Utilization of Immediate Post-Partum Intra Uterine Contraceptive Device and Associated Factors: A Facility based Cross Sectional Study among Mothers Delivered at Public Health Facilities of Sidama Zone, South Ethiopia

Abstract

Background: Insertion of an Intra Uterine device (IUD) immediately after delivery have a proven record of very high effectiveness, protection against unintended pregnancy, cost effectiveness, suitability and high user satisfaction. Despite these benefits, information on Post-Partum Intra Uterine device (PPIUD) acceptance and utilization was limited in Ethiopia. Therefore, this study was aimed to assess postpartum intra uterine contraceptive device utilization and its associated factors among mothers delivered in selected facilities found in South Ethiopia. Methods: A facility based cross-sectional study was conducted in two health facilities providing PPIUD insertion service (Yirgalem hospital and Bursa health center). Data were collected using structured questionnaire among 310 selected women. Frequency tables and graphs were used to describe the study variables. Bivariate and multivariate logistic regression analysis methods were used to identify factors associated with postpartum intrauterine device use. Variables with P-value of <0.05 with 95% CI were used to declare statistical significance. Results: Postpartum intra uterine contraceptive device use within 48 h of delivery was 21.6% while 38% of the respondents were interested in using PPIUD. Only 22.8% of participant mothers were counselled during ANC, labor and postpartum period. Mother who do not have a plan to have another child [AOR=2.36, 95% CI, (1.25, 4.47)], undecided plan to have another child [AOR=0.17, 95% CI, (0.05, 0.58)], mothers who did not heard [AOR=0.41, 95% CI: 0.41 (0.20, 0.83)] and not counselled about PPIUD [AOR=0.17, 95% CI: 0.17 (0.06, 0.52)] were associated with PPIUD utilization. Conclusion: Despite more than one-third of participants were accepted PPIUD, the actual utilization was low. Most mothers were not counselled during the important contact points through the whole cascade of pregnancy. Program managers need to develop strategies to raise pregnant mother awareness on PPIUCD through media sources. This study also highlights, the need to improve and integrate standard PPIUD counselling scheme during FANC, labor and postpartum period.