Background
Methods
Study design and setting
Study population
Recruitment procedures
Measurements
Quantitative measurements
Assessing knowledge
Assessing attitudes
Assessing practices
Qualitative data collection
Data analysis
Quantitative data analysis
Missing data
Qualitative data analysis
Results
Quantitative data
Response rates
Subject characteristics
Characteristic | Urban (N = 120) | Rural (N = 60) |
P
a
|
---|---|---|---|
n (%) |
n (%) | ||
Age, median (IQR) | 25 (23–30) | 28 (24–32) | 0.918 |
Catholic religious beliefs | 34 (28.3%) | 15 (25.0%) | 0.064 |
Protestant religious beliefs | 50 (41.7%) | 40 (66.7%) | 0.002 |
Other religious beliefs | 36 (30.0%) | 5 (8.3%) | 0.001 |
Married/cohabiting | 112 (93.3%) | 56 (93.3%) | 1.0 |
No or only primary-level education | 57 (47.5%) | - | - |
Secondary level education | 43 (36.4%) | - | - |
Tertiary level education | 20 (16.7%) | - | - |
Number of children | |||
0–1 | 37 (30.8%) | 12 (20.0%) | 0.124 |
2–3 | 60 (50.0%) | 21 (35.0%) | 0.057 |
≥ 4 | 23 (19.2%) | 27 (45.0%) | <0.001 |
Desired at least one more child | 84 (70.0%) | 35 (58.3%) | 0.119 |
Ever had an unwanted pregnancy | 52 (43.3%) | 30 (50.0%) | 0.397 |
Accepted unwanted pregnancy | 47 (90.4%) | 28 (93.3%) | 0.845 |
Characteristic | Urban (N = 120) | Rural (N = 60) |
P
|
---|---|---|---|
n (%) |
n (%) | ||
Knowledge of methods | |||
Injectables | 120 (100.0%) | 59 (98.3%) | 0.152 |
OC pills | 120 (100.0%) | 57 (95.0%) | 0.014 |
Condoms | 120 (100.0%) | 52 (86.7%) | <0.001 |
Implants | 117 (97.5%) | 55 (91.7%) | 0.082 |
IUD | 103 (85.8%) | 36 (60.0%) | 0.001 |
Permanent methods (BTL and vasectomy) | 86 (71.7%) | 31 (51.7%) | 0.043 |
Knowledge of whether methods were long-acting or short-acting. | |||
Correctly listed long-acting methods as such | 85 (70.8%) | 12 (20.0%) | <0.001 |
Correctly listed short-acting methods as such | 89 (74.2%) | 21 (35.0%) | <0.001 |
Knowledge of how methods are used | |||
Knew how at least one method is used | 120 (100.0%) | 60 (100.0%) | 1.0 |
Knew how all listed methods are used | 31 (25.8%) | 5 (8.3%) | 0.006 |
Belief in myths about contraceptives | |||
Agreed with “contraceptives cause cancer” | 64 (53.3%) | 34 (56.7%) | 0.564 |
Agreed with “contraceptives cause birth defects” | 65 (54.2%) | 22 (36.7%) | 0.017 |
Agreed with “contraceptives cause infertility” | 59 (49.2%) | 20 (33.3%) | 0.034 |
Which type of method is more effective? | |||
LARC methods | 75 (62.5%) | 35 (58.3%) | 0.543 |
Short-acting methods | 26 (21.7%) | 12 (20.0%) | 0.775 |
Did not know | 19 (15.8%) | 13 (21.7%) | 0.275 |
What do you think is the least effective method | |||
Withdrawal method | 62 (51.7%) | 14 (23.3%) | <0.001 |
Oral contraceptive pills | 41 (34.2%) | 22 (36.7%) | 0.770 |
Condoms | 13 (10.8%) | 13 (21.7%) | 0.054 |
What do you think is the most effective method | |||
Implants | 34 (28.3%) | 18 (30.0%) | 0.870 |
Injectables | 33 (27.5%) | 18 (30.0%) | 0.777 |
Sterilization (BTL/vasectomy) | 31 (25.8%) | 17 (28.3%) | 0.770 |
Condoms | 3 (2.5%) | 2 (3.3%) | 0.763 |
Oral contraceptive pills | 3 (2.5%) | 1 (1.7%) | 0.709 |
Ever used a LARC method | 23 (19.2%) | 19 (31.7%) | 0.062 |
Ever used a short-acting method | 104 (86.7%) | 47 (78.3%) | 0.191 |
Ever used oral contraceptive pills | 39 (32.5%) | 14 (23.3%) | 0.20 |
Ever used injectable contraceptive | 86 (71.7%) | 39 (65.0%) | 0.450 |
Ever used other short-acting methods (condoms, spermicides, moon beads) | 10 (8.3%) | 4 (6.7%) | 0.920 |
Ever used implant | 18 (15.0%) | 14 (23.3%) | 0.550 |
Ever used IUD | 5 (4.2%) | 3 (5.0%) | 0.958 |
Talked to partner prior to use of contraceptive method | 105 (87.5%) | 53 (88.3%) | 0.885 |
Partner supportive of contraceptive use | 92 (76.7%) | 50 (83.3%) | 0.356 |
Knowledge of contraceptive methods
Attitudes towards contraceptive methods
Practices regarding contraceptive methods
Type of method | Urban (N=) | Rural (N=) |
P
|
---|---|---|---|
n (%) |
n (%) | ||
Short-acting methods | 51 (42.5%) | 25 (41.7%) | 0.947 |
LARC methods | 12 (10.0%) | 13 (21.7%) | 0.433 |
Type of short-acting methods | |||
Injectable | 38 (31.7%) | 15 (25.0%) | 0.631 |
Oral contraceptive pills | 8 (6.7%) | 6 (10.0%) | 0.823 |
Others (condoms, spermicides, moon beads) | 5 (4.2%) | 4 (6.7%) | 0.868 |
Type of LARC | |||
Implants | 10 (8.3%) | 11 (18.3%) | 0.504 |
Intra-uterine device | 2 (1.7%) | 1 (1.7%) | 1.0 |
Bilateral tubal ligation | 0 | 1 (1.7%) | - |
Use of LARC methods
Use of short-acting methods
Reasons for choosing LARC methods
Reasons for not choosing long-acting methods among short-acting methods users
Reasons suggested by LARC method users for choosing a long-term method | Urban (N = 22) | Rural (N = 19) |
P
|
---|---|---|---|
n (%) |
n (%) | ||
Longer protection | 17 (77.3%) | 18 (94.7%) | 0.026 |
Better choice for child spacing | 17 (77.3%) | 16 (84.2%) | 0.231 |
Better effectiveness | 18 (81.8%) | 14 (73.7%) | 0.581 |
Needed method not requiring daily application | 16 (72.7%) | 12 (63.2%) | 0.592 |
More comfort and less worries during use | 15 (68.2%) | 12 (63.2%) | 0.407 |
Reason suggested by short-acting methods users for not choosing a long-acting method | Urban (N = 98) | Rural (N = 41) |
P
|
n (%) |
n (%) | ||
Needed a method they can control themselves | 74 (75.5%) | 28 (68.3%) | 0.385 |
Intended to conceive in near future | 67 (68.4%) | 25 (61.0%) | 0.507 |
Did not know the long-term methods | 31 (31.6%) | 16 (39.0%) | 0.040 |
Opposition from partners to long-term methods | 18 (18.3%) | 14 (34.1%) | 0.039 |
Unavailability of long-term methods | 14 (14.3%) | 11 (26.8%) | 0.079 |
Long-term methods are expensive | 15 (15.5%) | 5 (12.2%) | 0.694 |
No trained staff to give method | 10 (10.2%) | 9 (22.0%) | 0.057 |
Other reasons (e.g., side effects) | 10 (10.2%) | 2 (4.9%) | 0.325 |
Reason suggested by short-acting methods users, as well as some of the long-acting methods users who had used short-acting methods in the past for choosing a short-term method | (N = 104) | (N = 47) |
P
|
n (%) |
n (%) | ||
Ease of access | 95 (84.8%) | 41 (78.9%) | 0.344 |
Method is cheap | 91 (87.5%) | 32 (68.1%) | 0.010 |
Freedom to stop use without involving health provider | 87 (83.7%) | 28 (59.6%) | 0.001 |
Privacy | 80 (76.9%) | 33 (70.2%) | 0.918 |
Fewer side effects | 71 (68.3%) | 31 (66.0%) | 0.367 |
Did not know about other methods | 22 (21.2%) | 15 (31.9%) | 0.121 |
Can be used as a temporary or back up method | 13 (11.9%) | 16 (34.8%) | <0.001 |
Reasons for choosing short-acting methods
Factors associated with use of LARC methods
Client characteristic | Urban (N = 120) |
P
a
| Rural (N = 60) |
P
|
---|---|---|---|---|
n (%) |
n (%) | |||
Age (Years) | ||||
17–24 | 7 (12.5%) | Ref. | 3 (17.7%) | Ref. |
25–29 | 6 (19.4%) | 0.394 | 8 (36.4%) | 0.206 |
30–49 | 10 (30.3%) | 0.044 | 8 (38.1%) | 0.176 |
Education statusb
| ||||
None or primary | 8 (14.0%) | Ref. | - | - |
Secondary level | 7 (16.3%) | 0.784 | - | - |
Tertiary level | 8 (40.0%) | 0.014 | - | - |
Number of children | ||||
0–1 | 5 (13.5%) | Ref. | 2 (16.7%) | Ref. |
2–3 | 10 (16.7%) | 0.677 | 7 (33.3%) | 0.310 |
≥ 4 | 8 (34.8%) | 0.059 | 10 (37.0%) | 0.216 |
Still desired children | ||||
No | 11 (30.1%) | Ref. | 11 (44.0%) | Ref. |
Yes | 12 (14.3%) | 0.042 | 8 (22.9%) | 0.087 |
Partner supportive of contraceptive use | ||||
No | 3 (11.1%) | Ref. | 4 (36.4%) | Ref. |
Yes | 20 (21.5%) | 0.236 | 15 (30.6%) | 0.711 |
Agreed with contraceptives cause cancer | ||||
No | 8 (16.7%) | Ref. | 5 (23.8%) | Ref. |
Yes | 14 (21.9%) | 0.493 | 12 (35.3%) | 0.373 |
Agreed with contraceptives cause birth defects | ||||
No | 11 (21.2%) | Ref. | 13 (34.2%) | Ref. |
Yes | 11 (16.9%) | 0.561 | 6 (27.3%) | 0.578 |
Agreed with contraceptives cause infertility | ||||
No | 11 (18.6%) | Ref. | 14 (35.0%) | Ref. |
Yes | 11 (18.6%) | 1.0 | 5 (25.0%) | 0.434 |