Naira Kalra1, John Ayankola2, Stella Babalola1. 1. Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. 2. Nigerian Urban Reproductive Health Initiative (NURHI2), Ibadan, Nigeria.
Abstract
OBJECTIVE: To test the association between healthcare provider communication and adoption of long-acting reversible contraception (LARC) among women in Nigeria. METHODS: The present cross-sectional observational secondary analysis included women aged 18-49 who were interviewed between June 1 and July 31, 2014, at selected family planning sites in Ibadan and Kaduna, Nigeria. A multivariate generalized estimating equation was utilized to assess the predictors of LARC adoption. RESULTS: 597 women were interviewed, and the study showed that each unit increase on the GATHER index-a self-reported measure of interaction with the provider-was significantly associated with a 16% increased likelihood (adjusted odds ratio [AOR] 1.16, 95% confidence interval [CI] 1.03-1.32) of adopting LARCs. Joint decision making with a partner (AOR 1.51, 95% CI 1.0-2.20), desire to have children in the next 2 years (AOR 0.36, 95% CI 0.18-0.74), whether or not a pregnancy in the next 6 months would be a problem (AOR 1.69, 95% CI 1.16-2.46), and LARC use in the past (AOR 4.15, 95% CI 1.19-14.50) were associated with LARC uptake. CONCLUSION: Improved patient-provider communication involving patient preferences, information about all methods of contraception, and planned follow-up could play a central role in increasing the demand for, and uptake of, LARCs.
OBJECTIVE: To test the association between healthcare provider communication and adoption of long-acting reversible contraception (LARC) among women in Nigeria. METHODS: The present cross-sectional observational secondary analysis included women aged 18-49 who were interviewed between June 1 and July 31, 2014, at selected family planning sites in Ibadan and Kaduna, Nigeria. A multivariate generalized estimating equation was utilized to assess the predictors of LARC adoption. RESULTS: 597 women were interviewed, and the study showed that each unit increase on the GATHER index-a self-reported measure of interaction with the provider-was significantly associated with a 16% increased likelihood (adjusted odds ratio [AOR] 1.16, 95% confidence interval [CI] 1.03-1.32) of adopting LARCs. Joint decision making with a partner (AOR 1.51, 95% CI 1.0-2.20), desire to have children in the next 2 years (AOR 0.36, 95% CI 0.18-0.74), whether or not a pregnancy in the next 6 months would be a problem (AOR 1.69, 95% CI 1.16-2.46), and LARC use in the past (AOR 4.15, 95% CI 1.19-14.50) were associated with LARC uptake. CONCLUSION: Improved patient-provider communication involving patient preferences, information about all methods of contraception, and planned follow-up could play a central role in increasing the demand for, and uptake of, LARCs.
Keywords:
zzm321990LARCzzm321990; Contraception; Domestic violence; Family planning; Healthcare provider; Provider communication; Sexual and reproductive health