Predictors of postabortion contraception use in Cambodia

Abstract

To evaluate which characteristics collected at the point of abortion are associated with contraceptive use over the extended post-abortion period for women in Cambodia. Methods The study includes a cohort of 500 women who attended a Marie Stopes International Cambodia clinic for an induced abortion. The primary outcomes are use of effective contraception ≥80% of the time over the four and 12-month period post-abortion. We conducted a bivariate analysis to assess the association between each characteristic and the outcome, followed by multivariable modelling to identify the strongest predictors of the outcomes. Results Nearly 44% of the women used contraception for more than 80% of the time during both followup periods. Several socio-demographic and reproductive factors were crudely associated with the outcomes. In the multivariable model, prior use of contraception, intention to use postabortion contraception, increased number of children and medical abortion were associated with increased contraceptive use over the year post-abortion. Occupation was a predictor at four months only, and abortion method at 12 months only. Conclusions The models were satisfactory in predicting the outcome of contraceptive continuation both at four and 12 months. The paper sets out a methodology for modelling these predictors that can help inform more client-centred counselling and services for women. Implications: Factors known when attending a clinic for induced abortion can help inform more targeted and client-centred post-abortion family planning counselling and services for women in Cambodia.

Getting Intentional about Intention to Use: A Scoping Review of Person‐Centered Measures of Demand

“…Ross and Winfrey's (2001) secondary analysis of DHS data in 27 countries found that for each increase of one percentage point in stated ITU contraceptives, there was nearly a 1% rise in the actual use of contraceptives. ITU also has been found to have a positive relation to contraceptive continuation; Raine et al (2011) and Adelman, Free, and Smith (2019) found that a higher intent to use a method was associated with a lower risk of discontinuation. However, five papers found null or negative associations between ITU and use (Lutalo et al 2018;Hale et al 2016;Akelo et al 2013;Potard et al 2012;French, Albanese, and Gossett 2016).…”

“… 2018 ; Tang 2016 ; Johnson et al. 2019 ; Adelman, Free, and Smith 2019 ; Raine et al. 2011 ; Lutalo et al.…”

“…The final way ITU was used in the papers was to predict future use of contraception. Fifteen papers assessed the relationship and causal pathways between ITU and contraceptive use (Curtis and Westoff 1996;Kvalem et al 2000;Roy et al 2003;Ross and Winfrey 2001;Callahan and Becker 2014;Lori et al 2018;Johnson et al 2019;Adelman, Free, and Smith 2019;Raine et al 2011;Lutalo et al 2018;Haile et al 2016;Akelo et al 2013;Potard et al  2012;French, Albanese, and Gossett 2016). ITU was also used to identify the determinants that predict contraception use.…”

Women’s post-abortion contraceptive use: Are predictors the same for immediate and future uptake of contraception? Evidence from Ghana

“…Previous studies on the determinants of contraceptive use after abortion reveal varying results due to contextual differences, study designs and outcomes of interests [ 5 , 23 – 26 ]. Research also shows that contraceptive uptake is highest when immediately offered on-site, or within less than six months or up to a year [ 23 , 26 – 29 ]. For instance, Adelman, Free and Smith [ 29 ] examined the predictors of post-abortion contraception at four and 12 months among Cambodian women.…”

“…Research also shows that contraceptive uptake is highest when immediately offered on-site, or within less than six months or up to a year [ 23 , 26 – 29 ]. For instance, Adelman, Free and Smith [ 29 ] examined the predictors of post-abortion contraception at four and 12 months among Cambodian women. They found that previous contraceptive use, intention to use contraception, and number of living children were strongly associated with post-abortion contraception use.…”