DETERMINANTS OF POSTPARTUM IUCD UTILIZATION AMONG MOTHERS WHO GAVE BIRTH IN GAMO ZONE PUBLIC HEALTH FACILITIES, SOUTHERN ETHIOPIA: CASE-CONTROL STUDY

Abstract

ABSTRACT Background: Immediate postpartum intra uterine contraceptive device insertion has distinct advantages of ease of insertion, availability of skilled personnel and appropriate facilities and convenience for the women, as the side effects of Copper-T insertion get masked with the after pains of delivery. Besides the underlining problem and as to the knowledge of the researcher; nothing is known in Gamo zone about the determinants of PPIUCD. Objective: To assess determinants of postpartum IUCD utilization among mothers who gave birth in Gamo zone health facilities, southern Ethiopia, 2019. Methods: a facility based unmatched case control study was conducted in Gamo zone public health facilities, southern Ethiopia. A total of 536 participants were selected in the study with a 1:2 case to control ratio thus 179 cases and 357 controls were recruited. Data was collected by a pretested interviewer administered questionnaires from March 1 to April 15 2019. The data was coded, cleaned and entered by Epi-Info version 3.5.1 and exported to statistical package for social science (SPSS) version 25 for advanced analysis. Bivariable and multivariable logistic regression analysis were performed to see the association between outcome and explanatory variables. Result: A total of 510(175 cases and 335 control) were involved in the study, which makes a response rate of 95.1%. The odds of mothers who have partner support for IUCD insertion were ten times more likely to utilize PPIUCD than those do not have partner support. (AOR (95 CI) 10(4.03, 24.3)). Mothers who have a birth interval of 1-2 year and 3-5 years 12 and almost 10 times more likely to utilize PPIUCD than mothers who have greater than five years. (AOR (95 CI) 12.0(1.5, 97.7), 9.7(1.7, 55.1)) respectively. The odds of mothers who are spacer four times more likely to utilize PPIUCD than limiters (AOR (95 CI) 4(1.44,10.84)). Mothers who are counseled during early labor around 88% less likely to utilize PPIUCD than those counseled during ANC (AOR (95 CI) .125(.034, .46)). Conclusion and recommendation: Birth interval, fertility plan, timing of counseling, pregnancy plan and partner support were found to be statistically significant. Therefore, health professionals better to give counseling by incorporating partners during antenatal follow up and after delivery