Acceptance and Positive Attitude Increased Utilization of Long Acting and Permanent Family Planning Methods Among Reproductive Age Group Women from Debre Berhan District, Ethiopia: Quantitative and Qualitative Analysis

Abstract

Background: Wider access and use of long-acting and permanent methods of contraception are the most effective contraceptives available to contribute to reduction of the high levels of maternal mortality and morbidity. Yet, utilization of long acting and permanent contraception methods in Ethiopian is recorded to be low. Objective: The purpose of this study was to describe utilization of long acting reversible and permanent family planning methods and identify associated factors among women of 15-49 years age group in Debre Berhan district, Ethiopia. Methods: A community based cross-sectional study was conducted in four selected kebeles of Debre Berhan. Cluster sampling was used to select study subjects for survey while purposive sampling was used to select study subjects for qualitative study. A pre-tested structured questionnaire was used to collect quantitative data and interviewer topic guide was used for qualitative. The survey data was entered into Epi-Info version 3.5.4 and exported, cleaned and analyzed using SPSS version 21. Open code version 3.6.2 was used to categorize and code qualitative data. Factors associated with utilization of long acting and permanent contraceptive methods were identified using logistic regression model and content analysis of qualitative data. Results: Current utilization of long acting and permanent family planning methods among women of reproductive age was estimated to be 27.3% (95% CI: 23.4-31.2). Women of 24-35 age group were 2.23 (AOR=2.23; 95% CI: 1.18-4.18) times more likely to utilize long acting and permanent contraceptive methods as compared to those women whose age was 35 and above. Women who had positive attitude towards the method were 1.87 times more likely to use long acting and permanent contraceptive methods as compared to those women who had negative attitude (AOR=1.87; 95% CI: 1.13-3.07). Clients who were satisfied with treatment and advice given were 1.81 times more likely to use long acting and permanent contraceptive methods as compared to those clients who were not satisfied (AOR=1.81; 95% CI: 1.1-2.99). Myths and misconceptions about intrauterine device and implants were major barriers for the use of long acting and permanent contraceptive methods. Conclusion: Acceptance, positive attitude, client satisfaction and age were factors affecting utilization, whereas myth and misconception in the community hindered use of long acting and permanent contraceptive methods. Therefore, sustained and appropriate information on long acting and permanent contraceptive methods should be provided to raise awareness and build the attitude of women and the community. District health office should design educational programs that promote long acting family planning and reduce barriers at community level in the town. Moreover, health professionals should improve the quality of long acting and permanent contraceptive methods service, which enhances satisfaction.