Background: Discontinuation of contraceptives without any change in fertility intention is often associated with unintended pregnancy which ends up with induced abortion and unplanned birth. Despite the Ethiopian government’s emphasis on the provision of long-acting contraceptive methods, little attention has been paid to the study of its discontinuation; particularly, no study has been reported in the study area. Thus, this study aimed to assess the discontinuation rate of long-acting reversible contraceptives and associated factors among reproductive-age women in Butajira town, Central Ethiopia, 2020. Methods: Community-based cross-sectional study was conducted from 1 April to 1 May 2020. A systematic random sampling method was used to select 227 women. Data were collected by a structured and pretested questionnaire. Epi-data (version 4.6.2) and Statistical Package for the Social Sciences (version 25) were used for data entry and analysis, respectively. A multivariable logistic regression model was used to predict the relation between dependent and independent variables. Finally, a significant statistical association was assured using an adjusted odds ratio at a 95% confidence interval and p value < 0.05. Results: This study revealed that the discontinuation rate of long-acting reversible contraceptives was 50 (22.5%; 95% confidence interval: 17.8–27.2). The main reason for discontinuation was facing side effects 26(52%); from these menstrual disruption 19 (73.1%) was the main reason. Time consumed to reach the health facility (adjusted odds ratio: 6.16, 95% confidence interval: 1.46–25.97), desire to have more children (adjusted odds ratio: 5.3, 95% confidence interval: 1.13–24.81), and counseled about the benefit of long-acting reversible contraceptives (adjusted odds ratio: 0.08, 95% confidence interval: 0.02–0.39) were predictors of discontinuation of long-acting reversible contraceptives. Conclusions and Recommendations: This study showed that the discontinuation rate was high when compared to Ethiopian Demographic Health Survey 2016. Routine pre-insertion counseling about the benefits and side effects of long-acting reversible contraceptives by healthcare providers is highly recommended. In addition, we recommend further trials using larger sample sizes on predictors of discontinuation of long-acting reversible contraceptives.
Background: Provision of preconception care is significantly affected by the health care provider’s knowledge of preconception care. In Ethiopia, preconception care is rare, if even available, as part of maternal health care services. Thus, this study aimed to determine the level of knowledge of preconception care and associated factors among health care providers working in public health facilities in Eastern Ethiopia. Methods: A multicenter cross-sectional study was conducted from 1 March to 1 April 2020. A simple random sampling technique was used to select a total of 415 maternal health care providers. We utilized a structured, pretested, and self-administered questionnaire to collect data. Data were entered into EpiData (version 3.1) and exported to STATA (version 16) for analysis. Descriptive statistics and bivariate and multivariate logistic regression analyses were performed. All covariates with a p value ⩽0.20 in bivariate logistic regression were entered into a multivariate logistic regression analysis to control the confounding variables; variables with a p value <0.05 were considered statistically significant. Results: Out of 410 respondents, 247 (60.2%; 95% confidence interval: 55.4–65.1) had good knowledge of preconception care. Having an educational level of Bachelor of Science degree and above (adjusted odds ratio: 6.97, 95% confidence interval: 3.85–12.60), 5 or more years work experience (adjusted odds ratio: 2.60, 95% confidence interval: 1.52–4.49), working in a hospital (adjusted odds ratio: 2.50, 95% confidence interval: 1.25–4.99), reading preconception care guidelines (adjusted odds ratio: 3.06, 95% confidence interval: 1.40–6.68), and training on preconception (adjusted odds ratio: 2.90, 95% confidence interval: 1.37–6.15) were significantly associated with good knowledge of preconception care. Conclusions and Recommendations: Three out of five maternal health care providers in this study had good knowledge of preconception care. Facilitating continuous refreshment training and continuous professional development for health workers, preparing comprehensive preconception care guidelines for health institutions, and reading preconception care guidelines were highly recommended.
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