Prevalence and correlates of postabortion long-acting\xa0reversible contraceptive (LARC) use among young women (24 and below) in Nepal: Strategy in the search for improvements

Suresh Mehata,Jamie Menzel,Shadie Tofigh,Mukti Nath Khanal,Kathryn Andersen,Navaraj Bhattarai,Mukta Shah,Shibesh Chandra Regmi,Pratik Khanal

doi:10.1186/s12978-019-0708-7

Suresh Mehata, Jamie Menzel + Show 7 more

Open Access

https://doi.org/10.1186/s12978-019-0708-7

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Journal: Reproductive health	Publication Date: May 14, 2019
Citations: 5	License type: open-access

Affiliation: Ministry of Health and Population

Abstract

IntroductionPostabortion contraceptive use differs across countries, suggesting the need for country-level research to identify barriers and suggest appropriate interventions. This study aimed to identify the prevalence and correlates of postabortion long-acting reversible contraceptive (LARC) use among women aged 24 or younger in Nepal.MethodsThis is a cohort study using Health Management Information System (HMIS) data where individual case records of women seeking induced abortion or postabortion care were documented using structured HMIS 3.7 records. Analysis was performed on the individual case records of 20,307 women 24 years or younger who received induced abortion or postabortion care services in the three-year period from July 2014 to June 2017 at 433 public and private health facilities.FindingsOverall, LARC uptake during the study period was 11% (IUD: 3% and implant: 8%). The odds of LARC acceptance was higher for young women (24 and below) who belonged to Brahmin/Chhetri (AOR = 1.23; 95% CI: 1.02–1.47) and Janajatis (AOR = 1.20; 95% CI: 1.01–1.43) as compared to Dalits; young women who had an induced abortion (AOR = 3.75; 95% CI: 1.75–8.06) compared with postabortion care; and those receiving service from public sector health facilities (AOR = 4.00; 95% CI: 2.06–7.75) compared with private sector health facilities.ConclusionThe findings from this study indicate the need to focus on barriers to acceptance of LARC among several groups of young women (24 and below) receiving abortion care in Nepal: Dalits, Madhesis and Muslims; nulliparous women; and those receiving services at private sector health facilities.

Highlights

Postabortion contraceptive use differs across countries, suggesting the need for country-level research to identify barriers and suggest appropriate interventions
The findings from this study indicate the need to focus on barriers to acceptance of long-acting reversible contraceptive (LARC) among several groups of young women (24 and below) receiving abortion care in Nepal: Dalits, Madhesis and Muslims; nulliparous women; and those receiving services at private sector health facilities
This study utilizes data from Health Management Information System (HMIS) 3.7 to assess the prevalence of LARC use and its association with age, education, number of living children, caste/ethnicity, gestational age, diagnosis, abortion method, facility type and sector, and postabortion contraceptive acceptance

Summary

Introduction

Postabortion contraceptive use differs across countries, suggesting the need for country-level research to identify barriers and suggest appropriate interventions. This study aimed to identify the prevalence and correlates of postabortion long-acting reversible contraceptive (LARC) use among women aged 24 or younger in Nepal. Long-acting reversible contraceptives (LARCs), such as intrauterine devices (IUDs) and sub-dermal implants, offer the highest level of reversible protection against pregnancy and for a longer time period [3 years to 12 years] [2, 3]. They are safe, effective, and considered the most cost-effective methods [3, 4]. Factors affecting LARC use differ between countries suggesting the need for country-level research to identify barriers to use [6,7,8,9]

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