Intention to use long acting and permanent contraceptives methods and associated factors among family planning clients in Nekemte Town, Oromia Regional State, West Ethiopia

Abstract

Background: Long acting and permanent methods (LAPMs) of family planning are essentially important to achieve health related Millennium Development Goals as well as to meet individuals and couple’s needs. Worldwide, it is estimated that 210 million pregnancies occur each year, some 80 million are unintended and 33 million of these are due to ineffective use of a contraceptive method. An increase in the use of effective contraceptive methods results in reducing unintended pregnancies and the incidence of abortion. However, utilization of LAPMs is very low as family planning users are still concentrated on short-term methods, which requires repeated revisit to health institution to resupply. Yet, the level of and barriers to the use of LAPMs are not well explored. Objectives: The objective of this study was to assess intention to use long acting and permanent methods and associated factors among family planning clients in Nekemte Town. Methods: Health facility based cross-sectional study was conducted on randomly selected 388 subjects in March 2015 in Nekemte Town. The sample subjects were selected from all health facilities providing family planning services considering proportional to sample size. Data were collected using an interviewer-administered questionnaire, entered to Epi Data version 3.1 and analyzed using SPSS version 21 statistical software. Results: A total of 383(98.7%) mothers participated in the study. prevalence of intention to use LAPMs was 200(52.2%) and 176(46%) of respondents had negative attitude towards intention to use LAPMs. Intention to use LAPMs was higher among respondents who had supportive attitude toward LAPMs (AOR=2.1; 95% CI: 1.3-3.4), attended primary (AOR=2.6; 95% CI: 1.2-5.8), secondary (AOR= 5.2; 95% CI: 2.2-12.6) and higher (AOR=7.6; 95% CI: 2.9-19.7) education. Intention to use LAPMs was also higher among mothers who had no myths and misconception on LAPMs (AOR= 2.1; 95% CI: 1.2-3.6) and who had perceived IUCD and/ or implants don’t cause illness (AOR= 2.0; 95% CI: 1.2- 3.5). Those mothers who had no functional television had lower intention to use LAPMs (AOR=0.55; 95% CI: 0.32-0.96). The main reasons cited for not intending to use LAPMs was, fear of side effects 84(45.9%), husband disapproval 57(31.1%) and fear of infertility after use 20(10.9%). Conclusion: The intention to use LAPMs among respondents was low, presence of myths and misconception, lack of education and supportive attitude toward LAPMs adversely affected intention to use the methods. Fear of side effects, husband disapproval, and fear of infertility were some of the reasons for not intending the use of LAPMs. Recommendation: Information, education and communication/ behavioral change communication/ should address factors hindering intention to use LAPMs, particularly to raise positive attitude, addressing problems related to rumors, myths and misconception and side effects.