Characteristics of first-time family planning users and methods used at mobile clinics in rural Malawi

Abstract

Setting: Malawi committed to increase modern contraceptive prevalence rate to 60% for all women by 2020, but current use ranges from 37% to 59% among women of different ages and marital status.Objectives: To describe characteristics of first-time family planning (FP) users and associations between characteristics and methods used among women of childbearing age accessing injectables, oral contraceptives and implants in rural mobile clinics in Mulanje, Malawi, in 2017–2018.Design: This was a cross-sectional retrospective study.Results: Among 2120 first-time FP users, 65% were <25 years. Half (50%) had 2–4 live children and only 1% were nulliparous. HIV infection rate among all users was 4%. Of the three methods, injectables were used most (75%), with a significantly higher use in HIV-positive clients (91%). Nearly 25% of first-time users used implants and the proportion increased from 21% in 2017 to 34% in 2018.Conclusion: This study demonstrated that FP can be provided to young women in remote areas if the availability of well-trained providers is ensured. It highlighted the need to target younger and nulliparous women with a broad mix of contraceptives to improve access to, and uptake of, FP services to reach national commitments.