Facilitators to Immediate Post Partum Intra Uterine Contraceptive Device Uptake among Mothers Delivering in Meru Hospital

Abstract

Family planning allows people to attain their desired number of children and determine the spacing of pregnancies. It is important to promote uptake of family planning services because it is one of the four pillars of the Safe Motherhood Initiative to reduce maternal death in developing countries. It is also enshrined in health related Sustainable Development Goals. Post Partum

Intra Uterine Contraceptive Device (PPIUCD) is the oldest methods of family

planning. During the ancient times, foreign bodies like stones were introduced into the woman’s uterus for prevention of pregnancy. Post partum

method of contraception is highly recommended because it is long acting,

convenient, safe and highly effective with minimal side effects compared to

the hormonal methods. Despite these advantages, the method is the lowest in

use globally, regionally and locally. According to the Meru Hospital records

for the year 2017, the immediate PPIUCD uptake was very low at 3.4%. The

broad objective of this study was to assess the factors that facilitate uptake of

PPIUCD at Meru Hospital. The study site was post natal ward maternity department of Meru Hospital for a period of two months that is September and

October in the year 2018. A descriptive research design was used and the study population was the mothers who were admitted in the ward during the study period. A sample size of 74 respondents was used as the representative to the target population of 289 mothers. Simple random sampling was used to get the sample for the facilitators. Data were collected using structured questionnaires and interview schedules. The data collection instruments were

pretested at Embu Level five Hospital and split half reliability test technique

used. Validity was ensured through review of literature from similar studies

and by consulting supervisors in the department. Permission to conduct the

study was sought from National Commission for Science, Technology and

Innovation through Chuka University Ethics and Research Committee. De-scriptive analysis was done to get percentages using Statistical Package for Social Science (SPSS) for windows version 23.0. Qualitative data were analyzed by grouping data into themes according to the study objectives. The

analyzed data were presented in tables, charts and narratives. The findings of

the study revealed that; the main client related facilitators to PPIUCD uptake

were older age above 30

years, employment, tertiary level of education and knowledge on the method as a result of the providers’ effort to share information. That is 70% of older aged mothers, 60% of the employed and 40% with

tertiary education had the insertion. The main provider facilitator to PPIUCD

uptake was timely counseling and insertion services. 20% of those who had

the insertion said that timely counseling was done during antenatal period.

The main method related facilitator to PPIUCD uptake was past experience

and preference to alternative methods of contraception. 50% of those who

accepted the insertion had previous bad experience and side effects of other

alternative methods. Some 30% of users perceived that the method was effective and convenient because once inserted no need for frequent visits to the clinic. The study concluded that clients, providers and method factors facilitated uptake of immediate PPIUCD. The study recommends putting in place

strategies to improve the uptake of the method by considering the client, provider and method related facilitators.