Use of Modern Family Planning Methods in Fishing Communities of Lake Victoria, Uganda.

Annet Nanvubya,Mathias Wambuzi,Ali Ssetaala,Julius Ssempiira,Leslie Nielsen,Annet Nalutaaya,Sabrina Welsh,Stephen Asiimwe,Juliet Mpendo,Fredrick Makumbi,Bernard S Bagaya,Paul Kitandwe,Noah Kiwanuka,Virginia J Vitzthum

doi:10.1371/journal.pone.0141531

Abstract

IntroductionFishing communities (FCs) in Uganda have high HIV infection rates but poor access to health services including family planning (FP). Although FP is a cost-effective public health intervention, there is a paucity of data on knowledge and use of modern FP in FCs. This study determined knowledge and use of modern FP methods in FCs of Uganda.MethodsData were accrued from a 12-month follow up of 1,688 HIV-uninfected individuals, 18–49 years from 8 FCs along Lake Victoria, between September 2011 and March 2013. Data on knowledge and use of modern FP were collected through a semi-structured questionnaire. Prevalence Risk Ratios with corresponding 95% CIs were used to determine factors associated with Modern FP knowledge and use.ResultsThe mean age was 31.4 years, with nearly half (48.8%) being females while more than half (58.6%) had attained up to primary education level. Knowledge of modern FP was high, 87.5% (1477/1688); significantly higher among females [adj. PRR = 4.84 (95% CI; 3.08, 7.61)], among older respondents (25–29 years) [adj. PRR = 1.83 (95% CI; 1.12, 2.99)] compared to younger ones (18–24 years) and among those conducting business [adj. PRR = 2.42(95% CI; 1.02, 5.74)] relative to those primarily in fishing. Just over a third (35.2%, 595/1688) reported use of at least one modern FP method. Use of modern FP methods was significantly higher among females [adj. PRR = 2.04 (95% CI; 1.56, 2.65, and among those reporting multiple sexual partnerships [adj. PRR = 2.12, 95% CI; 1.63, 2.76)]. Nonuse of modern methods was mostly due to desire for more children (30.6%), fear of side effects (12.2%) and partner refusal (5.2%).ConclusionDespite their high knowledge of FP, FCs have low use of modern FP methods. Key barriers to use of modern FP methods were high fertility desires, fear of perceived side effects and partner refusal of methods.

Highlights

Annet Nanvubya1*, Julius Ssempiira1, Juliet Mpendo1, Ali Ssetaala1, Annet Nalutaaya1, Mathias Wambuzi1, Paul Kitandwe1, Bernard S
In Uganda, Fishing communities (FCs) have been shown to have HIV infection rates approximately three to six times higher than in the general population [1,5,6,7,8,9]. This vulnerability stems from complex, interdependent causes which include the mobility of many fisher folk, the time fishermen and fish traders spend away from home, their access to daily cash income in an overall context of poverty and vulnerability, their demographic profile and the ready availability of commercial sex in many fishing villages [5,6,7,10]
Because of the high HIV rates, these communities are being targeted for HIV care and prevention interventions which include use of modern Family Planning (FP) methods

Summary

Methods

Data were accrued from a 12-month follow up of 1,688 HIV-uninfected individuals, 18–49 years from 8 FCs along Lake Victoria, between September 2011 and March 2013. Data on knowledge and use of modern FP were collected through a semi-structured questionnaire. Prevalence Risk Ratios with corresponding 95% CIs were used to determine factors associated with Modern FP knowledge and use. The studied FCs included Kasenyi landing site and Islands of Myende, Namisoke, Kiimi, Makusa, Jaana, Kavenyanja and Zinga. These communities are remotely located and face challenges with regard to land and water transport. Uganda is a multi-ethnic country with the Baganda as the majority. Other ethnic groups include the Banyankore, Basoga, Banyoro, Batoro, Bagisu, Luo and are collectively referred to in this paper as non-Baganda. This study was conducted in an area predominately inhabited by the Baganda ethnicity

Results

Discussion

Conclusion