Factors influencing use of long-acting versus short-acting contraceptive methods among reproductive-age women in a resource-limited setting
Factors influencing use of long-acting versus short-acting contraceptive methods among reproductive-age women in a resource-limited setting
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DOI：
10.1186/s12905-017-0382-2
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发表时间：
2017-04-04
影响因子：
2.5
通讯作者：
Bajunirwe, Francis
中科院分区：
文献类型：
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作者：
Tibaijuka, Leevan;Odongo, Robert;Bajunirwe, Francis
背景：在许多资源有限的环境中，意外怀孕仍然是一个普遍问题，主要是由于获得现代计划生育服务的机会有限。特别是，较有效的长效可逆避孕方法（即宫内节育器和激素植入）的使用率仍然低于短效避孕方法（即避孕套、激素药丸、注射激素和杀精剂）。在乌干达参加计划生育和产前保健诊所的育龄妇女中，我们评估了对使用现代避孕方法的看法和做法。我们特别旨在评估影响方法选择的因素。方法：我们进行了一项混合方法的横断面研究，其中我们对180名客户进行了结构化访谈，对36名客户进行了4次焦点小组讨论（fgd），并对卫生服务提供者进行了8次深入的个人定性访谈。我们总结了定量数据，并对fgd和定性访谈的转录本进行了潜在内容分析。结果：LARC方法的使用率为23%。方法特征（如客户控制）似乎比结构因素（如方法可用性）或客户个体特征（如知识和感知）更经常地驱动方法选择。选择LARC方法最常见的原因是：保护期较长；更好的child-spacing;和有效性。不选择LARC方法的最常见原因包括需要客户控制的方法和希望在不久的将来怀孕。选择short - short方法的最常见原因是易于访问；更低的成本;隐私;感觉副作用少；以及在不涉及医疗服务提供者的情况下停止使用某种方法的自由。客户的个人特征，这似乎是重要的客户知识和子女的数量。似乎重要的结构因素是方法的可得性。结论：我们的研究结果表明，在这种情况下，提高育龄妇女LARC吸收的干预措施应考虑：将所需的方法特征纳入LARC方法；有针对性地推广和供应LARC；增加咨询、宣传和教育。
Background: Unplanned pregnancy remains a common problem in many resource-limited settings, mostly due to limited access to modern family planning (FP) services. In particular, use of the more effective long-acting reversible contraceptive (LARC) methods (i. e., intrauterine devices and hormonal implants) remains low compared to the shortacting methods (i. e., condoms, hormonal pills, injectable hormones, and spermicides). Among reproductive-age women attending FP and antenatal care clinics in Uganda, we assessed perceptions and practices regarding the use of modern contraceptive methods. We specifically aimed to evaluate factors influencing method selection.Methods: We performed a mixed-methods cross-sectional study, in which we administered structured interviews to 180 clients, and conducted 4 focus group discussions (FGDs) with 36 clients and 8 in-depth personal qualitative interviews with health service providers. We summarized quantitative data and performed latent content analysis on transcripts from the FGDs and qualitative interviews.Results: The prevalence of ever use for LARC methods was 23%. Method characteristics (e. g., client control) appeared to drive method selection more often than structural factors (such as method availability) or individual client characteristics (such as knowledge and perceptions). The most common reasons for choosing LARC methods were: longer protection; better child-spacing; and effectiveness. The most common reasons for not choosing LARC methods included requiring a client-controlled method and desiring to conceive in the near future. The most common reasons for choosing shortacting methods were ease of access; lower cost; privacy; perceived fewer side effects; and freedom to stop using a method without involving the health provider. The personal characteristics of clients, which appeared to be important were client knowledge and number of children. The structural factor which appeared to be important was method availability.Conclusions: Our results suggest that interventions to improve uptake of LARC among reproductive age women in this setting should consider: incorporating desired method-characteristics into LARC methods; targeted promotion and supply of LARC; and increased counselling, sensitization, and education.