Data were analyzed from 381 women, making response rate of 97.1%. Mean age of participants were 27(SD±4.6). Majority of participants were urban resident (89%). Less than one fifth of respondents attend diploma and above (17.1%). Half of the women were housewife (50.4%) (Table 1).
Table 1: Sociodemographic characteristics of postpartum women in Hossana health institutions, 2018(n=381)
Variable
|
Frequency
|
Percentage
|
Age (years)
|
16-20
|
31
|
8.1
|
21-25
|
124
|
32.5
|
26-30
|
154
|
40.4
|
31-35
|
50
|
13.1
|
36-40
|
22
|
5.8
|
Residence
|
Urban
|
339
|
89.0
|
Rural
|
42
|
11.0
|
Marital status
|
Married
|
369
|
96.9
|
Single
|
7
|
1.8
|
Separated
|
5
|
1.3
|
Educational status
|
Can’t read and write
|
15
|
3.9
|
Can Read & Write
|
19
|
5.0
|
Primary
|
141
|
37.0
|
Secondary
|
141
|
37.0
|
Diploma & Above
|
65
|
17.1
|
Working status
|
Housewife
|
192
|
50.4
|
Merchant
|
51
|
13.4
|
Government Employee
|
67
|
17.6
|
Private Employee
|
58
|
15.2
|
Other
|
13
|
3.4
|
Reproductive characteristics of respondents
More than two-third (71%) of participants had two or more births. Median number of alive children per women and birth interval were 2 IQR [1,4] and 36 months IQR [24,48] respectively. Around one-third (28.3%) participants do not want any more children for the future.
Less than one fifth (18.1%) intended to give birth within 2 years. More than one-forth (28.6%) had never discussed with health professionals and 52.4% were advised on LARC during the immediate postpartum period (Table 2).
Table 2: Reproductive characteristics of postpartum women in Hossana health institutions, 2018(n=381)
Variable
|
LARC use
|
Yes
n(%)
|
No
n(%)
|
Parity
|
1
|
72(65.5)
|
38(34.5)
|
2-4
|
137(61.7)
|
85(38.3)
|
≥5
|
33(67.3)
|
16(32.7)
|
Number of alive children
|
1
|
75(65.8)
|
39(34.2)
|
2-4
|
135(60.8)
|
87(39.2)
|
≥5
|
32(71.1)
|
13(28.9)
|
Place of last birth
|
Home
|
15(71.4)
|
6(28.6)
|
Health institution
|
227(63.1)
|
133(36.9)
|
Birth interval(in month) (n=272)
|
0-23
|
28(73.7)
|
10(26.3)
|
24-35
|
56(64.4)
|
31(35.6)
|
36 & above
|
87(59.2)
|
60(40.8)
|
Number of children want for the future
|
0
|
74(68.5)
|
34(31.5)
|
1-3
|
131(59.8)
|
88(40.2)
|
4-6
|
37(68.5)
|
17(31.5)
|
Intended to give birth within 2years (n=273)
|
Yes
|
49(71.0)
|
20(29.0)
|
No
|
119(58.3)
|
85(41.7)
|
Ever discussed with health professionals
|
Yes
|
123(45.2)
|
149(54.8)
|
No
|
16(14.7)
|
93(85.3)
|
Advised during immediate postpartum
|
Yes
|
95(47.5)
|
105(52.5)
|
No
|
44(24.3)
|
137(75.7)
|
Knowledge, Attitude and previous LARC use
More than two-third (71.4%) of the women had high level of knowledge towards LARC. Around half of them (53.2%) had positive attitude towards LARC. Two-third (68.5%) of participant’s partner had supportive attitude towards LARC. Two-third (66.4%) of the respondents had ever used at least one type of modern contraception and one-fourth (26%) had ever used LARC before delivery of last child (Table 3).
Table 3: Knowledge, attitude and previous LARC use among postpartum women in Hossana health institutions, 2018(n=381)
Variable
|
LARC use
|
Yes
|
No
|
Knowledge towards LARC
|
High level of knowledge
|
121(44.5%)
|
151(55.5%)
|
Low level of Knowledge
|
18(16.5%)
|
91(83.5%)
|
Attitude towards LARC
|
Positve
|
77(41.8%)
|
107(58.2%)
|
Negative
|
61(38.4%)
|
98(61.6%)
|
Previous LARC use
|
Used before
|
58(59.2%)
|
40(40.8%)
|
Never used
|
81(28.6%)
|
202(71.4%)
|
Prevalence of postpartum LARC use
Two-third (66.6%) of postpartum women had started to use modern family planning method. LARC method use among participants was 36.5% (implant 34.1%, IUCD-2.4%). The main reason for not using LARC was fear of side effect (39.3%) followed by false rumors towards LARC (it cause harm to uterus, infertility, interfere with work, fly/lost in the body) (21.9%) (Table 4).
Table 4: method-mix adopted among postpartum women in Hossana health institutions, 2018(n=381)
Contraception method
|
Frequency
|
Percentage
|
Injectable
|
98
|
25.7
|
Implants
|
130
|
34.1
|
IUCD
|
9
|
2.4
|
Pills
|
15
|
3.9
|
Condom
|
2
|
0.5
|
Non users
|
127
|
33.4
|
Factors associated with LARC use
Previous LARC use and ever discussed with Health Professionals on LARC were found to be significantly associated with LARC use. Those women who have ever used LARC before were 3.3 times more likely to use LARC on postpartum period (AOR=3.3, 95%CI(1.7-6.5). Postpartum women who have ever discussed with health professionals on LARC were 2.5 times more likely to use LARC (AOR=2.5, 95% CI (1.1-5.7)) (Table 5).
Table 5: Bivariate and Multivariate analysis of factors associated with LARC use among postpartum women in hossana health institutions, 2018 (n=381)
Variable
|
LARC use
|
COR (95%CI)
|
AOR (95%CI)
|
Yes (n%)
|
No (n%)
|
Residence
|
Urban
|
130(38.3)
|
209(61.7)
|
1
|
|
Rural
|
9(21.4)
|
33(78.6)
|
0.43 (.20-.94)
|
0.53 (0.19-1.42)
|
working status
|
Working
|
75(39.7)
|
114(60.3)
|
1.31 (.86-1.99)
|
|
Not working
|
64(33.3)
|
128(66.7)
|
1
|
|
Intention to give birth within 2 years
|
Yes
|
20(29.0)
|
49(71.0)
|
1
|
|
No
|
85(41.7)
|
119(58.3)
|
1.75(.97-3.15)
|
1.82 (0.94-3.54)
|
Knowledge towards LARC
|
Good
|
121(44.5)
|
151(55.5)
|
4.01(2.31-7.08)
|
0.95 (0.43-2.10)
|
Poor
|
18(16.5)
|
91(83.5)
|
1
|
|
Partner attitude
|
Supportive
|
118(45.2)
|
143(54.8)
|
2.59 (1.48-4.54)
|
0.50 (0.24-1.03)
|
Not supportive
|
20(24.1)
|
63(75.9)
|
1
|
|
Previous LARC use
|
Yes
|
58(59.2)
|
40(40.8)
|
3.61 (2.24-5.83)
|
3.34(1.70-6.55)*
|
No
|
81(28.6)
|
202(71.4)
|
1
|
|
Adviced during immediate postpartum
|
Yes
|
95(47.5)
|
105(52.5)
|
2.81 (1.81-4.36)
|
1.26 (0.66-2.42)
|
No
|
44(24.3)
|
137(75.7)
|
1
|
|
Ever discussed on LARC with professionals
|
Yes
|
123(45.2)
|
149(54.8)
|
4.79 (2.68-8.58)
|
2.56 (1.14-5.74)**
|
No
|
16(14.7)
|
93(85.3)
|
1
|
|
*Significant at <0.05 ** significant at <0.001