Qureshi, Zahida; Jamner, Alanna; Filippi, Veronique; Gwako, George; Osoti, Alfred; Mehrtash, Hedieh; Baguiya, Adama; Bello, Folasade Adenike; Compaoré, Rachidatou; Gadama, Luis; +4 more... Kim, Caron R; Msusa, Ausbert Thoko; Tunçalp, Ӧzge; Calvert, Clara; (2021) Level and determinants of contraceptive uptake among women attending facilities with abortion-related complications in East and Southern Africa. International Journal of Gynecology & Obstetrics, 156 Su (S1). pp. 27-35. ISSN 0020-7292 DOI: https://doi.org/10.1002/ijgo.13898
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Abstract
OBJECTIVE: To investigate the level and determinants of nonreceipt of contraception among women admitted to facilities with abortion-related complications in East and Southern Africa. METHODS: Cross-sectional data from Kenya, Malawi, Mozambique, and Uganda collected as part of the World Health Organization (WHO) Multi-Country Survey on Abortion-related morbidity. Medical record review and the audio computer-assisted self-interviewing system were used to collect information on women's demographic and clinical characteristics and their experience of care. The percentage of women who did not receive a contraceptive was estimated and the methods of choice for different types of contraceptives were identified. Potential determinants of nonreceipt of contraception were grouped into three categories: sociodemographic, clinical, and service-related characteristics. Generalized estimating equations were used to identify the determinants of nonreceipt of a contraceptive following a hierarchical approach. RESULTS: A total of 1190 women with abortion-related complications were included in the analysis, of which 33.9% (n = 403) did not receive a contraceptive. We found evidence that urban location of facility, no previous pregnancy, and not receiving contraceptive counselling were risk factors for nonreceipt of a contraceptive. Women from nonurban areas were less likely not to receive a contraceptive than those in urban areas (AOR 0.52; 95% CI, 0.30-0.91). Compared with women who had a previous pregnancy, women who had no previous pregnancy were 60% more likely to not receive a contraceptive (95% CI, 1.14-2.24). Women who did not receive contraceptive counselling were over four times more likely to not receive a contraceptive (AOR 4.01; 95% CI, 2.88-5.59). CONCLUSION: Many women leave postabortion care having not received contraceptive counselling and without a contraceptive method. There is a clear need to ensure all women receive high-quality contraceptive information and counselling at the facility to increase contraceptive acceptance and informed decision-making.
Item Type | Article |
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Faculty and Department |
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology & International Health (2023-) Faculty of Epidemiology and Population Health > Dept of Population Health (2012- ) |
Research Centre |
Maternal and Newborn Health Group Centre for Maternal, Reproductive and Child Health (MARCH) |
PubMed ID | 34676892 |
Elements ID | 167066 |