The significant influence of history of induced abortion on the utilisation of long-acting reversible contraceptive methods in the immediate post abortion period, Northern Ethiopia

Abstract

Background

Rapid population growth, untended pregnancy, and related consequences remain the concern of Sub-Saharan African countries, including Ethiopia. Despite this, long-acting reversible contraceptives methods are still underutilised and no studies have sought the factors in this study setting. Therefore, this study conducted to assess the prevalence and determining factors of long-acting reversible contraceptives utilisation following an abortion in Northern Ethiopia.

Method

Facility-based cross-sectional study design was employed. A total of340 post aborted women selected by a systematic sampling method from August 1 to October 30, 2018. Data were entered into Epi-Info version 7 software and exported to SPSS version 20 for analysis. Both bivariate and multivariate logistic regression models were used to identify factors associated with the outcome variable.

Results

The overall post-abortion long-acting reversible contraceptives utilisation was 57(16.76%) with 47(82.46%) implantand 10 (17.54%) intrauterine devices. Age range 20–29 years (AOR = 0.09, 95% CI 0.02–0.37), employed (AOR = 5.22, 95% CI 1.99–13.67), had ≥2 alive children (AOR = 7.02, 95% CI 1.58–31.23), induced abortion (AOR = 8.41, 95% CI 3.28–21.59), surgical abortion (AOR = 5.99, 95% CI 2.25–15.94), previous awareness (AOR = 3.18, 95% CI 1.14–8.82) and history of prior utilisation (AOR = 3.59, 95% CI 1.08–11.97) were the factors significantly associated with utilisation of post-abortion long-acting reversible contraceptives.

Conclusion

Long-acting reversible contraceptive methods level of utilisation following an abortion in this study was low. Advocating and raising awareness should always consider on benefits and effectiveness of long-acting reversible contraceptives for all type of abortion and methods of termination as an integral part of reproductive health care services.

人工流产史对流产后长效可逆避孕方法应用的重大影响：埃塞俄比亚北部 摘要

背景：人口快速增长、意外怀孕及其相关后果仍然是撒哈拉以南非洲国家, 包括埃塞俄比亚所担忧的问题。尽管如此, 长效可逆避孕方法仍未得到充分的应用, 尚未有研究寻找该问题的影响因素。因此, 本研究旨在评估埃塞俄比亚北部流产后应用长效可逆避孕方法的情况和决定因素。

方法：采用基于设施的横断面研究设计。2018年8月1日至10月30日, 采用系统抽样法共抽取340名流产后妇女。数据输入Epi - Info 7版软件并导出到SPSS 20版进行分析。二元和多元Logistic回归模型均用于识别与结局变量相关的因素。

结果：流产后长效可逆性避孕药的总体应用率为57 ( 16.76 % ), 植埋为47 ( 82.46 % ), 宫内节育器10 ( 17.54 % )。年龄20 ∼ 29岁( AOR = 0.09, 95 % CI 0.02 ∼ 0.37 )、在岗( AOR =5.22, 95 % CI 1.99 ∼ 13.67 )、≥2个活产儿( AOR =7.02, 95 % CI 1.58 ∼ 31.23 )、人工流产( AOR= 8.41, 95 % CI 3.28 ∼ 21.59 )、手术流产( AOR = 5.99, 95 % CI 2.25 ∼ 15.94 )、既往知晓( AOR = 3.18, 95 % CI 1.14 ∼ 8.82 )和既往应用( AOR = 3.59, 95 % CI 1.08 ∼ 11.97 )是流产后长效可逆性避孕药应用的影响因素。

结论：本研究中人工流产术后长效可逆避孕方法应用率水平较低。倡导和提高认识应始终考虑长效可逆避孕药对所有类型流产和终止方法的益处和有效性, 作为生殖保健服务的一个组成部分。

缩写： AOR：调整后的优势比； CI:可信区间； COR：粗优势比；IUD：宫内节育器；

LARCs：长效可逆避孕法； SPSS：社会学统计软件包；USA：美利坚合众国；WHO：世界卫生组织

Keywords:

• Post-abortion
• long-acting reversible contraceptives
• Northern Ethiopia

Acknowledgment

All authors thank Aksum University for ethical approval. We would like to extends our appreciation to study participants for their kind response to be involved in this study and data collectors for their outstanding commitment.

Author contributions

YMM was interpreting the data, writing the methodology and review the manuscript. ATT supervised data collection and involved in data cleaning and analysis. BKR has been involved in drafting the manuscript, data analysis and revised the contents carefully. Finally, all authors read and approved the manuscript.

Disclosure statement

The authors declare that there is no conflict of interest regarding the publication of this paper.

Data availability statement

The data used to support the findings of this study are available from the corresponding author upon request.