Intrauterine device uptake among women seeking family planning services at Mbagathi and mama Lucy Kibaki hospitals in Nairobi county, Kenya
Mbuthia, Florence Wangari
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Intrauterine Device is a method of contraception, which is underutilized in Sub Saharan African countries including Kenya despite the method being safe, long acting, reversible and effective in preventing unintended pregnancies. The main objective of this study was to determine the uptake of Intrauterine Device among women seeking Family Planning services at Mbagathi and Mama Lucy Kibaki hospitals in Nairobi County. The specific objectives were to establish the level of Intra Uterine Device uptake among women seeking Family Planning services and to determine drivers and barriers to Intrauterine Device uptake among the study population. This was a descriptive cross sectional facility based study involving women of reproductive ages 15-49 years seeking family planning services at the two level four Government Hospitals in Nairobi County. Systematic sampling method was used to select respondent and 380 women who were distributed proportionately in the two facilities were interviewed. Data was collected using both quantitative and qualitative approaches where an interviewer administered questionnaires, focus group discussions and key informant interviews were used as the data collection tools. Descriptive statistics were used to describe the variables while chi square tests assessed associations. Logistic regression was performed for variables that were significant at bivariate analysis. The uptake of IUD among respondent was 7.9%. The uptake of IUD increased with age with those above 30 years using the device more than those below 30 years. Parity was significant in uptake of the method with those having more than two children using the method more compared to those who had one or two children (p<0.0001). Majority of women (84.6%) were able to identify what an IUD is and how it is used. Awareness of the fact that the facility was providing the IUD significantly influenced the uptake. Myths, rumours and misconception were mentioned by 71.3% of women but having heard them was not associated with uptake of IUD (p=0.167), however they were cited to be barrier to IUD uptake by key informant .The main myths, rumours and misconception that were mentioned included; One can conceive with IUD and give birth to a baby with device embedded in the body (35.8%), IUD can travel to other parts of the body (26.6%) and spread infections to other parts of the body (19.6%). Fear and conceptual concern were also cited as barrier to IUD uptake. Eighty three percent of the IUD users were satisfied with the device and 97% of the users would recommend the method to others. FP providers influenced IUD uptake by either recommending or advising against it. In conclusion the uptake of IUD was 7.9%. Parity, awareness of IUD availability and a favourable perception were the main drivers to IUD uptake. Myths, rumours and misconceptions largely persist in the region. The study recommends to the ministry of health a need to increase IUD uptake and Family planning programmes a need to focus more on young women and those of lower parity to increase the uptake of IUD. Health providers need to dispel myths, rumours and misconceptions and allay fears and concern about IUD. The study recommends further study to find out health provider’s influence on IUD uptake as well as a similar or comparative study in rural areas to find out IUD uptake and for ease of generalization.