Perceptions and Acceptance of Levonorgestrel Implants among Family Planning Clients within greater Banjul Area, The Gambia

Abstract

A better understanding of women’s perception of levonorgestrel implants has the potential to help women and their partners freely choose the number and spacing of their children and thus, increase contraceptive prevalence. The contraceptive prevalence rate is very low in the Gambia; only 8 per cent of the women of reproductive age use modern methods of family planning and 1 per cent using traditional methods and an implant utilization rate of 3.9%. Therefore, the purpose of the study is centered on exploring the perceptions and acceptance level of Levonorgestrel Implants among family planning (FP) clients in Western Health Region One (WHR, 1). The perception and acceptance of implants among users is not well documented in the Gambia despite established knowledge of availability at little or no cost in most health facilities. A phenomenological qualitative study design was employed and twelve women were purposively selected from two hospitals to serve as participants. Focus group discussions were used as data collection method among six women per discussion. Qualitative data analysis method used for the study was the Editing Analysis Style where, the data were interpreted in search of meaningful segments and units. The data were analyzed using themes and categorizing the responses of the participants under each theme with verbatim quotes used wherever necessary. Sociodemographic findings revealed that majority of the women were between the ages of 30-39 (SD± 5.35) ranging from 25 to 45 years with a mean age of 32.75 years. More than half of the study participants had between 1-4 children (n = 7, 58.33), with a mean parity of 3.75 (SD±2.48). Almost all of them were Muslims (n =11, 91.66 %). All of them received some form of education with the highest level being secondary (Conventional) (n = 6, 50%). Majority were housewives (n= 6, 50%), married (n = 11, 91.66%). The findings showed that six themes emerged from both Focus Group Discussions where the majority of the respondents gave similar answers. The themes that were reported on were; efficacy, service provider’s attitude, husband/spousal approval, undesired effects, myths and misconceptions, and satisfaction. In conclusion, the use of Implants for family planning depends on clients’ perceptions. Therefore, understanding client’s perceptions on implants would help to improve prevalence, thus reducing unintended pregnancies, induced abortions, short birth intervals, fertility rates and maternal mortality and morbidity in the country.