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. 2015 Dec;60(8):987-97.
doi: 10.1007/s00038-015-0683-x. Epub 2015 May 13.

Determinants of family planning service uptake and use of contraceptives among postpartum women in rural Uganda

Katelyn M Sileo  1 , Rhoda K Wanyenze  2 , Haruna Lule  3 , Susan M Kiene  4   5   6
Affiliations

Determinants of family planning service uptake and use of contraceptives among postpartum women in rural Uganda

Katelyn M Sileo et al. Int J Public Health. 2015 Dec.

Abstract

Objective: Uganda has one of the highest unmet needs for family planning globally, which is associated with negative health outcomes for women and population-level public health implications. The present cross-sectional study identified factors influencing family planning service uptake and contraceptive use among postpartum women in rural Uganda.

Methods: Participants were 258 women who attended antenatal care at a rural Ugandan hospital. We used logistic regression models in SPSS to identify determinants of family planning service uptake and contraceptive use postpartum.

Results: Statistically significant predictors of uptake of family planning services included: education (AOR = 3.03, 95 % CI 1.57-5.83), prior use of contraceptives (AOR = 7.15, 95 % CI 1.58-32.37), partner communication about contraceptives (AOR = 1.80, 95 % CI 1.36-2.37), and perceived need of contraceptives (AOR = 2.57, 95 % CI 1.09-6.08). Statistically significant predictors of contraceptive use since delivery included: education (AOR = 2.04, 95 % CI 1.05-3.95), prior use of contraceptives (AOR = 10.79, 95 % CI 1.40-83.06), and partner communication about contraceptives (AOR = 1.81, 95 % CI 1.34-2.44).

Conclusions: Education, partner communication, and perceived need of family planning are key determinants of postpartum family planning service uptake and contraceptive use, and should be considered in antenatal and postnatal family planning counseling.

Keywords: Contraception; Family Planning; Uganda.

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Figures

Fig. 1
Fig. 1
Independent variables and outcome variables mapped on to the theoretical framework: Andersen’s Behavioral Model of Health Services Use, Uganda 2010. FP family planning
Fig. 2
Fig. 2
Receiver operating characteristic (ROC) curves for block 1–4 predicting family planning service uptake, Uganda 2010. Block 1 (enabling factors): area under curve = 0.60. 95 % CI (0.52–0.67), p = 0.01. Block 2 (predisposing factors): area under curve = 0.68, 95 % CI (0.61–0.75), p < 0.001. Block 3 (relationship factors): area under curve = 0.76, 95 % CI (0.70–0.82), p < 0.001. Block 4 (need): area under curve = 0.79, 95 % CI (0.73–0.84), p < 0.001. The dotted lines are the ROC curve for each block. The solid diagonal line is the line of no discrimination
Fig. 3
Fig. 3
Receiver operating characteristic (ROC) curves for block 1–4 predicting contraceptive use, Uganda 2010. Block 1 (enabling factors): area under curve = 0.58. 95 % CI (0.50–0.66), p = 0.06. Block 2 (predisposing factors): area under curve = 0.66, 95 % CI (0.59–0.73), p < 0.001. Block 3 (relationship factors): area under curve = 0.74, 95 % CI (0.68–0.81), p < 0.001. Block 4 (need): area under curve = 0.76, 95 % CI (0.70–0.82), p < 0.001. The dotted lines are the ROC curve for each block. The solid diagonal line is the line of no discrimination
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