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Factors influencing the likelihood of acceptance of postpartum intrauterine devices across four countries: India, Nepal, Sri Lanka, and Tanzania
Author(s) -
Makins Anita,
Taghinejadi Neda,
Sethi Maya,
Machiyama Kazuyo,
Thapa Kusum,
Perera Gamini,
Munganyizi Projestine S.,
Bhardwaj Ajey,
Arulkumaran Sabaratnam
Publication year - 2018
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12599
Subject(s) - medicine , tanzania , developing country , family planning , family medicine , marital status , logistic regression , sri lanka , sociocultural evolution , odds , nursing , population , environmental health , socioeconomics , economic growth , sociology , anthropology , economics , research methodology
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.