Factors affecting uptake of the levonorgestrel-releasing intrauterine device: A mixed-method study of social franchise clients in Nigeria

Autor: Anthony Adindu Nwala, Kate H Rademacher, Aurélie Brunie, Kayla Stankevitz, Megan Lydon, Kendal Danna, Kayode Afolabi
Rok vydání: 2021
Předmět:
Medical Implants
Maternal Health
Logistic regression
Vascular Medicine
Biochemistry
Geographical Locations
Pregnancy
Surveys and Questionnaires
Medicine and Health Sciences
Contraceptive Agents
Female

Levonorgestrel
Prospective Studies
Young adult
Drug Implants
Multidisciplinary
Obstetrics and Gynecology
Drugs
Contraceptives
Middle Aged
Contraception
Scale (social sciences)
Engineering and Technology
Medicine
Female
Contraceptive implant
Research Article
Biotechnology
medicine.drug
Adult
medicine.medical_specialty
Science
Nigeria
Hemorrhage
Bioengineering
Qualitative property
Intrauterine device
Injections
Young Adult
Signs and Symptoms
medicine
Humans
Female Contraception
Pharmacology
business.industry
Biology and Life Sciences
Intrauterine Devices
Copper

Hormones
Male Contraception
Family medicine
People and Places
Africa
Women's Health
Survey data collection
Medical Devices and Equipment
Clinical Medicine
business
Zdroj: PLoS ONE, Vol 16, Iss 9, p e0257769 (2021)
PLoS ONE
ISSN: 1932-6203
Popis: Background Despite the positive characteristics of the levonorgestrel-releasing intrauterine device (IUD)–a long-acting, highly effective contraceptive with important non-contraceptive attributes–the method has not been widely available in low- and middle-income countries. This study of hormonal IUD, copper IUD, implant and injectable users in Nigeria compares their characteristics, reasons for method choice, and experiences obtaining their method. Methods We conducted a phone survey with 888 women who received a hormonal IUD, copper IUD, contraceptive implant or injectable from 40 social franchise clinics across 18 states in Nigeria. We analyzed survey data descriptively by method and assessed factors associated with hormonal IUD use through multivariate logistic regression models. Follow-up in-depth interviews conducted with 32 women were analyzed thematically. Results There were few differences by method used in the socio-demographic profiles and contraceptive history of participants. Among users choosing a long-acting, reversible method, the top reasons for method choice included perceptions that the method was “right for my body,” long duration, recommended by provider, recommended by friends/family, few or manageable side effects, and high effectiveness. Among hormonal IUD users, 17% mentioned reduced bleeding (inclusive of lighter, shorter, or no period), and 16% mentioned treatment of heavy or painful periods. Qualitative data supported these findings. Among survey respondents, between 25% and 33% said they would have chosen no method if the method they received had not been available. Both quantitative and qualitative data indicated that partner support can affect contraceptive use, with in-depth interviews revealing that women typically needed partner permission to use contraception, but men were less influential in method choice. Conclusions Expanding access to the hormonal IUD as part of a full method mix provides an opportunity to expand contraceptive choice for women in Nigeria. Findings are timely as the government is poised to introduce the method on a wider scale.
Databáze: OpenAIRE