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. 2022 Jan 6;19(1):4.
doi: 10.1186/s12978-021-01300-x.

Introducing the hormonal Intrauterine Device in Madagascar, Nigeria, and Zambia: results from a pilot study

Kendal Danna  1 , Grace Jaworski  1 , Bakoly Rahaivondrafahitra  2 , Francia Rasoanirina  2 , Anthony Nwala  3 , Masauso Nqumayo  4 , Gina Smith  4 , Pierre Moon  1 , Ashley Jackson  1   5 , Sarah Thurston  1 , Amanda Kalamar  6
Affiliations

Introducing the hormonal Intrauterine Device in Madagascar, Nigeria, and Zambia: results from a pilot study

Kendal Danna et al. Reprod Health. .

Abstract

Background: The hormonal Intrauterine Device (IUD) is a highly effective contraceptive option growing in popularity and availability in many countries. The hormonal IUD has been shown to have high rates of satisfaction and continuation among users in high-income countries. The study aims to understand the profiles of clients who choose the hormonal IUD in low- and middle-income countries (LMICs) and describe their continuation and satisfaction with the method after 12 months of use.

Methods: A prospective longitudinal study of hormonal IUD acceptors was conducted across three countries-Madagascar, Nigeria, and Zambia-where the hormonal IUD had been introduced in a pilot setting within the of a broad mix of available methods. Women were interviewed at baseline immediately following their voluntary hormonal IUD insertion, and again 3 and 12 months following provision of the method. A descriptive analysis of user characteristics and satisfaction with the method was conducted on an analytic sample of women who completed baseline, 3-month, and 12-month follow-up questionnaires. Kaplan-Meier time-to-event models were used to estimate the cumulative probability of method continuation rates up to 12 months post-insertion.

Results: Each country had a unique demographic profile of hormonal IUD users with different method-use histories. Across all three countries, women reported high rates of satisfaction with the hormonal IUD (67-100%) and high rates of continuation at the 12-month mark (82-90%).

Conclusions: Rates of satisfaction and continuation among hormonal IUD users in the study suggest that expanding method choice with the hormonal IUD would provide a highly effective, long-acting method desirable to many different population segments, including those with high unmet need.

Keywords: Acceptability; Continuation; Hormonal IUD; Hormonal IUS; LARC; LNG-IUS; Satisfaction.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan–Meier time-to-event curves of the hormonal IUD in Madagascar, Nigeria, and Zambia
See this image and copyright information in PMC

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