Anita Makins1,2, Neda Taghinejadi2, Maya Sethi1, Kazuyo Machiyama3, Kusum Thapa4, Gamini Perera5, Projestine S Munganyizi6, Ajey Bhardwaj7, Sabaratnam Arulkumaran1,8. 1. International Federation of Gynecology and Obstetrics, London, UK. 2. Oxford University Hospitals NHS Foundation Trust, Oxford, UK. 3. London School of Hygiene and Tropical Medicine, London, UK. 4. Nepal Society of Obstetricians and Gynaecologists, Kathmandu, Nepal. 5. Sri Lanka College of Obstetricians and Gynaecologists, Colombo, Sri Lanka. 6. Association of Gynaecologists and Obstetricians of Tanzania, Dar es Salaam, Tanzania. 7. Avni Health Foundation, Mumbai, India. 8. St George's, University of London, London, UK.
Abstract
OBJECTIVE: To examine the factors that positively influenced the likelihood of accepting provision of postpartum intrauterine devices (PPIUDs) across four countries: Sri Lanka, Nepal, Tanzania, and India. METHODS: Healthcare providers were trained across 24 facilities in counselling and insertion of PPIUDs as part of a large multicountry study. Women delivered were asked to take part in a 15-minute face-to-face structured interview conducted by in-country data collection officers prior to discharge. Univariate analysis was performed to investigate factors associated with acceptance. RESULTS: From January 2016 to November 2017, 6477 health providers were trained, 239 033 deliveries occurred, and 219 242 interviews were conducted. Of those interviewed, 68% were counselled on family planning and 56% on PPIUD, with 20% consenting to PPIUD. Multiple counselling sessions was the only factor resulting in higher consent rates (OR 1.30-1.39) across all countries. Odds ratios for women's age, parity, and cadre of provider counselling varied between countries. CONCLUSION: Consent for contraception, specifically PPIUD, is such a culturally specific topic and generalization across countries is not possible. When planning contraceptive policy changes, it is important to have an understanding of the sociocultural factors at play.
OBJECTIVE: To examine the factors that positively influenced the likelihood of accepting provision of postpartum intrauterine devices (PPIUDs) across four countries: Sri Lanka, Nepal, Tanzania, and India. METHODS: Healthcare providers were trained across 24 facilities in counselling and insertion of PPIUDs as part of a large multicountry study. Women delivered were asked to take part in a 15-minute face-to-face structured interview conducted by in-country data collection officers prior to discharge. Univariate analysis was performed to investigate factors associated with acceptance. RESULTS: From January 2016 to November 2017, 6477 health providers were trained, 239 033 deliveries occurred, and 219 242 interviews were conducted. Of those interviewed, 68% were counselled on family planning and 56% on PPIUD, with 20% consenting to PPIUD. Multiple counselling sessions was the only factor resulting in higher consent rates (OR 1.30-1.39) across all countries. Odds ratios for women's age, parity, and cadre of provider counselling varied between countries. CONCLUSION: Consent for contraception, specifically PPIUD, is such a culturally specific topic and generalization across countries is not possible. When planning contraceptive policy changes, it is important to have an understanding of the sociocultural factors at play.
Authors: Kristy Hackett; Sarah Huber-Krum; Joel M Francis; Leigh Senderowicz; Erin Pearson; Hellen Siril; Nzovu Ulenga; Iqbal Shah Journal: Glob Health Sci Pract Date: 2020-06-30
Authors: Danielle M Harris; Anita Dam; Kate Morrison; Chastain Mann; Ashley Jackson; Shannon M Bledsoe; Andrea Rowan; Kim Longfield Journal: Stud Fam Plann Date: 2022-08-03