Prevalence and predictors of long-acting reversible contraceptive use among sexually active women in 26 sub-Saharan African countries

Abstract

Background Long-acting reversible contraceptives (LARCs) are associated with high efficacy rates and continuity of use. Based on the foregoing, we sought to examine the prevalence and factors associated with LARC use among sexually active women in 26 countries in sub-Saharan Africa(SSA). Methods Secondary data from Demographic and Health Surveys conducted in 26 countries in SSA between January 2010 and December 2019 were pooled and analysed. A total of 56 067 sexually active women 15–49 y of age met the inclusion criteria. Bivariate and multivariate regression analyses were performed to examine the association between selected factors and the use of LARCs in SSA. Results were presented as crude odds ratios and adjusted odds ratios (aORs) with statistical precision at <0.05. Results The prevalence of LARC use was 21.73%, ranging from 1.94% in Namibia to 54.96% in Benin. Sexually active women with secondary or higher education (aOR 1.19 [95% confidence interval {CI} 1.08 to 1.32]), those cohabiting (aOR 1.25 [95% CI 1.06 to 1.47]) and those with four or more children (aOR 2.22 [95% CI 1.78 to 2.78]) were more likely to use LARCs compared with those without education, never married and with no biological child. Conclusions The use of LARCs in the 26 countries in SSA was relatively low. Hence, the identified contributory factors of LARC use should be tackled with appropriate interventions. These include continuous campaigns on the efficacy of LARCs in reducing unintended pregnancy, maternal mortality and morbidity.

Factors associated with use of long-acting reversible and permanent contraceptives among married women in rural Kenya: A community-based cross-sectional study in Kisii and Kilifi counties

“…Increased educational attainment especially secondary school and above influence service use of and female decision-making power on reproduction health issues particular family planning. The findings agrees with other studies conducted in Kenya, Ethiopia and Uganda that had shown that higher education is an important predictor of LAPM use [ 23 , 59 , 60 ].…”

“…Independent variables were identified based on a review of literature of previous studies on LAPM [ 19 , 30 , 31 , 37 – 44 ] and included age measured in completed years at the time of the interview categorized into age groups (15–19, 20–29, 30–39, and 40–49 years); level of education (none, primary, and secondary and above), household wealth tercile (poor, middle, and rich), future fertility preference (no more/none and have ((an)other) child(ren), number of children ever born (CEB) as at the time of the survey (0–2, 3–5 and 6 or more), exposure to media was classified as yes for those who had listened to radio or watched television or read newspaper or accessed social media at least once a week and no for those who had not [ 23 ] and the main decision-maker on a woman’s health (woman alone, woman with a partner, and other). The other decision-makers included the husband/partner alone, father or father-in-law, mother or mother-in-law, other male family members, and other female family members.…”

“…The low national prevalence could be attributed to the availability and access of these methods as suggested by the proportion of health facilities in Kenya offering IUCD, implants, female, and male sterilization to be 75%, 58%, 7%, and 5%, respectively [ 20 ], or other factor related reason, opposition to use, lack of knowledge, and method related reasons; lack of trained providers and wide availability of short-acting methods in the rural areas [ 21 ]. Previous studies associated the use of LAPM with the number of living children [ 22 , 23 ], having three or more children [ 22 , 24 – 27 ], area of residence [ 22 ], region [ 22 , 28 , 29 ], woman’s age [ 22 , 23 , 28 , 29 ], education levels [ 23 , 27 , 28 , 30 – 32 ], wealth status [ 23 – 25 , 28 , 31 ], joint decision making on family planning use with partner [ 33 , 34 ], no desire for more children [ 30 ], and level of knowledge on LAPMs [ 26 , 32 ]. While determinants of LAPM have been documents in several programs implemented in diverse settings to promote utilization, there remain a need to understand prevalence and determinants in the rural Kenyan context.…”

Long-acting reversible contraceptives utilization and its determinants among married Yemeni women of childbearing age who no longer want children

“…[ 14 ] Population-based studies have estimated that the use of LARCs among married women ranged from 1.9% to 55.0% in Africa. [ 15 , 25 ] A nationwide study reported that approximately 5% of currently married Nepalese women of reproductive age use LARCs. [ 16 ] The evidence shows that the use of LARCs reported in the current study is higher than that reported by the Nepalese study but within the range reported in SSA, which could be attributed to differences in the study population as well as access to health services.…”

“…Our literature search yielded studies that investigated the use of LARCs among reproductive women in sub-Saharan Africa (SSA) [ 14 , 15 ] and Nepal. [ 16 ] Nonetheless, the emphasis, study sample, or geographical location of these related studies limits their generalizability to the study setting.…”