Strengthening Youth Friendly Health Services through Expanding Method Choice to include Long-Acting Reversible Contraceptives for Ethiopian Youth

Fariyal F. Fikree, Worknesh K. Abshiro, Murtala M. Mai, Kidest L. Hagos, Mengistu Asnake

Abstract

Despite robust evidence regarding long-acting reversible contraceptive (LARC) low failure rates, immediate return to fertility and safety, LARC uptake among youth is low. We evaluated the effect on contraceptive uptake of training youth-friendly service providers to counsel and provide all contraceptive methods including LARCs in the same unit. A convenience purposive sampling technique was used to select 20 youth friendly health units; ten each in Amhara and Tigray regions, Ethiopia; randomly allocated to the intervention (five) and non-intervention (five) arms. Data were abstracted from the family planning registers over an eleven-month period: three months pre-intervention and eight months post-intervention. Analysis of contraceptive uptake and chi-square tests of association were conducted. The number of LARCs new acceptors in the intervention arm was 781 (pre-intervention=116; post intervention=665) as compared to 358 in the non-intervention arm (pre-intervention=95; post intervention=263). Odds of adopting LARCs at pre-intervention (0.70); rose to 1.30 for the post-intervention phase (p-value <0.0001); comparing intervention to non-intervention study arms. Training youth friendly service providers to counsel and provide all contraceptive methods including LARCs in one location resulted in higher LARCs uptake for all sexually active young women; including those planning on delaying their first pregnancy. (Afr J Reprod Health 2017; 21[3]: 37-48).

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References

Williamson LM, Parkes A, Wight D, Petticrew M and

Hart GJ. Limits to modern contraceptive use among young women in developing countries: a systematic review of qualitative research. Reprod Health. 2009; 6:3.

Blum RW. Youth in sub-Saharan Africa. J Adolesc

Health. 2007; 41(3):230-238.

Kothari MT, Wang S, Head SK and Abderrahim N.

Trends in adolescent reproductive and sexual behaviors. DHS Comparative Reports No. 29. Calverton, MD: ICF International; 2012.

Hubacher D, Mavranezouli I and McGinn E. Unintended

pregnancy in sub-Saharan Africa: magnitude of the problem and potential role of contraceptive implants to alleviate it. Contraception. 2008; 78(1):73-78.

Bearinger LH, Sieving RE, Ferguson J and Sharma V.

Global perspectives on the sexual and reproductive health of adolescents: patterns, prevention and potential. Lancet. 2007; 369(9568):1220-1231.

Cleland J, Ali MM and Shah I. Trends in protective

behavior among single vs. married young women in sub-Saharan Africa: the big picture. Reprod Health Matters. 2006; 14:17-22.

Blanc AK, Tsui AO, Croft TN and Trevitt JL. Patterns

and trends in adolescents‘ contraceptive use and discontinuation in developing countries and comparisons with adult women. Int Perspec Sex Reprod Health. 2009;35(2):63-71.

Singh S, Darroch JE and Ashford LS, Adding it up: The

costs and benefits of investing in sexual and reproductive health 2014, New York: Guttmacher Institute, 2014. Available at: https://www.guttmacher.org/sites/default/files/report_pdf/addingitup2014.pdf. Accessed on: December 14, 2016.

Darroch JE, Woog V, Bankole A and Ashford LS.

Adding it up: costs and benefits of meeting the contraceptive needs of adolescents. New York.

Guttmacher Institute. 2016. Available at: http://www.guttmacher.org/report/adding-it-meeting-contraceptive-needs-of-adolescents. Accessed on: December 14, 2016.

Chandra-Mouli V, Chatterjee S and Bose K. Do efforts

to standardize, assess and improve the quality of health service provision to adolescents by government-run health services in low and middle income countries, lead to improvements in service-quality and service-utilization by adolescents? Reprod Health. 2016;13:10-17.

Prata N, Weidert K and Sreenivas A. Meeting the need:

youth and family planning in sub-Saharan Africa. Contraception. 2013; 88(1):83-90.

Centers for Disease Control; U.S. selected practice

recommendations for contraceptive use, 2013: Adapted from the World Health Organization selected practice recommendations for contraceptive use, 2nd Edition. Available at: http://www.cdc.gov/mmwr/pdf/rr/rr6205.pdf. Updated June 21, 2013. Accessed on: November 14, 2016.

Winner B, Peipert JF, Zhao Q, Buckel C, Madden T,

Allsworth JE and Secura GM.. Effectiveness of long-acting reversible contraception. N Engl J Med. 2012; 366(21):1998-2007.

World Health Organization. Medical Eligibility Criteria

Wheel for Contraceptive Use. Available at: http://apps.who.int/iris/bitstream/10665/173585/1/9789241549257_eng.pdf?ua=1. Updated, 2015. Accessed on: August 22, 2016.

Forrest JD. U.S. women‘s perceptions of and attitudes

about IUD. Obstet Gynecol Surv. 1996; 51(12 Suppl): S30-34. 16. Glasier A, Scorer J and Bigrigg A. Attitudes of women in Scotland to contraception: a qualitative study to explore the acceptability of long-acting methods. J Fam Plann Reprod Health Care. 2008; 34(4):213-217.

Tyler CP, Whiteman MK, Zapata LB, Curtis KM, Hillis SD and Marchbanks PA. Health care provider attitudes and practices related to intrauterine devices for nulliparous women. Obstet Gynecol. 2012; 119(4):762-771.

Madden T, Allsworth JE, Hladky KJ, Secura GM, and Peipert JF. Intrauterine contraception in Saint Louis: a survey of obstetrician and gynecologists‘ knowledge and attitudes. Contraception. 2010; 81(2):112-116.

Anguzu R, Tweheyo R, Sekandi JN, Zalwango V, Muhumuza C, Tusiime S and Serwadda D. Knowledge and attitudes towards use of long acting reversible contraceptives among women of reproductive age in Lubaga division, Kampala district, Uganda. BMC Res Notes. 2014; 7:153-161.

Alemayehu M, Belachew T and Tilahun T. Factors

associated with utilization of long acting and permanent contraceptive methods among married women of reproductive age in Mekelle town, Tigray

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