Abstract
Intrauterine Contraceptive Device (IUCD) is a highly effective and reversible modern contraceptive, which is still significantly underutilized in Ethiopia. The aim of this study was to identify factors affecting the use of IUCDs among women of reproductive age group in Addis Ababa. Facility-based, unmatched case-control study was employed among randomly selected cases and controls in selected health centers in Addis Ababa from August to October 2017. The cases (n = 128) were women of reproductive age group who were IUCD users and controls (n = 256) were women of reproductive age group who were users of oral or injectable contraceptives during the study period. After randomly selecting two health center from each sub-city the number of cases and controls were equally allocated to each of the selected health centers. In each selected health center, all eligible cases were enrolled consecutively until the sample size was achieved. Two consecutive controls were selected for each case. Data was collected face-to-face by trained nurses by using structured questionnaire. Factors associated with IUCD use were identified by multi-variable binary logistic regression models using the backward conditional stepwise method. In the multi-variable analysis, IUCD use was strongly associated with husbands/partners being supportive of IUCD use (Adjusted OR = 13.24, 95% CI; 5.30-33.02), being literate women (Adjusted OR = 5.31, 95% CI; 1.05-26.93), women having a perception of IUCD does not cause infection (Adjusted OR = 4.38, 95% CI; 1.45-13.26) and the source of information about IUCD being mass-media (Adjusted OR = 3.81, 95% CI; 1.49-9.74). The findings of the study reinforce the need of husbands/partners involvement in the interventions to enhance utilization of IUCD. Moreover, due attention should also be provided for delivering IUCD-related messages in the public mass-media.
Highlights
Contraceptives reduce the number of abortions, prevent unintended pregnancies, and lower the incidence of death and disability related to complications of pregnancy and childbirth
In the multi-variable analysis, Intrauterine Contraceptive Device (IUCD) use was strongly associated with husbands/partners being supportive of IUCD use (Adjusted Odds ratios (OR) = 13.24, 95% confidence interval (CI); 5.30–33.02), being literate women (Adjusted OR = 5.31, 95% CI; 1.05–26.93), women having a perception of IUCD does not cause infection (Adjusted OR = 4.38, 95% CI; 1.45–13.26) and the source of information about IUCD being mass-media (Adjusted OR = 3.81, 95% CI; 1.49–9.74)
After controlling for confounding variables in the multi-variable binary logistic regression analysis using backward stepwise method (Table 5), IUCD use was associated with husbands/partners being supportive, educational status, women having a perception of IUCD does not cause infection and the source of information about IUCD being mass media/ friends
Summary
Contraceptives reduce the number of abortions, prevent unintended pregnancies, and lower the incidence of death and disability related to complications of pregnancy and childbirth. It is reported that an additional 24 million abortions, 6 million miscarriages, 70,000 maternal deaths and 500,000 infant deaths would be prevented, if all women with an unmet need for contraceptives were able to use modern methods worldwide [1, 2]. Ethiopia still remains one of the countries with low contraceptive use rate, high fertility rate (the second populous and one of the highest fertility rates in Africa, with about 40% of its population is under fifteen) and high number of unintended pregnancies [4,5,6,7,8]. Increasing the uptake of modern contraception is one of the solutions in order to decrease the fertility rate and to reduce the unmet need for family planning [4, 6, 9, 10].
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