Factors affecting hormonal and non hormonal contraceptive method use in women presenting to Reproductive Health Services-A Centers (RHS-A) of Karachi

Abstract

Fertility is an important predictor of maternal mortality: high fertility levels being associated with high maternal mortality. Factors like use of contraception, fertility preferences are empirically shown to influence fertility levels. Choosing a method of birth control, its effectiveness and safety are the key considerations. Objectives of the study were to determine the proportion of women using hormonal and non-hormonal contraceptive methods among modern contraceptive users and to determine factors associated with use of hormonal and non-hormonal contraceptive methods. This was a Cross sectional study conducted on women of 15-49 years of age who were continuously and consistently using a modern contraceptive method for at least last three months. Women were selected by convenient sampling technique from four family planning centers located in Karachi. Women who refused to participate or those women who had language problem were excluded from the study. Information was gathered regarding demographic and socioeconomic status, previous pregnancies, health concerns, previous knowledge of contraceptives and husband's approval. After adjusting for other variables in the model, it was found that with every one year increase in age of women the odds of hormonal use decreased (OR 0.91; 95% CI 0.88, 0.93). It was also found that with every one additional child in the family, the odds of hormonal use decreased (OR 0.79; 95% CI 0.73, 0.86). Women whose husbands approved of contraception were found at lesser odds of hormonal use (OR 0.43; 95% CI 0.25, 0.73). Women whose source of knowledge of contraceptives were family and friends were also found at decreased odds of hormonal use (OR 0.64; 95% CI 0.45, 0.92). Women with health concerns were found at elevated odds of hormonal use (OR 1.70; 95% CI 1.32, 2.19). The hormonal user in our study is a young woman of 29 years of age, with an average of four pregnancies and same number of living children, who does not require her husband's approval for contraceptive use. Her existing knowledge of contraceptive use is influenced by family and friends who is not in favor hormonal use. She is concerned about her health related to her current contraceptive method. Media has little role for dissemination of information regarding contraceptives.