Factors associated with uptake of long-acting reversible contraceptives among female soldiers aged between 18 and 45 years in Bombo Military Barracks

Abstract

Introduction: Globally, long acting reversible contraceptives (LARCs) are the most effective modern contraceptive methods for preventing unintended pregnancy. However, these methods are still underutilized in low-resource countries more so among female soldiers working at Bombo Military Barracks despite having contraceptive as well as non-contraceptive benefits. Thus, a study was initiated to explore the factors associated with uptake of LARCs among female aged between 18 and 45 years. Objective: The general objective is to determine the factors associated to the uptake of long acting reversible contraceptives among female soldiers aged 18-45 years at Bombo Military Barracks. Methods: Descriptive cross-sectional study employing quantitative and qualitative data collection methods was used and sampling 223 female soldiers, the study successfully solicited views from 201 respondents giving a response rate of 90.5%. Primary data was obtained using a structured questionnaire instrument anchored on a five point Likert scale. From the field, data was sorted, edited and processed using SPSS (v.20).qualitative data used narratives by key informants Results were presented using a frequency table and descriptive statistics of mean and standard deviation. Results: Overall 201 military women were interviewed with 92.6% response rate and 41.3% of the respondents were aged between 31-40 years followed by those aged 20-30 years 33.3%. The prevalence of LARCs utilization was 48.8%. Bivariate analysis using Chi-square test found that age (p=.025), education level (p=003), marital status (p=.009) and parity (p=.041) had statistically significant difference or relationship with use of LARC. On the other hand, period of service (p=.305) and religion (p=.069) had no statistically significant relationship with LARC use. Multivariate analysis using logistic regression indicates that military women aged 20-30 and 31-40 years were 1.92 and 1.87 times respectively more likely to use LARC compared to those aged 41-50 years (AOR=1.92, 95%CI:.907-4.058, p=0.088 and AOR=1.87, 95%CI:.915-3.799, p=0.086). Certificate (AOR=1.79, 95%CI:.498-5.43, p=.372) and bachelor’s degree (AOR=1.10, 95%CI: .451-2.672, p=.836) holders were about 1.79 and 1.10 times more likely to use LARC respectively compared to master’s degree holders. Married military (AOR=1.87, 95%CI: .513-6.805, p=.343), divorced/separated (AOR=1.86, 95%CI: .391-8.829, p=.436) and single women (AOR=1.59, 95%CI: .421-5.986, p=.495) were 1.87, 1.86 and 1.59 times respectively more likely to use LARC compared widowed military women. On parity, primi-gravida women were about 1.4 times more likely to use LARC compared to multi-gravida military women (AOR=1.43, 95%CI: .773-2.645, p=0.255). The individual factors likely to influence LARC use identified were; women’s knowledge regarding usage of LARCs (Mean=4.23), level of awareness on contraceptive side effects (Mean=4.21) and knowledge on the benefits of long term contraceptives (Mean=3.73). Service provider factors influencing uptake of LARC with mean greater than the overall average mean identified were; encouragement from health workers (Mean=4.66), encouragement by medical staff on seeking advice in case of complication (Mean=4.14), counselling (Mean=4.01), benefits of long acting contraceptives (Mean=4.01), timeliness of medical services (Mean=3.93) and readily available family planning information (Mean=3.78). Conclusion: The uptake of LARC was low at 48.8%. Socio-demographic factors; age, education level, marital status and parity had important attributes in explaining the uptake of LARCs. There is need to revive and support family planning education programs at barracks and community level. Retraining the service providers is mandatory if improvement in the quality of provider interaction and knowledge of proper usage are to be achieved. Promote the uptake of contraceptives at family level and strengthen delivery of family planning services to the people in need. The leadership of UPDF should strengthen and implement policies concerning reproductive health in the army.