Contraceptive Utilization and Unmet Need for Contraception Among Women Undergoing Treatment for Tuberculosis in Addis Ababa, Ethiopia: a Cross-Sectional Study

Abstract

Introduction

Pregnancy can pose a risk to women on tuberculosis (TB) treatment with a threat to the wellbeing of the mother and fetus. Physiological and stress-related effects result when pregnancy occurs during TB illness and while on treatment. Hence, this study aimed to assess contraceptive utilization, unmet need among women on TB treatment, and integration of family planning (FP) services with TB clinics in Addis Ababa, Ethiopia.

Methods

A facility-based cross-sectional study was conducted using an interviewer-administered questionnaire. A total of 316 women aged 18–49 who were on TB treatment were enrolled. Contraceptive utilization rate, unmet need, and integration of FP and TB services were determined. Logistic regression models were conducted to identify factors associated with contraceptive utilization.

Results

Among women on TB treatment 49 (41.9%) were using contraceptives. Out of contraceptive users, 10 (34.5%) used contraceptives to limit and 18 (62.1%) used to space. Only parity had a significant association with contraceptive utilization. Women who had 1–3 children were less likely to use contraception than those who had ≥4 children. Among women who were married or sexually active, 12 (18.9%) had an unmet need. Of the study participants, 144 (45.6%) had been informed about FP services at the TB clinics.

Conclusion

The contraceptive utilization rate in the current study (41.9%) is slightly higher than the national prevalence (36.2%) yet it is still low. Furthermore, the unmet need (18.9%) was lower than the national report for the general population (22%). Educating women about the risk of getting pregnant while visiting the health facility for TB medication will help to improve their chances of better recovery and avoid medication side effects on the fetus. TB guidelines can consider providing FP counseling when initiating treatment to provide women with the power of information to make deliberate decisions.

Keywords:

• TB
• contraceptive
• unmet need

Data Sharing Statement

Data available from the research undertaking are available with the corresponding author upon reasonable request.

Ethics Approval and Consent to Participate

The research was ethically approved by St. Paul’s Hospital Millennium Medical College and St. Peter’s TB Specialized Hospital. Signed informed consent was obtained from each participant. This study complies with the Declaration of Helsinki.

Acknowledgment

St Paul’s Hospital Millennium Medical College is acknowledged for providing full funding. Study participants’ dedication to the research is appreciated. Abebaw Kebede is supported by a training program from NIH/Fogarty International Center Global Infectious Diseases grant D43TW009127. Pre-Publication Support Service (PREPSS) supported the development of this manuscript by providing pre-publication peer-review and copy editing.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

Full financial support of the study was obtained from St. Paul’s Hospital Millennium Medical College.