FACTORS INFLUENCING MODERN CONTRACEPTIVE CHOICES AMONG WOMEN ATTENDING THE FAMILY PLANNING CLINIC, UNIVERSITY COLLEGE HOSPITAL, IBADAN

Abstract

Choices about childbearing and contraceptive use are important health decisions. Restriction of choices and lack of information on methods is a constraint for contraceptive users to obtain a method that suits their needs, thereby resulting in lower levels of contraceptive uptake. Hence, this study was designed to assess the factors influencing modern contraceptive choices among women attending the family planning clinic of University College Hospital, Ibadan. A cross-sectional study using systematic random sampling technique to select 341 consenting women was conducted. A pre-tested interviewer-administered questionnaire which contained respondents' demographic characteristics, factors influencing the choice of modern contraception, previous and current experience relating to contraceptive use and level of satisfaction with modern contraception was adopted. Contraceptive continuation scores were categorised into unlikely (≤4), likely (5-6) and very likely (≥7). Satisfaction scores of ≤6 and > 6 were categorised as low and high respectively. Data were analysed using descriptive statistics, Chi-square and multi-nominal logistic regression at 5% level of significance. Age of the respondents was 35.5 ± 6.4 years; 99.4% were married and 89.0% were in monogamous marriage. Forty-seven percent had tertiary education and 41.3% had senior secondary school certificate. Current method of contraceptive was influenced by perceived effectiveness (72.8%) and few side effect (56.1%). Implant was the commonest choices for women with secondary (48.2%) and tertiary education (42.9%), while IUCD (22.7%) and injectables (18.6%) was the least common respectively. Majority (78.5%) reported irregular menstruation, weight gain/loss (27.2%), breast tenderness (5.0%), stomach pain (4.1%) and frequent headache (1.7%). Of the 121 women that encountered problems, 85.0% were likely to continue, 6.1% likely to adopt traditional methods while 6.1% would rather opt out completely. However, among the 213 that had not encountered problems, 60.0% were likely to continue and 19.0% were very likely to continue their chosen methods even if they eventually encounter problem. A significant association was found between satisfaction with modern contraception and continuation. Factors influencing continuation of chosen method included availability (95.9%), easy discontinuation of method (90.3%) and husband support (88.3%). A major reason for being satisfied with chosen method was adequate information before choice (98.2%). A significant association was found between the chosen method of contraception and higher level of education. Husbands with secondary and higher education had significant influence on the kind of contraceptive chosen by their wives. Women whose choice of a particular method was not because it had worked for their mothers, were twice (OR=0.54, 95%: 0.39-0.94) less likely to have chosen IUCD over implant than women who said yes. Women who had secondary education were (OR=0.44, 95% CI:0.24-0.82) less likely to have chosen IUCD over implant than women who had tertiary education. Higher level of education and previous use of contraceptives by respondents' mothers are factors influencing modern contraceptive choices. More emphasis should be geared towards public awareness and sensitization on the availability of various modern contraceptive methods. Advocacy on girl child education should be intensified.