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 contraceptives, factors responsible for continuation of chosen method of

contraception, previous and current experiences relating to contraceptive use and level of

satisfaction with modern contraceptive was adopted. Contraceptive continuation scores

were categorised into unlikely (≤ 4), likely (5-6) and very likely (≥7). Satisfaction scores

of ≤ 6 and ˃ 6 were categorized as low and high respectively. Data were analysed using

descriptive statistics, Chi-square and multinomial 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 contraception was influenced by perceived

effectiveness (72.8%) andfew side effects (56.1%). Implant was the commonest choice 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

iv

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 modern contraceptive 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 (0R=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 begeared

towards public awareness and sensitizationon the availability of various modern

contraceptive methods. Advocacy on girl child education should be intensified