Abstract
Aim: To document reasons for the low uptake of Copper 380A contraceptive in Zaria, Northern Nigeria. Study Design: Qualitative analysis from In-depth interviews (IDI) and Focus group discussions (FGD). Setting: Zaria, Northern Nigeria. Methods: Five high volume public facilities within Zaria metropolis were selected for the study (the teaching hospital, two district hospitals serving the metropolis and two primary care centers). The most experienced provider in each of these facilities was engaged in an IDI to explore reasons for the low uptake of IUD from their perspective. Similarly, a session of FGD was conducted in each of the facility involving at least eight family planning clients who were para 4 or more and not using the IUD. Results: There were a total of 397 new clients that were served various methods of contraceptive across the five facilities three months prior to the study. Intrauterine device only accounted for 11.8% of these clients while Injectable was responsible for 62% of clients. 72% of the IUD insertions took place in the teaching hospital. There were no IUD insertions in the two primary care centers within the last three months prior to study. Conclusion: Misconceptions, lack of information concerning IUD particularly at the primary care levels, lack of male involvement and providers’ incompetence were the main barriers to accessing IUD services in Zaria, Nigeria. In the course of this investigation, local Ethics were observed.
Highlights
Current data revealed that the contraceptive prevalence rate of Nigeria is about 10% and this is far less than the African average of 30% [1] [2]
We investigated the factors militating against the uptake of Intrauterine device (IUD) from both the provider and client perspective using qualitative methods
The service delivery records revealed that there were a total of 397 clients served with various modern contraceptives across the five selected facilities of which IUD accounted for only 12% of the methods while injectable contraceptives were given to 62% of the clients (Table 1)
Summary
Current data revealed that the contraceptive prevalence rate of Nigeria is about 10% and this is far less than the African average of 30% [1] [2]. Established data documented regional differences in the pattern of contraceptive use. In the South-West and South-South, Intrauterine device (IUD) is the commonest contraceptive in use accounting for 30% - 55% of clients [4]-[6]. In the South-East, injectable contraceptive and fertility awareness methods are the commonest methods in use [7] [8]. In North-West and North East the injectables appeared to be the commonest method accounting for over 50% of clients [9] [10], whereas in the North-Central region over one-third of clients used the IUD [11]
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