Use of Contraceptives among Postpartum Women in Nepal: A case of Makawanpur District

Abstract

Background: The use of contraceptive methods by the postpartum women has the potential to reduce the unwanted pregnancies and help in reduction of both maternal and childhood mortality and morbidity arising from unsafe abortions and inadequate spacing of births. However, its use remains low in Nepal and very little is known about the factors affecting its use. This information is vital to develop the programming strategies on postpartum family planning. Therefore, the study was conducted to identify the prevalence and determinants of postpartum contraceptives in Nepal. Methods: We conducted a community based cross sectional quantitative study in October 2016 among the women aged 15 to 49 years who delivered a child within the last one year of the survey date. Multi-stage sampling technique was used to interview a total of 313 women of Makawanpur district through household survey using structured questionnaire. We used chi-square analysis to test the association between the independent and dependent variables. Binary logistic regression analysis was used for those variables which were found significant in chi-square test. Odds ratios with 95% confidence intervals were computed to identify factors associated with contraceptive use. Results: Almost half (49.8%) of the women in the postpartum period were using a method of contraception. The most commonly used method was injectable Depo-Provera (35.9%). The use of postpartum contraceptives was found to be significantly associated with the income, education, ethnicity, religion, menstruation status, planned spacing for next child and easy access to health facility. More importantly, the study suggested the strong positive association between the use of postpartum contraceptives and use of maternal health services (ANC, institutional delivery and PNC) in the previous pregnancy. Conclusion: The use of postpartum contraceptives still remains low especially among rural, poor and lower caste groups. Specific programs need to be implemented to address the unmet need of marginalized group. Integrating postpartum contraceptives service in maternal and child health care programs and strengthening the counseling service would help to increase contraceptive use in the postpartum period.