Purchase of Contraceptive Methods in Kongo Central Province, the Democratic Republic of Congo: Data from the Lelo Family Planning Mini-Campaign Survey

Abstract

Background and aim: Access to contraceptive methods remains low in the world in general and in Sub-Saharan Africa (SSA). Data of these contraceptive methods in rural areas of the Democratic Republic of Congo (DRC) remain poorly known. The aim is to identify the socio-demographic characteristics of clients associated with purchasing contraceptives methods via different distribution system in Kongo Central province. Methods: Cross-sectional study including data from mini Lelo Family Planning contraceptive method distribution campaigns organized in 11 health zones of Kongo Central province, from January to March 2020 by community-based distributors (DBC), learner DBCs (DBCa), graduated DBCs (DBCg) and clinical providers (CP). Results: The median age of clients was 25 years old. A quarter of them were men and almost half of the clients were in a conjugal relationship and 46.5% were single. The majority (70.4%) had a high school education. The male condom was the most requested method during Lelo Family Planning, followed by implants. Natural methods remain the methods preferred by clients < 20 years and single; modern methods by those aged > 25 years. Among the hormonal methods, the implant was the most popular modern method, while the short and long-lasting injectable hormonal methods were more in demand by women < 25 years of age. Conclusion: Natural methods are still the most preferred among male clients despite the poor protection they provide. Modern methods have to be promoted for male's partners to assure better couple protection especially in rural area where maternal mortality remains high.

Family Planning: Choosing Contraceptive Methods in Kongo Central Province, the Democratic Republic of the Congo

“…The use of LARC has increased with the number of pregnancies achieved, children alive and children who have died. This confirms the results of previous study in the Kongo Central province, which showed a preference for rural women, married and older (≥25 years) for LARC [3]. This trend can be explained in our study by the fact that these women who are still sexually active, having had several pregnancies and children alive, wish to delay or stop with Open Journal of Obstetrics and Gynecology motherhood.…”

“…This partly justifies that some clients under 25 already have many children alive, up to seven children (Table 2). Thus, this category of women may require other methods such as the IUD, which is a first-line contraceptive method, very effective, long-acting [19], but which is less preferred by clients [3] [9], despite its advantages [17], indeed, because it is less known, less popularized or because providers do not master insertion techniques. This contraceptive method can be offered to all women, regardless of parity [17].…”

“…This contraceptive method can be offered to all women, regardless of parity [17]. It is the same for permanent contraception (through tubal ligation), which should also be part of the methods to be offered to clients who want it and those who consider that the number of children alive is sufficient mainly regardless of the age and in whom infertility secondary to the use of LARC is no longer a problem, their concern being the irreversible limitation of births [3], using the rights-based approach to family planning [20]. According to the study on the impact of contraceptive use among women desiring tubal ligation carried out at the Evangelical Medical Institute in Kimpese, Democratic Republic of Congo, the demand for surgical contraception comes mainly from married women and poorly educated (often in rural areas).…”

“…This requires accessibility to contractive methods and covering unmet contraceptive needs, especially for poor populations in rural areas, who often present lower contraceptive prevalence than their urban counterparts [2] [3].…”

“…A previous study on contraceptive methods carried out in the province of Kongo Central (DRC) showed that women from rural areas, are married and older (over 25 years) tend to choose LARC [3].…”