title: Factors associated with utilization of long acting and permanent contraceptive methods among married women of reproductive age in Mekelle town, Tigray region, north Ethiopia.
abstract: BACKGROUND
  Ethiopia is the second most populous country in Sub-Saharan Africa. Total Fertility Rate of Ethiopia is 5.4 children per women, population growth rate is estimated to be 2.7% per year and contraceptive prevalence rate is only 15% while the unmet need for family planning is 34%. Overall awareness of Family Planning methods is high, at 87%. The prevalence of long acting and permanent contraceptive methods (LAPMs) in Tigray region was very low which accounts for 0.1% for implants and no users for intra-uterine contraceptive device (IUCD) and female sterilization. Moreover almost all modern contraceptive use in Ethiopia is dependent on short acting contraceptive methods. The objective of this study was to assess factors associated with utilization of long acting and permanent contraceptive methods (LAPM) among married women of reproductive age group in Mekelle town.
  
  
  METHODS
  A cross sectional community based survey was conducted from March 9-20, 2011. Multistage sample technique was used to select the participants for the quantitative methods whereas purposive sampling was used for the qualitative part of the study. Binary descriptive statistics and multiple variable regressions were done.
  
  
  RESULTS
  The study consisted of quantitative and qualitative data. From the quantitative part of the study the response rate of the study was 95.6%. Of the qualitative part two FGDs were conducted for each married women and married men. 64% of the married women heard about LAPMs. More than half (53.6%) of the married women had negative attitude towards practicing of LAPMs. The overall prevalence of LAPMs use was 12.3% however; there were no users for female or male sterilization. The main reason cited by the majority of the married women for not using LAPMs was using another method of contraception 360 (93.3%). Mothers who had high knowledge were 8 times more likely to use LAPMs as compared with those who had low knowledge (AOR = 7.9, 95% CI of (3.1, 18.3). Mothers who had two or more pregnancies were 3 times more likely to use LAPM as compared with those who had one pregnancy (AOR = 2.7, 95% CI of (1.4, 5.1).
  
  
  CONCLUSIONS
  A significant amount of the participants had low knowledge on permanent contraceptive particularly vasectomy. More than half (53.6%) of married women had negative attitude towards practicing of LAMPs. Few of married women use female sterilization and none use of female sterilization and or vasectomy. Positive knowledge of LAMPs, women who had two and above pregnancies and women who do not want to have additional child were significantly associated. Information education communication should focus on alleviating factors hinder from practicing of LAPMs.
authors.affiliation: Department of Public Health, Mekelle University, Mekelle, Ethiopia.
authors.forename: Mussie
authors.initials: M
authors.lastname: Alemayehu
authors.forename: Tefera
authors.initials: T
authors.lastname: Belachew
authors.forename: Tizta
authors.initials: T
authors.lastname: Tilahun
mesh_terms: D000328:Adult; D001294:Attitude to Health; D016001:Confidence Intervals; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D003271:Contraceptive Agents, Female / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005002:Ethiopia / Q000453:epidemiology; D005193:Family Planning Services / Q000706:statistics & numerical data*; D005260:Female; D006266:Health Education / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008393:Marriage / Q000706:statistics & numerical data*; D016017:Odds Ratio; D011247:Pregnancy; D011275:Pregnancy, Unwanted; D015995:Prevalence; D019035:Rural Health Services / Q000458:organization & administration; D013245:Sterilization, Reproductive / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D016387:Women's Health; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female