Introduction: Pregnancies that occur during the first year postpartum are more likely
to be unplanned. This leads to an increased risk of adverse maternal and perinatal outcomes.
However, modern contraceptive use during this period helps to reduce unplanned pregnancies and its associated adverse outcomes. There is scant data on
postpartum contraceptives in pastoral communities in Tanzania. This study aimed to assess awareness and
factors associated with postpartum modern contraceptives use among women of
reproductive age in Bukombe District, Geita Region.？Method: A community based cross-sectional
study was conducted in a predominant pastoral community of Bukombe district in
Geita region in north-western Tanzania from May-June 2018. A total of 511 postpartum women who were in their first year after child birth were
studied. A multistage sampling technique was used to select study participants. Data analysis was performed using SPSS version 21.
Multivariable logistic regression analysis was used to determine independent
predictors of postpartum modern contraceptive use.？Results: Most (97.3%) of the participants were aware
about modern contraceptives. The prevalence of postpartum modern contraceptive
use was 11.9%. The most frequent used contraceptive method was Implant 6.5%.
Majority (75%) of women started to use the contraceptive at the first three months after
delivery. Living in urban (AOR = 1.84, 95% CI: 1.20 - 3.79), business women’s (AOR = 2.34, 95% CI: 1.31 - 2.28), having last born aged 3 - 4 months (AOR = 3.30, 95% CI: 1.11 - 9.85) and menses resumption (AOR = 9.23, 95% CI: 3.60 - 23.72) were associated with postpartum modern contraceptive use. Fear of
side effects, poor knowledge about contraceptives, husband restrictions, distance to
health facility and availability of contraceptive？were the barriers for use of contraceptive use.？Conclusion: We found low uptake of postpartum modern contraceptive use
in this population. Numerous factors were associated with modern contraceptive
use. Therefore, health communication targeting this group is warranted to improve modern contraceptive uptake.
References
[1]
WHO (2019) Programming Strategies for Postpartum Family Planning.
http://www.who.int/reproductivehealth
[2]
Jalang, R., Thuita, F., Barasa, S.O. and Njoroge, P. (2017) Determinants of Contraceptive Use among Postpartum Women in a County Hospital in Rural Kenya. BMC Public Health, 17, Article No. 604. https://doi.org/10.1186/s12889-017-4510-6
[3]
Sedgh, G., Singh, S. and Hussain, R. (2014) Intended and Unintended Pregnancies Worldwide in 2012 and Recent Trends. Studies in Family Planning, 45, 301-314.
https://doi.org/10.1111/j.1728-4465.2014.00393.x
[4]
Ministry of Health Community Development Gender Elderly and Children
(MoHCDGEC) [Tanzania, Mainland], Ministry of Health (MoH) [Zanzibar], National Bureau of Statistics (NBS) O of the C, Government Statistician (OCGS) and ICF (2010) Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHS-MIS).
[5]
Keogh, S.C., Kimaro, G., Muganyizi, P. and Philbin, J. (2015) Incidence of Induced Abortion and Post-Abortion Care in Tanzania. PLoS ONE, 10, e0133933.
https://doi.org/10.1371/journal.pone.0133933
[6]
Mahmood, S.E., Srivastava, A., Shrotriya, V.P., Shaifali, I. and Mishra, P. (2011) Original Article Postpartum Contraceptive Use in Rural Bareilly. Indian Journal of Community Health, 23, 56-57. https://doi.org/10.4103/2230-8598.108408
[7]
Daniels, K., Daugherty, J., Jones, J., et al. (2015) Current Contraceptive Use and Variation by Selected Characteristics among Women Aged 15-44: United States, 2011-2013. National Health Statistics Reports, No. 86, 1-14.
[8]
Fekadu, Y. (2017) Knowledge Attitude and Utilization of Emergency Contraception among Health Science and Medical Students of Arba Minch University, 2015. Journal of Women’s Health Care, 6, 383. https://doi.org/10.4172/2167-0420.1000383
[9]
Tibaijuka, L., Odongo, R., Welikhe, E., Mukisa, W., Kugonza, L., Busingye, I., et al. (2017) Factors Influencing Use of Long-Acting versus Short-Acting Contraceptive Methods among Reproductive-Age Women in a Resource-Limited Setting. BMC Women’s Health, 17, Article No. 25. https://doi.org/10.1186/s12905-017-0382-2
[10]
Garrett, C.C., Keogh, L.A., Kavanagh, A., Tomnay, J. and Hocking, J.S. (2015) Understanding the Low Uptake of Long-Acting Reversible Contraception by Young Women in Australia: A Qualitative Study. BMC Women’s Health, 15, Article No. 72. https://doi.org/10.1186/s12905-015-0227-9
[11]
Kasner, E., Hunter, C.A. and Kariko, K. (2013) Knowledge and Attitudes about Long-Acting Reversible Contraception among Latina Women Who Desire Sterilization. Women’s Health Issues, 23, e257-e263.
[12]
Cleland, J. and Zulu, E.M. (2011) Family Planning in Sub-Saharan Africa: Progress or Stagnation. Bulletin of the World Health Organization, 89, 137-143.
https://doi.org/10.2471/BLT.10.077925
[13]
Cowman, W., Hardy-fairbanks, A., Endres, J. and Colleen, K. (2013) A Select Issue in the Postpartum Period: Contraception the Importance of Providing Postpartum Contraception Counseling. Proceedings in Obstetrics and Gynecology, 3, 1-15.
https://doi.org/10.17077/2154-4751.1198
[14]
Lauria, L., Donati, S., Spinelli, A., Bonciani, M. and Grandolfo, M.E. (2014) The Effect of Contraceptive Counselling in the Pre- and Post-Natal Period on Contraceptive Use at Three Months after Delivery among Italian and Immigrant Women.
[15]
Adeyemi, A.B., Ijadunola, K.T., Orji, E.O., Kuti, O. and Alabi, M.M. (2005) The Unmet Need for Contraception among Nigerian Women in the First Year Post- Partum. The European Journal of Contraception & Reproductive Health Care, 10, 229-234. https://doi.org/10.1080/13625180500279763
[16]
Ministry of Health Community Development Gender Elderly and Children
(MoHCDGEC) [Tanzania, Mainland], Ministry of Health (MoH) [Zanzibar], National Bureau of Statistics (NBS) O of the C, Government Statistician (OCGS) and ICF (2016) Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHS-MIS).
[17]
URT. The United Republic of Tanzania (2013) National Bureau of Statistics: 2012 Population and Housing Census Population Distribution by Administrative Areas. Natl Bur Stat Minist Financ, 177, 180.
[18]
Welfare, S. (2018) Planning Research Agenda 2013-2018 Tanzania National Family.
[19]
Rutaremwa, G., Kabagenyi, A., Wandera, S.O., Jhamba, T., Akiror, E. and Nviiri, H.L. (2015) Predictors of Modern Contraceptive Use during the Postpartum Period among Women in Uganda: A Population-Based Cross Sectional Study Health Behavior, Health Promotion and Society. BMC Public Health, 15, 8-14.
https://doi.org/10.1186/s12889-015-1611-y
[20]
Adetunji, J.A. (2011) Rising Popularity of Injectable Contraceptives in Sub-Saharan Africa. African Population Studies, 25, 587. https://doi.org/10.11564/25-2-247
[21]
Tebeje, B. and Workneh, D. (2017) Prevalence, Perceptions and Factors Contributing to Long Acting Reversible Contraception Use among Family Planning Clients, Jimma Town, Oromiya Region, South-West Ethiopia. Journal of Women’s Health Care, 6, 1-10. https://doi.org/10.4172/2167-0420.1000351
[22]
Mengesha, Z.B., Worku, A.G., Feleke, S.A., Conde-Agudeloa, A., Belizan, J., Bremanb, R., et al. (2015) Contraceptive Adoption in the Extended Postpartum Period Is Low in Northwest Ethiopia. BMC Pregnancy Childbirth, 15, 160.
https://doi.org/10.1186/s12884-015-0598-9
[23]
Abraha, T.H., Teferra, A.S. and Gelagay, A.A. (2017) Postpartum Modern Contraceptive Use in Northern Ethiopia: Prevalence and Associated Factors. Epidemiol Health, 39, e2017012. https://doi.org/10.4178/epih.e2017012
[24]
Kopp, D.M., Rosenberg, N.E., Stuart, G.S., Miller, W.C., Hosseinipour, C., Bonongwe, P., et al. (2017) Patterns of Contraceptive Adoption, Continuation, and Switching after Delivery among Malawian Women. PLoS ONE, 12, e0170284.
https://doi.org/10.1371/journal.pone.0170284
[25]
United Nations (2015) Trends in Contraceptive Use Worldwide.
[26]
Nigussie, A.T., Girma, D. and Tura, G. (2016) Postpartum Family Planning Utilization and Associated Factors among Women who Gave Birth in the Past 12 Months, Kebribeyah Town, Somali Region, Eastern Ethiopia. Journal of Women’s Health Care, 5, 6. https://doi.org/10.4172/2167-0420.1000340
[27]
Pasha, O., Goudar, S.S., Patel, A., Garces, A., Esamai, F., Chomba, E., et al. (2015) Postpartum Contraceptive Use and Unmet Need for Family Planning in Five Low- Income Countries. Reproductive Health, 12, 1-7.
https://doi.org/10.1186/1742-4755-12-S2-S11
[28]
Ndugwa, R.P., Cleland, J., Madise, N.J., Fotso, J. and Zulu, E.M. (2010) Menstrual Pattern, Sexual Behaviors, and Contraceptive Use among Postpartum Women in Nairobi Urban Slums. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 88, 341-355. https://doi.org/10.1007/s11524-010-9452-6
[29]
Sedgh, G. and Hussain, R. (2014) Reasons for Contraceptive Nonuse among Women Having Unmet Need for Contraception in Developing Countries. Studies in Family Planning, 45, 151-169. https://doi.org/10.1111/j.1728-4465.2014.00382.x
[30]
Apanga, P.A. and Adam, M.A. (2015) Factors Influencing the Uptake of Family Planning Services in the Talensi District, Ghana. Pan African Medical Journal, 20, 1-9.
https://doi.org/10.11604/pamj.2015.20.10.5301
