The Uptake of Modern Contraceptive Methods Among Clients of Post-Abortion Care Services in Urban Guinea

Abstract

In West Africa, there are limited data on the uptake of modern contraceptive methods among post-abortion care (PAC) clients. This study aimed at describing the knowledge, attitudes and practices of PAC clients towards modern contraceptive methods and identifying the factors associated with the uptake of long-acting contraceptive methods in Guinea. We conducted a cross-sectional study from March to August 2014 with a sample of 426 PAC clients in two communal medical centres in Conakry. Data were collected using a structured questionnaire and analysed using Stata software, version 14. A logistic regression was conducted to identify the factors associated with the uptake of long-acting contraceptive methods. Overall 45,5 % were students, and among them, 66.9% had a secondary or higher level of education. Among the respondents 21,8% had a history of abortion. Induced abortion (83.6%) was the most common type of abortion leading women to seek PAC services. Most of clients (73.6%) had previously heard about family planning (FP), either at school (42.7%), in a health facility/pharmacy (26.5%) or in the neighbourhood (5.9%). Among them, only 34% had used a contraceptive method in the last six months prior to the PAC visit. However, 79.1% of the sample had an unmet need for FP. During the PAC visit, 86.6% of women expressed a desire to postpone any pregnancy in the next 12 months. Overall, 388 women (91.1%) adopted a modern contraceptive method. Most of women (n=375; 96.6%) obtained the chosen contraceptive method before discharge. The intrauterine device (IUD) was the preferred contraceptive method for women (n=130; 34.7%) followed by implants (n=107; 28.5%). Having a history of abortion (OR= 2.5; CI= 1.3-4.7) and a non-desire for pregnancy in the following 12 months (OR= 4.8; CI= 2.0-11.5) were the factors statistically significantly associated with the uptake of long-acting contraceptive methods. In our context, induced or unsafe abortion mainly concerned students. There is a need to improve the uptake of contraceptive methods, especially among students and intensify awareness on the consequences of unsafe abortion among youths.

Profil des utilisatrices et facteurs associés à la satisfaction des clientes de la qualité des soins après avortement au Burkina Faso: étude transversale menée dans six régions

“…The overall satisfaction level among our clients was good, with over eight out of ten women expressing satisfaction. Our results align with those reported in Guinea (94%) 37 and Ethiopia (84% and 87%) 35 , 46 but are higher than in Tanzania and Zanzibar (52%). 39 This high level of satisfaction might be attributed to the “courtesy bias” or social desirability often seen in exit interviews post-hospitalisation.…”

“…Le niveau de satisfaction globale de nos clientes était bon avec plus de huit femmes satisfaites sur dix. Nos résultats sont similaires à ceux rapportés en Guinée (94%) 37 et en Éthiopie (84% et 87%) 35 , 46 et plus élevés qu’en Tanzanie et à Zanzibar (52%). 39 Ce bon niveau de satisfaction pourrait être lié au « biais de courtoisie » ou de désirabilité sociale fréquemment décrit dans les enquêtes de satisfaction à la sortie de l’hospitalisation (« exit interview »).…”

“… 36 , 38 En Guinée, il a été montré que l’appréciation positive de la protection de la vie privée et la confidentialité étaient associées à une meilleure satisfaction des SAA. 37 Selon les études anthropologiques, les SAA sont des occasions de non-respect de la vie privée et de la confidentialité vis-à-vis des femmes en Afrique au Sud du Sahara. 46–48 Il est ainsi impératif d’améliorer le cadre d'accueil des clientes des SAA pour la protection de leur intimité.…”

A Systematic Review and Meta-Analysis on Post-Abortion Contraceptive Utilization and Associated Factors in Ethiopia

“…This systematic review and meta-analysis estimated the national pooled prevalence of post-abortion contraceptive utilization in Ethiopia. Accordingly, the pooled prevalence of utilization of post-abortion contraceptives in Ethiopia was 63.64%(95% CI: 57.75–69.53) and this result was lower than the finding of the study conducted in Kenya 76% ( 47 ), two studies from Tanzania 86% ( 48 ) and 90% ( 49 ), Somalia 88% ( 50 ), Guinea 91.1% ( 51 ), Sub-Saharan countries 73% ( 52 ), Asia and sub-Saharan countries 77% ( 53 ), Pakistan 72.9% ( 54 ), Brazil 97.4% ( 55 ), Turkey 75.9% ( 9 ), and India 81% ( 56 ). This difference might be due to methodological differences such as data analysis and sampling of study participants, variation in maternal socio-demographic characteristics, and economic and health service utilization differences.…”

Post-abortion needs-based education via the WeChat platform to lessen fear and encourage effective contraception: a post-abortion care service intervention-controlled trial

“…The main reason for the unintended pregnancy before intended abortion among the two groups was the use of less effective contraception [ 28 , 29 , 32 ], and there was no difference in the contraceptive methods taken by women before intended abortion. After the intervention, compared to the control group, the number of effective contraceptive measures increased noticeably in the WeChat group, and the changes were statistically significant (Table 3 ).…”