Factors Associated with Contraceptive Use Among Women Who Presented with Induced Abortions in Fort Portal Regional Referral Hospital Uganda.

TABLE OF CONTENTS

DECLARATION ............................................................................................................................ ii

APPROVAL ................................................................................................................................... ii

DEDICATION...............................................................................................................................iii

ACKNOWLEDGEMENT............................................................................................................. iv

TABLE OF CONTENTS................................................................................................................ v

LIST OF TABLES....................................................................................................................... viii

LIST OF FIGURES ....................................................................................................................... ix

LIST OF ABBREVIATIONS......................................................................................................... x

OPERATIONAL DEFINITIONS.................................................................................................. xi

ABSTRACT.................................................................................................................................. xii

CHAPTER ONE............................................................................................................................. 1

GENERAL INTRODUCTION....................................................................................................... 1

1.0 INTRODUCTION ............................................................................................................... 1

1.1 Background.......................................................................................................................... 1

1.2 Problem Statement............................................................................................................... 2

1.3 Justification of the Study ..................................................................................................... 2

1.4 General Objective ................................................................................................................ 3

1.5 Specific Objectives .............................................................................................................. 3

1.6 Research Questions.............................................................................................................. 3

1.7 Conceptual Framework........................................................................................................ 4

CHAPTER TWO ............................................................................................................................ 5

LITERATURE REVIEW ............................................................................................................... 5

2.0 LITERATURE REVIEW .................................................................................................... 5

2.1 Contraceptive Use................................................................................................................ 5

2.2 Consequences of Contraceptive Non-Use ........................................................................... 5

2.3 Contraceptive use among Women With Abortions............................................................. 6

2.4 Contraceptive Non-Use, Discontinuation and Failure ......................................................... 6

2.5 Factors Associated with Contraceptive Use ........................................................................ 6

2.5.1 Personal Factors ............................................................................................................... 6

2.5.2 Demographic Factors ....................................................................................................... 7

2.5.3 Health System Factors...................................................................................................... 7

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2.6 Abortions.............................................................................................................................. 8

2.6.1 Burden .............................................................................................................................. 8

2.6.2 Reasons for Inducing Abortion ........................................................................................ 8

2.6.3 Consequences of Abortion ............................................................................................... 9

2.6.4 Diagnosis of Induced Abortion ........................................................................................ 9

CHAPTER THREE ...................................................................................................................... 11

METHODOLOGY ....................................................................................................................... 11

3.1 Study Design...................................................................................................................... 11

3.2 Study Setting...................................................................................................................... 11

3.3 Study Population................................................................................................................ 11

3.4 Eligibility ........................................................................................................................... 11

3.5 Sampling ............................................................................................................................ 11

3.6 Sample Size........................................................................................................................ 11

3.7 Study Variables.................................................................................................................. 12

3.8 Quality Control .................................................................................................................. 12

3.9 Data Management .............................................................................................................. 12

3.9.1 Data Collection............................................................................................................... 12

3.9.2 Data Processing.............................................................................................................. 12

3.9.3 Data Analysis ................................................................................................................. 12

3.9.4 Ethical Considerations.................................................................................................... 12

CHAPTER FOUR......................................................................................................................... 13

PRESENTATION OF RESULTS ................................................................................................ 13

4.0 Results................................................................................................................................ 13

4.1 Socio Demographic and Reproductive Characteristics...................................................... 13

4.1.1 Respondents’ Marital Status .......................................................................................... 13

4.1.2 Respondents’ religious denomination ............................................................................ 14

4.1.3 Respondents’ Geographical Distribution ....................................................................... 14

4.1.4 Respondents’ Occupation............................................................................................... 15

4.1.5 Respondents’ Educational Level.................................................................................... 15

4.1.6 Respondents’ Contraceptive Usage................................................................................ 16

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CHAPTER FIVE .......................................................................................................................... 17

DISCUSSION OF RESULTS, CONCLUSION AND RECOMMENDATIONS ....................... 17

5.0 Discussion.......................................................................................................................... 17

5.1 Prevalence of contraceptive use among women with induced abortions in Fort Portal

Regional Referral Hospital ........................................................................................................... 17

5.2 Factors Associated With Contraceptive Use...................................................................... 18

5.2.1 Age ................................................................................................................................. 18

5.2.2 Source of Income or Occupation.................................................................................... 18

5.3 Conclusion ......................................................................................................................... 19

5.4 Recommendations.............................................................................................................. 19

5.5 Study Limitations............................................................................................................... 19

REFERENCES ............................................................................................................................. 20

APPENDICES .............................................................................................................................. 24

APPENDIX I: QUESTIONNAIRE.............................................................................................. 24

APPENDIX II: CONSENT OR ASSENT FOR STUDY............................................................. 27

APPENDIX III: FRAMEWORK.................................................................................................. 29

APPENDIX IV: BUDGET ........................................................................................................... 30

APPENDIX V: MAP OF UGANDA SHOWING THE LOCATION OF FORT PORTAL........ 31

APPENDIX VI: MAP OF UGANDA SHOWING THE LOCATION OF FPRRH .................... 32

APPENDIX VII: MAP OF STUDY AREA ................................................................................. 33

APPENDIX VIII: LETTER OF INTRODUCTION FROM KIU ................................................ 34

ABSTRACT Background Over 100,000 abortions are performed daily and 50% of these are unsafe ( Lalonde A, Beaudoin F, Smith J, Plourde S, Perron L,2006) . According to WHO, about 30,000 women of reproductive age in Sub-Saharan Africa die from abortions related complications performed by untrained and unskilled healthcare providers using unacceptable procedures ( WHO,2008) . In Uganda, 297,00 abortions are performed every year most of which are done by unskilled healthcare providers such as pharmacists, clinical officers and community based traditional attendants (Singh S, Moore A, Bankole A, Mirembe F, Wulf D, 2006). Methods A retrospective cross sectional study was done using both quantitative and qualitative data collected from a list of 249 women with history of induced abortion out of 582 women who presented with abortions during the study period at department of obstetrics and gynaecology Fort Portal Regional Referral Hospital Uganda. Secondary data was collected and examined using a Pre-Tested Questionnaire from patients’ medical record files and available registers at different service points in the hospital. The data was then analysed and displayed using tables and charts. Results The research showed the prevalence of contraceptive use among women with induced abortion in Fort Portal Regional Referral hospital is 63.4%. However, factors found independently associated with contraceptive use among women with induced abortion were; age, not being a student and having a source of income. Conclusion The contraceptive use prevalence among women with induced abortions was high (63.4%) while older age was associated with contraceptive ever use, being a student was associated with nonuse of contraceptives.