一年以上的方法和接受月经不出血作为避孕副作用有关。不同国家之间的感知优势和劣势相似，包括对月经副作用的担忧和对可生物降解植入物的可生物降解性的担忧。潜在的使用者，他们的合作伙伴和提供者对新的长效方法感兴趣，但是，包括注射剂和植入剂在内的熟悉形式可能是最直接可接受的。可生物降解的植入物需要明确的咨询信息来减轻潜在的恐惧。
Method-related concerns represent an important cause of contraceptive non-use and discontinuation. User preferences must be incorporated into the design of new contraceptive technologies to ensure product success and improve family planning outcomes. We assessed preferences among potential users in Burkina Faso and Uganda for six contraceptive methods currently under development or ready for introduction: a new copper intra-uterine device (IUD), a levonorgestrel intra-uterine system, a new single-rod implant, a biodegradable implant, a longer-acting injectable, and a method of non-surgical permanent contraception. Questions were added to nationally-representative PMA2020 household surveys that asked 2,743 and 2,403 women in Burkina Faso and Uganda, respectively, their interest in using each new method. We assessed factors associated with interest through multivariable logistic regression models. We conducted qualitative interviews and focus groups with 398 women, 78 men, and 52 family planning providers and key informants to explore perceived advantages and disadvantages of the methods. Respondents expressed interest in using all new methods, with greatest interest in the longer-acting injectable (77% in Burkina Faso, 61% in Uganda), followed by a new single-rod implant. Least interest was expressed in a new copper IUD (26% Burkina Faso, 15% in Uganda). In both countries, women with less education had higher odds of interest in a longer-acting injectable. Interest in most new methods was associated with desiring a method lasting longer than one year and acceptance of lack of menstrual bleeding as a contraceptive side effect. Perceived advantages and disadvantages were similar between countries, including concerns about menstrual side effects and fear of the biodegradable nature of the biodegradable implant. Potential users, their partners, and providers are interested in new longer-acting methods, however, familiar forms including the injectable and implant may be the most immediately acceptable. A biodegradable implant will require clear counseling messages to allay potential fears.