Level of Uptake and Influencing Factors of Long Acting Reversible Contraception among Post-abortion Women in Uganda

Level of Uptake and Influencing Factors of Long Acting Reversible Contraception among Post-abortion Women in Uganda | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Level of Uptake and Influencing Factors of Long Acting Reversible Contraception among Post-abortion Women in Uganda Samson Ralph Enyamitoit, Simon Byonanuwe, Irene Kahimakazi, Ubarnell Almenares, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3546455/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Women in sub-Saharan Africa often fail to obtain or use modern contraceptives, particularly Long Acting Reversible Methods (LARC), for many reasons. Women rely primarily on traditional and short-acting contraceptives which are prone to incorrect or inconsistent use and failure. In Uganda, utilization of modern contraceptives has steadily increased from 8–35% over the last decade. However, LARC use has remained as low as 7.8% and could be worse in specific sites. Whereas unsafe abortions contribute up to 26% of all maternal deaths in Uganda, there is limited use of effective contraceptive methods such as LARC. Methods An institutional based cross-sectional study involving 317 post abortion patients admitted at the gynecology ward of Hoima Regional Referral Hospital (HRRH) in western Uganda were enrolled between January 2022 and April 2022. Interviewer-administered questionnaires were used to collect data. Descriptive statistics and binary logistic regression analyses to assess for factors influencing uptake of LARC among post abortion women were conducted using STATA 14.2. Variables in final multivariate model were significant when p < 0.05. The measure of association was reported as odds ratios with corresponding 95% confidence interval and p-value. Results The level of uptake of LARC was 38.9%. The most commonly taken up LARC was implant at 79%. Family income (AOR = 5.65, CI: 2.594–15.862, p = 0.001), previous history of LARC (AOR = 4.8, CI: 2.828–8.054, p < 0.0001), previous use of any other contraceptives other than LARC (AOR = 3.1, CI: 1.57–5.39, p = 0.004), fear of complications (AOR = 0.29, CI: 0.176–0.732, p < 0.0001), fear of process of insertion or removal (AOR = 0.53, CI: 0.213–0.961, p < 0.0001) and an opposing partner to the method (AOR = 4.10, CI: 1.90–6.910, p = 0.006) were found to independently influence uptake of LARC among post abortion women admitted at HRRH Conclusions The level of uptake of LARC remains low in this area. Improving family incomes, partner involvement and mass sensitization regarding LARC will go a long way in promoting LARC use among post abortion women in this area. Sexual & Reproductive Medicine Contraception contraceptive LARC abortion family planning unintended pregnancy Figures Figure 1 Figure 2 Introduction Sub-Saharan African women frequently struggle to access or use contemporary contraceptives, especially the long-acting ones, for a variety of supply and demand side issues ( 1 ). Women typically utilize conventional, short-acting contraceptives, which are prone to failure due to improper or irregular use ( 2 ). Utilization of modern birth control in Uganda has progressively increased from 8–35% ( 3 ) over the last decade. However, just 7.8% of women continue to use long-acting reversible contraception ( 3 ) and some places, like Hoima Regional Referral Hospital, may be worse, according to sources. While unsafe abortions in Uganda can cause up to 26% of all maternal deaths ( 4 ), there is limited use of effective contraceptive methods such as long acting reversible contraceptive methods ( 5 ). Globally, 80 million women including teenagers get unintended pregnancies with 44 million induced abortions, 31 million spontaneous abortions and 47,000 women and teenagers who die due to unsafe abortions ( 6 ). In Uganda, 39 in 1000 pregnant women of reproductive age experience abortion most of which are unintended and unsafe ( 4 ). The World Health Organization (WHO) recommends women at least six months after an abortion before next pregnancy to avoid complications ( 7 ). This makes post abortion long acting reversible contraception the most effective post-abortion contraceptive approach immediately after an abortion ( 8 ). Limited information is available concerning factors influencing the uptake of LARC among post abortion patients in most contextual settings including Hoima. The current study results will pave way towards promoting uptake of LARC and minimizing maternal and neonatal complications linked to unwanted pregnancies or pregnancies conceived within six months among post abortion women in this area. Methods The study was conducted at Hoima Regional Referral Hospital gynecology ward over a period of three months between January and April 2022. This is a government’s regional referral health facility located in Hoima city, approximately 200 kilometers North West of Uganda’s capital Kampala. The hospital has a bed capacity of over 400 and provides both out-patients and in-patients services. According to UBoS, (2016), this facility serves a population of about 573,903 people ( 3 ). Post abortion patients admitted on gynecology ward prior to their discharge were approached by the research team and sensitized about the study. Detailed information regarding post miscarriage contraception and particularly long acting reversible contraception methods regarding what they are, their mode of action, adverse effects, and contraindications among others were given to the participants. Those who accepted to join the study were requested to give an informed written consent to participate in the study. Participants that accepted to take up any log acting reversible contraceptive method accordingly had the method administered in accordance with the standard protocols and guidelines after a quick history and physical examination particularly aimed at quickly identifying the very sick and hemodynamically unstable patients as well as ruling out any existing contraindications to (Intrauterine contraceptive Devices) IUCD or Implant insertion at that time such as history of any allergies for those who had used any of the methods before, any serious active pelvic infection particularly for the IUCD among others. Pre-tested structured investigator administered questionnaires with the help of a translator if needed were used to collect data. We included all post abortion women who had been evacuated or those who had complete abortion admitted on gynecology ward prior to their discharge. Women who were hemodynamically unstable at the time of the study were however excluded. Women who had any contraindication to implant or IUCD insertion at the time of the study were also meant to be excluded. A sample size of 324 was considered following calculation using Daniel formula (2009) ( 9 ). Consecutive enrolment for all the study participants for all women who met the eligibility criteria was done until the required sample size was achieved. Data collection procedure Post abortion women (who had been evacuated and/or had complete abortion) admitted on gynecology ward prior to their discharge were approached by the researcher, educated and counseled about the study. Detailed information regarding post abortion contraception and particularly LARC methods regarding what they are, their mode of action, adverse effects, and contraindications among others were given to the participants. Those who accepted to join the study were requested to give an informed written consent to participate in the study. Participants that accepted to take up any LARC method accordingly had the method administered in accordance with the standard protocols and guidelines after a quick history and physical examination particularly aimed at quickly identifying the very sick and hemodynamically unstable patients as well as ruling out any existing contraindications to IUCD or Implant insertion at that time such as history of any allergies for those who had used any of the methods before, any serious active pelvic infection particularly for the IUCD among others. Pre-tested structured investigator administered questionnaires with the help of a translator if needed were used to collect data. A total of 324 women were consecutively included for the study on a daily basis. However, a total of seven of these were very sick patients at the point of data collection and were therefore excluded from the study. Only 317 patients had their data fully collected and analyzed. Data presentation and analysis Data from questionnaires were entered into Microsoft excel version 2010 and then exported to STATA version 14.2. The factors influencing uptake of long-acting reversible contraceptive methods among post abortion patients were assessed using chi square tests followed by binary logistic regression. Biologically plausible variables and those with p < 0.05 were considered for multivariate analysis. The variables in the final multivariate model were significant when p < 0.05. The measure of association was reported as odds ratios with corresponding 95% confidence interval and p -value. All statistical analyses were carried out in STATA version 14.2. The results were presented in different tables as shown in the results section. Ethical consideration Voluntary recruitment of all the study participants was done and an informed consent document was signed. Informed consent from participants was obtained after fully explaining the details of the study to them in both English and Runyoro, the local language particularly for the participants who did not understand English. Emancipated minors were not required to have sought their guardian’s approval in order to consent. Participants were free to withdraw from the study at any time they wished without coercion or compromise of care that they were entitled to. Participants undergoing LARC were likely to encounter bleeding, some discomfort, and slight pain. Thorough assessment for any bleeding diatheses and counseling about the discomfort and pain were done, including any risks related to anesthesia, prior to any procedure of putting the LARC method. Related risk of introducing infection was minimized by ensuring that sterile procedures were strictly followed. Additionally, post-abortion contraception was one of the components of PAC that had to be instituted in this setting. In case of complications then the researcher through the institution was tasked with the management including reimbursement of the same. Standard operating procedures for prevention of COVID-19 such as social distancing, washing of hands with water and soap and wearing of mask were strictly adhered throughout the study. Priority was not given in terms of tribe, interest group, race, or religion. Results A total of 324 post abortion women who had been evacuated or those who had completed abortion admitted on gynecology ward prior to their discharge were consecutively included for the study on a daily basis. These had post abortion contraception and method-specific LARC and counseling done. However, a total of seven of these were very sick patients and were hemodynamically unstable at the point of data collection and were therefore excluded from the study. Only 317 patients had their data fully collected and analyzed, of whom 124 took up one f the LARC methods; either IUCD or Implant, while the 193 did not take up any of the methods. Out of the 324 post abortion patients admitted at Hoima Regional Referral Hospital who were considered for the study, 126(38.9%) were able to take up one of the long acting reversible contraceptive methods (that is; IUCD or Implant). This is sown in Fig. 1 . The most commonly taken up long acting reversible contraceptive method among post abortion patients was implant 98(79%). A few, 26(21%) however, chose IUCD. This is presented in Fig. 2 . Level of uptake of LARC methods among post abortion patients admitted at HRRH Most commonly taken up LARC method among post abortion patients admitted at HRRH Bivariable analysis revealed that religion, education level, marital status, total monthly family income, gravidity, previous history of LARC, previous use of any other contraceptives not LARC, fear of complications, whether or not she had heard about LARC before, fear of process of insertion or removal, if she had had another satisfying method of contraception, if a friend, relative or neighbor had had bad experiences with LARC, and if her partner was opposed to it significantly influenced uptake of long acting reversible contraceptive methods among post abortion patients admitted at HRRH. This is shown in Table 1 . These variables were then all entered into a multivariable model and the findings are presented in Table 2 . Following multivariable analysis, total monthly family income (AOR = 5.65, CI: 2.594–15.862, p = 0.001), previous history of LARC (AOR = 4.8, CI: 2.828–8.054, p < 0.0001), previous use of any other contraceptives not LARC (AOR = 3.1, CI: 1.57–5.39, p = 0.004), fear of complications (AOR = 0.29, CI: 0.176–0.732, p < 0.0001), fear of process of insertion or removal (AOR = 0.53, CI: 0.213–0.961, p < 0.0001), and an opposing partner to the method (AOR = 4.10, CI: 1.90–6.910, p = 0.006) were found to significantly influence the uptake of LARC methods among post abortion women admitted at HRRH. Specifically, women with monthly family income of more than 300,000Ugx (about 80 $ ) were more than fivefold likely to take up LARC compared to those whose earning was less than 300,000Ugx. Similarly, women with a prior history of using a LARC method were 4.8 times likely to use any LARC method following an abortion. Same observation was noted for women with previous use of any other contraceptives not LARC. These were 3.1 times likely to use LARC following an abortion. Fear of complications and fear of process of insertion or removal of long acting reversible contraceptive method was associated with 0.29 times and 0.53 times less likelihood to take up the LARC method following abortion at this hospital respectively. Noted also was that post-abortion women whose spouses were not opposed to long acting reversible contraception were more than four times likely to use the method at HRRH. Table 1 Bivariate analysis of the influencing factors for uptake of LARC among post abortion patients admitted at HRRH (N = 317) Variable Category Taken up the method UOR(95%CI) p- value Yes (n = 124) No (n = 193) Age (years) 40 3(50.0%) 3(50.0%) 0.82(0.153–4.387) 0.8148 Religion Christian 110(41.0%) 158(59.0%) 1.00 Moslem 12(60.0%) 8(40.0%) 0.46(0.184–1.173) 0.1047 Bisaka 2(6.9%) 27(93.1%) 9.39(2.189–40.342) 0.0026 * Education level No formal education 9(20.0% ) 36(80.0%) 1.00 Primary 24(36.4%) 42(63.6%) 0.44(0.180–1.061) 0.0675 Secondary and higher 91(44.2%) 115(55.8%) 0.32(0.145–0.689) 0.0038 * Marital status Single 15(26.8%) 41(73.2%) 0.51(0.269–0.968) 0.0395 * Married 109(41.8%) 152(58.2%) 1.00 Total monthly family income ≤ 300,000 Ugx 91(48.4%) 97(51.6%) 1.00 300,000 Ugx 33(25.6%) 96(74.4%) 2.73(1.675–4.446) Gravidity Primegravida 12(22.2%) 42(77.8%) 0.39(0.194–0.765) 0.006 * Multigravida 112(42.6%) 151(57.4%) 1.00 Gestational age ≤ 12 weeks 86(41.0%) 124(59.0%) 1.00 0.3485 > 12 weeks 38(35.5%) 69(64.5%) 1.26(0.778–2.039) Number of abortions so far 1 103(40.6%) 151(59.4%) 1.00 0.2944 > 1 21(33.3%) 42(66.7%) 1.36(0.763–2.438) Type of abortion Induced 27(31.4%) 59(68.6%) 1.00 0.0869 Spontaneous 97(42.0%) 134(58.0%) 0.63(0.374–1.069) Number of living children ≤ 2 72(42.4%) 98(57.6%) 1.00 0.4984 > 2 52(38.5%) 83(61.5%) 1.17(0.739–1.859) Previous history of LARC Yes 28(54.9%) 23(45.1%) 2.16(1.176–3.951) 0.0129 * No 96(36.1%) 170(63.9%) 1.00 Previous use of any other contraceptives not LARC Yes 91(44.8%) 112(55.2%) 1.99(1.222–3.256) 0.0058 * No 33(28.9%) 81(71.1%) 1.00 Fear of complications Yes 84(31.0%) 187(69.0%) 0.07(0.028–0.165) < 0.0001 No 40(87.0%) 6(13.0%) 1.00 Unsure of future family plans Yes 91(39.4%) 140(60.6%) 1.04(0.628–1.736) 0.868 No 33(38.4%) 53(61.6%) 1.00 Has heard about LARC before? Yes 18(17.1%) 87(82.9%) 1.00 < 0.0001 * No 106(50.0%) 106(50.0%) 0.21(0.117–0.368) Fear of process of insertion or removal Yes 66(27.4%) 175(72.6%) 0.12(0.064–0.213) < 0.0001 * No 58(76.3%) 18(23.7%) 1.00 Have another satisfying method of contraception Yes 9(10.6%) 76(89.4%) 0.12(0.058–0.252) < 0.0001 * No 115(49.6%) 117(50.4%) 1.00 Friend, relative or neighbor has had bad experiences with LARC Yes 25(19.1%) 106(80.9%) 0.21(0.123–0.349) < 0.0001 * No 99(53.2%) 87(46.8%) 1.00 Partner opposed to it Yes 70(57.9%) 51(42.1%) 1.00 < 0.0001 * No 54(43.5%) 142(73.6%) 3.61(2.238–5.821) *p < 0.05, UOR = Unadjusted Odds Ratio, CI = Confidence Interval, Ugx = Uganda shilling Table 2 Multivariable analysis of the influencing factors for uptake of LARC among post abortion patients admitted at HRRH (N = 317) Variable Category AOR(95%CI) p- value Religion Christian 1.00 Moslem 1.41(0.261–5.315) 0.448 Bisaka 2.16(1.031–7.244) 0.131 Marital status Single 1.19(0.208–6.765) 0.848 Married 1.00 Education level No formal education 1.00 Primary 0.07(0.011–1.389) 0.073 Secondary and higher 0.25(0.072–0.389) 0.127 Total monthly family income ≤ 300,000 Ugx 1.00 > 300,000 Ugx 5.65(2.594–15.862) 0.001 * Gravidity Primegravida 1.00 Multigravida 1.72(0.418-7.100) 0.451 Previous history of LARC Yes 4.8(2.828–8.054 < 0.0001 * No 1.00 Previous use of any other contraceptives not LARC Yes 3.1(1.57–5.39) 0.004 * No 1.00 Fear of complications Yes 0.29(0.176–0.732 < 0.0001 * No 1.00 Has heard about LARC before? Yes 1.00 No 0.37(0.129–1.077) 0.068 Fear of process of insertion or removal Yes 0.53(0.213–0.961) < 0.0001 * No 1.00 Have another satisfying method of contraception Yes 0.04(0.014–0.370) 0.101 No 1.00 Friend, relative or neighbor has had bad experiences with LARC Yes 0.36(0.161–0.688) 0.410 No 1.00 Partner opposed to it Yes 1.00 No 4.10(1.90–6.910) 0.006 * *p < 0.05, AOR = Adjusted Odds Ratio, CI = Confidence Interval, Ugx = Uganda Shilling Discussion The current study results have revealed that the level of uptake of long acting reversible contraceptive methods among post abortion patients admitted at Hoima Regional Referral Hospital was 38.9%. These women were able to take up one of the LARC methods; that is, either an IUCD or Implant following abortion. This finding was found to be comparable with the findings of Goldstone et al ( 10 ) in Australia which showed an increased uptake of LARC after abortion among women presenting for abortion of 38.0%. The current uptake for LARC among post abortion patients at HRRH was much higher than the overall uptake in developing countries of 28% as reported by Darroch and Singh ( 11 ) and one reported in New Zealand by Mehata et al ( 12 ) (17%) and in Northern Ethiopia by Mittiku et al ( 13 ) where the overall uptake of LARC following abortion was 16.76%. It was however lower than one reported in China by Luo et al., (2018) ( 14 ) (42.5%) and in Enugu, Nigeria by Okafor (2016) of 50% ( 15 ). As was noted in their study report, post abortion contraception uptake was higher in facilities that offered contraceptive services in the same structures where the abortion services were offered than others. This difference among the different study settings probably explains this discrepancy in the level of uptake. This study found that the implant was the most commonly taken up long acting reversible contraceptive method among post abortion patients at 79%. This was consistent with previous researchers such as Mittiku et al., (2021) in Ethiopia of 82.46% ( 13 ) and Ampt et al., (2019) in Kenya of 1.3% ( 16 ) and Twesigye, Buyungo and Kaula, (2016) in Uganda ( 17 ). Discrepancy however was noted with Luo et al., (2018) in China where up to 35.2% of the post abortion women chose IUCDs. A lot of myths and misperceptions have been raised in regard to the use of IUCDs especially in Africa ( 18 ). Here in Uganda for example, as suggested by Twesigye et and colleagues (2016) ( 17 ) and Celik, (2016) ( 19 ), a good number of women have associated IUCDs with future infertility, perception that it can disseminate into the blood circulation and subsequently ‘migrate’ to certain organs such as the heart and lungs, that it can cause cancer, among others. These associated myths towards certain contraceptive methods such as the IUCD probably explains the observed low uptake of this particular method as compared to the implants in this setting where the research was conducted. The current study has also established that women with a total monthly family income of more than 300,000Ugx (about 80 US dollars) were more than fivefold likely to take up LARC compared to those whose earning was less than 300,000Ugx (85 US dollars) (AOR = 5.65, CI: 2.594–15.862, p = 0.001). This result was in agreement with the one reported by Anguzu and colleagues ( 20 ) where uptake of long acting reversible contraceptive methods was highest among women from richest households and that an increase in wealth index steadily improved the use of long acting reversible contraceptive methods from 2.2% among women from poorest households to 3.84% among women from richest households. Similarly, Gujo and Kare, (2021) ( 21 ) in Ethiopia observed a higher odds of utilization of LARC among women who earned high monthly income. The Uganda Demographic and Health Survey (2016) has stressed this factor before, noting that contraceptive use increases with wealth. According to their countrywide survey, women with no education were less likely (26%) than women who have any education (38%-51%) to use a method ( 3 ). It is possible that women of high socioeconomic status are able to acquire long acting reversible contraceptive methods after an abortion without difficulty and therefore has a positive relationship with their uptake. Also, women of higher socioeconomic status have higher chances of being educated, a factor which has been raised by several scholars as a predictor of increased uptake of LARC methods. In this study, women with a prior history of using long acting reversible contraceptive method before were 4.8 times likely to use any LARC method again (AOR = 4.8, CI: 2.828–8.054, p < 0.0001). Same observation was noted for women with previous history of use of any other contraceptives besides LARC. These were 3.1 times likely to use long acting reversible contraceptive methods following an abortion (AOR = 3.1, CI: 1.57–5.39, p = 0.004). These were consistent with findings of Anguzu et al., (2018) in Uganda ( 20 ). However, these findings were not in agreement with those by Luo et al., (2018) ( 14 ) regarding long-acting reversible contraceptive use in the post-abortion period among women seeking abortion in China where previous use of long acting reversible contraceptive methods had reduced odds for an intention to use long acting reversible contraceptive methods. Fears of complications associated with LARC and fear of process of insertion or removal of the LARC method was associated with 0.29 times (AOR = 0.29, CI: 0.176–0.732, p < 0.0001) and 0.53 times (AOR = 0.53, CI: 0.213–0.961, p < 0.0001) less likelihood to take up the LARC method following abortion at this hospital respectively. As has been noted before by Samuel et al., (2016), an increase in the uptake of post-abortion LARC can be achieved by a double counseling strategy which is a continuum of counseling after an abortion is done to patients to sensitize them and get informed consent. Moreover, in China, Luo et al., (2018) ( 14 ) found out that barriers to the use of LARC methods were anxiety relating to impaired future fertility (56.2%), long acting reversible contraception being harmful to health (45.2%), irregular bleeding (44.3%), risk of intrauterine contraceptive device failure (41.6%) and lack of awareness with respect to long acting reversible contraception (36.1%). This literature provides an insight into searching for barriers to uptake of post abortion long acting reversible contraception in various other settings including HRRH. For long, various researchers have emphasized the importance of counseling regarding the associated pain during both insertion and removal of the contraceptive method. For example, in Kenya, some women stopped using contraceptives after they experienced purportedly perceived side effects of the contraceptives ( 22 ). Such effects may therefore justify the less likelihood to take up the long acting reversible contraceptive methods in certain parts of the world including HRRH where our study was conducted. The study observed that post-abortion women whose spouses were not opposed to LARC were more than four times likely to use the method at HRRH (AOR = 4.10, CI: 1.90–6.910, p = 0.006). We noted a similar observation by Gashaye et al., (2020) ( 23 ) and Gujo and Kare, (2021) ( 21 ) in Ethiopia where the odds of the utilization of long acting reversible contraceptive methods were increased among women discussed contraceptive methods with their husbands. This study result clearly suggests the importance of actively engaging men in reproductive health and family planning programs in this study setting, the entire country and world over. As suggested by Gashaye et al., (2020) ( 23 ), male involvement in the counseling and decision making process regarding the advantages of using LARC may improve the negative influence of partners on LARC utilization. Male involvement in contraceptive use particularly in LARC methods is a key strategy towards the success of family planning programs and women’s empowerment and has been associated with better outcomes in reproductive health such as contraceptive acceptance, continuation, and safer sexual behaviors ( 24 ). According to Jonas, Kalichman, Kalichman, Morroni, and Mathews, (2020) ( 25 ); improving men’s knowledge of, and attitudes toward the contraceptive implant (and perhaps all other LARC methods) might therefore increase their support for their partner’s use of the method(s), which in turn might promote uptake of the method(s) among women. Study limitation This being an institutional based study may not generalize the entire population and this could have impacted on our overall level of uptake. Conclusion The level of uptake of LARC remains low in this area. Improving family incomes, partner involvement and mass sensitization regarding LARC will go a long way in promoting LARC use among post abortion women in this area. Abbreviations COVID-19 Corona Virus Disease 19 LARC Long Acting Reversible Contraceptive UBOS Uganda Bureau of Statistics HRRH Hoima Regional Referral Hospital IUCD Intrauterine Contraceptive Device Declarations Competing interests The authors declare no conflict of interest in regard to the publication of this work Ethical approval and consent of participants This study was approved by the Research Ethics Committee of Kampala International University, approval number KIU-2021-43 Funding No funding was obtained for this study References Skiles, M. P., Cunningham, M., Inglis, A., Wilkes, B., Hatch, B., Bock, A. & Barden-O’fallon J. The effect of access to contraceptive services on injectable use and demand for family planning in Malawi. Int Perspect Sex Reprod Health. 2015;41(26):20–30. Secura, G. M., Allsworth, J. E., Madden, T., Mullersman, J. L. & Peipert JF. The Contraceptive CHOICE Project: reducing barriers to long-acting reversible contraception. 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Evaluating the impact of a quality management intervention on post-abortion contraceptive uptake in private sector clinics in western Kenya: a pre-and post-intervention study. Reprod Health. 2018;15(8):1–10. Gashaye KT, Tsegaye AT, Abebe SM, Woldetsadik A, Ayele TA, Gashaw ZM. Determinants of long acting reversible contraception utilization in Northwest Ethiopia: An institution-based case control study. PLoS One [Internet]. 2020;15(10):1–19. Available from: http://dx.doi.org/10.1371/journal.pone.0240816 Abera A, Girmay A, Yadeta D. Assessment of Male Involvement in Long-Acting and Permanent Contraceptive Use of Their Partner in West Badewacho, Southern Ethiopia. Open Access J Contracept. 2021;21(12):63–72. Jonas K, Kalichman M, Kalichman S, Morroni C, Mathews C. Factors affecting men’ s support for the use of the contraceptive implant by their female intimate partners. Contracept Reprod Med. 2020;5(36):1–8. 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Also discoverable on Platform About Our Team In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3546455","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":245332529,"identity":"b9caf2ff-fc50-441a-8edb-9acc75792d64","order_by":0,"name":"Samson Ralph Enyamitoit","email":"","orcid":"https://orcid.org/0000-0001-6646-7613","institution":"Department of Obstetrics and Gynecology, Kampala International University Western Campus, Bushenyi, Uganda","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Samson","middleName":"Ralph","lastName":"Enyamitoit","suffix":""},{"id":245332661,"identity":"2acae2e9-bb09-46aa-aecc-934954b3dc48","order_by":1,"name":"Simon Byonanuwe","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA0ElEQVRIiWNgGAWjYBACAzjJ3gBiWJCihecAiCFBrBYQkEgAk4S1mEskH3v4o2CbnLnk86sbfhRIMPC3dyfg1WI5Iy3dmMfgtrHl7Jyymz1Ah0mcObsBv8Nu5JhJMxjcTtxwOyftBg9Qi4FELmEtkj9AWm6eSbv5h1gtEjwgLTfYj90myhbLnmdp0iC/GJzJYbstYyDBQ9Av5uzJxyR//LktZ3D8+LObb/7YyPG39+LXwiCQAGPxgOOIB79yEOA/AGOxPyCsehSMglEwCkYkAADf7UhYM+OD1AAAAABJRU5ErkJggg==","orcid":"https://orcid.org/0000-0002-5360-556X","institution":"Department of Obstetrics and Gynecology, Kampala International University Western Campus, Bushenyi, Uganda","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Simon","middleName":"","lastName":"Byonanuwe","suffix":""},{"id":245336166,"identity":"4e121403-4f42-4d5f-a297-d9f5d1418045","order_by":2,"name":"Irene Kahimakazi","email":"","orcid":"https://orcid.org/0000-0001-7289-7003","institution":"Department of Obstetrics and Gynecology, Kampala International University Western Campus, Bushenyi, Uganda","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Irene","middleName":"","lastName":"Kahimakazi","suffix":""},{"id":245336167,"identity":"7f619999-d197-42c8-ba6b-b7e0e16dad31","order_by":3,"name":"Ubarnell Almenares","email":"","orcid":"","institution":"Department of Obstetrics and Gynecology, Kampala International University Western Campus, Bushenyi, Uganda","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Ubarnell","middleName":"","lastName":"Almenares","suffix":""},{"id":245336168,"identity":"5209ac5e-9696-4202-9db6-c88c3e7e8852","order_by":4,"name":"Emmanuel Sentongo","email":"","orcid":"https://orcid.org/0009-0008-2973-8283","institution":"Department of Obstetrics and Gynecology, Kampala International University Western Campus, Bushenyi, Uganda","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Emmanuel","middleName":"","lastName":"Sentongo","suffix":""},{"id":245336169,"identity":"04de584c-334e-4a6f-b0ee-e6e2ffb7ee85","order_by":5,"name":"Jean W. Latortue","email":"","orcid":"","institution":"Department of Obstetrics and Gynecology, Franklin County Rural Health Clinic, Mount Vernon, Texas, USA","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Jean","middleName":"W.","lastName":"Latortue","suffix":""},{"id":245336170,"identity":"c91feb82-283c-465b-80d1-00bf21c885e2","order_by":6,"name":"Maxwell Okello","email":"","orcid":"","institution":"Department of Obstetrics and Gynecology, Kampala International University Western Campus, Bushenyi, Uganda","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Maxwell","middleName":"","lastName":"Okello","suffix":""},{"id":245336171,"identity":"fced70e7-9614-49d7-b679-25c9b68f255d","order_by":7,"name":"Yarine Fajardo Tornes","email":"","orcid":"","institution":"Department of Obstetrics and Gynecology, Kampala International University Western Campus, Bushenyi, Uganda","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yarine","middleName":"Fajardo","lastName":"Tornes","suffix":""}],"badges":[],"createdAt":"2023-11-02 18:14:52","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":true,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false,"coiExplicitlySet":false},"doi":"10.21203/rs.3.rs-3546455/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3546455/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":45808217,"identity":"54c31c8d-587b-419c-acb9-d51456dbf043","added_by":"auto","created_at":"2023-11-03 12:09:19","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":20430,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eLevel of uptake of LARC methods among post abortion patients at HRRH\u003c/em\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-3546455/v1/718d9aa985222b0af2ccee51.png"},{"id":45808218,"identity":"54da7110-201a-4e74-a746-8a6c2afd82ae","added_by":"auto","created_at":"2023-11-03 12:09:20","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":54604,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eMost commonly taken up LARC method among post abortion patients admitted at HRRH\u003c/em\u003e\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-3546455/v1/0df229cd6e17f26adb6aeb34.png"},{"id":45809480,"identity":"b73afe41-ac36-4556-8976-dc6ce1feea39","added_by":"auto","created_at":"2023-11-03 12:17:20","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":395053,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3546455/v1/56a8db13-0b68-4341-bd4f-c338312becf3.pdf"}],"financialInterests":"","formattedTitle":"\u003cp\u003e\u003cstrong\u003eLevel of Uptake and Influencing Factors of Long Acting Reversible Contraception among Post-abortion Women in Uganda\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eSub-Saharan African women frequently struggle to access or use contemporary contraceptives, especially the long-acting ones, for a variety of supply and demand side issues (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Women typically utilize conventional, short-acting contraceptives, which are prone to failure due to improper or irregular use (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Utilization of modern birth control in Uganda has progressively increased from 8\u0026ndash;35% (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) over the last decade. However, just 7.8% of women continue to use long-acting reversible contraception (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) and some places, like Hoima Regional Referral Hospital, may be worse, according to sources. While unsafe abortions in Uganda can cause up to 26% of all maternal deaths (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e), there is limited use of effective contraceptive methods such as long acting reversible contraceptive methods (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eGlobally, 80\u0026nbsp;million women including teenagers get unintended pregnancies with 44\u0026nbsp;million induced abortions, 31\u0026nbsp;million spontaneous abortions and 47,000 women and teenagers who die due to unsafe abortions (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). In Uganda, 39 in 1000 pregnant women of reproductive age experience abortion most of which are unintended and unsafe (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). The World Health Organization (WHO) recommends women at least six months after an abortion before next pregnancy to avoid complications (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). This makes post abortion long acting reversible contraception the most effective post-abortion contraceptive approach immediately after an abortion (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Limited information is available concerning factors influencing the uptake of LARC among post abortion patients in most contextual settings including Hoima. The current study results will pave way towards promoting uptake of LARC and minimizing maternal and neonatal complications linked to unwanted pregnancies or pregnancies conceived within six months among post abortion women in this area.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThe study was conducted at Hoima Regional Referral Hospital gynecology ward over a period of three months between January and April 2022. This is a government\u0026rsquo;s regional referral health facility located in Hoima city, approximately 200 kilometers North West of Uganda\u0026rsquo;s capital Kampala. The hospital has a bed capacity of over 400 and provides both out-patients and in-patients services. According to UBoS, (2016), this facility serves a population of about 573,903 people (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Post abortion patients admitted on gynecology ward prior to their discharge were approached by the research team and sensitized about the study. Detailed information regarding post miscarriage contraception and particularly long acting reversible contraception methods regarding what they are, their mode of action, adverse effects, and contraindications among others were given to the participants. Those who accepted to join the study were requested to give an informed written consent to participate in the study. Participants that accepted to take up any log acting reversible contraceptive method accordingly had the method administered in accordance with the standard protocols and guidelines after a quick history and physical examination particularly aimed at quickly identifying the very sick and hemodynamically unstable patients as well as ruling out any existing contraindications to (Intrauterine contraceptive Devices) IUCD or Implant insertion at that time such as history of any allergies for those who had used any of the methods before, any serious active pelvic infection particularly for the IUCD among others. Pre-tested structured investigator administered questionnaires with the help of a translator if needed were used to collect data.\u003c/p\u003e \u003cp\u003eWe included all post abortion women who had been evacuated or those who had complete abortion admitted on gynecology ward prior to their discharge. Women who were hemodynamically unstable at the time of the study were however excluded. Women who had any contraindication to implant or IUCD insertion at the time of the study were also meant to be excluded. A sample size of 324 was considered following calculation using Daniel formula (2009) (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Consecutive enrolment for all the study participants for all women who met the eligibility criteria was done until the required sample size was achieved.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eData collection procedure\u003c/h2\u003e \u003cp\u003ePost abortion women (who had been evacuated and/or had complete abortion) admitted on gynecology ward prior to their discharge were approached by the researcher, educated and counseled about the study. Detailed information regarding post abortion contraception and particularly LARC methods regarding what they are, their mode of action, adverse effects, and contraindications among others were given to the participants. Those who accepted to join the study were requested to give an informed written consent to participate in the study. Participants that accepted to take up any LARC method accordingly had the method administered in accordance with the standard protocols and guidelines after a quick history and physical examination particularly aimed at quickly identifying the very sick and hemodynamically unstable patients as well as ruling out any existing contraindications to IUCD or Implant insertion at that time such as history of any allergies for those who had used any of the methods before, any serious active pelvic infection particularly for the IUCD among others. Pre-tested structured investigator administered questionnaires with the help of a translator if needed were used to collect data. A total of 324 women were consecutively included for the study on a daily basis. However, a total of seven of these were very sick patients at the point of data collection and were therefore excluded from the study. Only 317 patients had their data fully collected and analyzed.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eData presentation and analysis\u003c/h2\u003e \u003cp\u003eData from questionnaires were entered into Microsoft excel version 2010 and then exported to STATA version 14.2. The factors influencing uptake of long-acting reversible contraceptive methods among post abortion patients were assessed using chi square tests followed by binary logistic regression. Biologically plausible variables and those with \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05 were considered for multivariate analysis. The variables in the final multivariate model were significant when \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05. The measure of association was reported as odds ratios with corresponding 95% confidence interval and \u003cem\u003ep\u003c/em\u003e-value. All statistical analyses were carried out in STATA version 14.2. The results were presented in different tables as shown in the \u003cspan refid=\"Sec6\" class=\"InternalRef\"\u003eresults\u003c/span\u003e section.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eEthical consideration\u003c/h2\u003e \u003cp\u003e Voluntary recruitment of all the study participants was done and an informed consent document was signed. Informed consent from participants was obtained after fully explaining the details of the study to them in both English and Runyoro, the local language particularly for the participants who did not understand English. Emancipated minors were not required to have sought their guardian\u0026rsquo;s approval in order to consent. Participants were free to withdraw from the study at any time they wished without coercion or compromise of care that they were entitled to. Participants undergoing LARC were likely to encounter bleeding, some discomfort, and slight pain. Thorough assessment for any bleeding diatheses and counseling about the discomfort and pain were done, including any risks related to anesthesia, prior to any procedure of putting the LARC method. Related risk of introducing infection was minimized by ensuring that sterile procedures were strictly followed. Additionally, post-abortion contraception was one of the components of PAC that had to be instituted in this setting. In case of complications then the researcher through the institution was tasked with the management including reimbursement of the same. Standard operating procedures for prevention of COVID-19 such as social distancing, washing of hands with water and soap and wearing of mask were strictly adhered throughout the study. Priority was not given in terms of tribe, interest group, race, or religion.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 324 post abortion women who had been evacuated or those who had completed abortion admitted on gynecology ward prior to their discharge were consecutively included for the study on a daily basis. These had post abortion contraception and method-specific LARC and counseling done. However, a total of seven of these were very sick patients and were hemodynamically unstable at the point of data collection and were therefore excluded from the study. Only 317 patients had their data fully collected and analyzed, of whom 124 took up one f the LARC methods; either IUCD or Implant, while the 193 did not take up any of the methods. Out of the 324 post abortion patients admitted at Hoima Regional Referral Hospital who were considered for the study, 126(38.9%) were able to take up one of the long acting reversible contraceptive methods (that is; IUCD or Implant). This is sown in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The most commonly taken up long acting reversible contraceptive method among post abortion patients was implant 98(79%). A few, 26(21%) however, chose IUCD. This is presented in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \n\u003cp\u003e\u003cstrong\u003eLevel of uptake of LARC methods among post abortion patients admitted at HRRH\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMost commonly taken up LARC method among post abortion patients admitted at HRRH\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBivariable analysis revealed that religion, education level, marital status, total monthly family income, gravidity, previous history of LARC, previous use of any other contraceptives not LARC, fear of complications, whether or not she had heard about LARC before, fear of process of insertion or removal, if she had had another satisfying method of contraception, if a friend, relative or neighbor had had bad experiences with LARC, and if her partner was opposed to it significantly influenced uptake of long acting reversible contraceptive methods among post abortion patients admitted at HRRH. This is shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. These variables were then all entered into a multivariable model and the findings are presented in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003eFollowing multivariable analysis, total monthly family income (AOR\u0026thinsp;=\u0026thinsp;5.65, CI: 2.594\u0026ndash;15.862, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001), previous history of LARC (AOR\u0026thinsp;=\u0026thinsp;4.8, CI: 2.828\u0026ndash;8.054, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.0001), previous use of any other contraceptives not LARC (AOR\u0026thinsp;=\u0026thinsp;3.1, CI: 1.57\u0026ndash;5.39, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.004), fear of complications (AOR\u0026thinsp;=\u0026thinsp;0.29, CI: 0.176\u0026ndash;0.732, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.0001), fear of process of insertion or removal (AOR\u0026thinsp;=\u0026thinsp;0.53, CI: 0.213\u0026ndash;0.961, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.0001), and an opposing partner to the method (AOR\u0026thinsp;=\u0026thinsp;4.10, CI: 1.90\u0026ndash;6.910, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.006) were found to significantly influence the uptake of LARC methods among post abortion women admitted at HRRH. Specifically, women with monthly family income of more than 300,000Ugx (about 80\u003cspan\u003e$\u003c/span\u003e) were more than fivefold likely to take up LARC compared to those whose earning was less than 300,000Ugx. Similarly, women with a prior history of using a LARC method were 4.8 times likely to use any LARC method following an abortion. Same observation was noted for women with previous use of any other contraceptives not LARC. These were 3.1 times likely to use LARC following an abortion. Fear of complications and fear of process of insertion or removal of long acting reversible contraceptive method was associated with 0.29 times and 0.53 times less likelihood to take up the LARC method following abortion at this hospital respectively. Noted also was that post-abortion women whose spouses were not opposed to long acting reversible contraception were more than four times likely to use the method at HRRH.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBivariate analysis of the influencing factors for uptake of LARC among post abortion patients admitted at HRRH (N\u0026thinsp;=\u0026thinsp;317)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eTaken up the method\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eUOR(95%CI)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003ep-\u003c/em\u003evalue\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes (n\u0026thinsp;=\u0026thinsp;124)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo (n\u0026thinsp;=\u0026thinsp;193)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27(45.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33(55.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20\u0026ndash;30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e71(36.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e124(63.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.43(0.795\u0026ndash;2.568)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.2328\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31\u0026ndash;40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23(41.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33(58.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.17(0.562\u0026ndash;2.451)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.6695\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3(50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3(50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.82(0.153\u0026ndash;4.387)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.8148\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eReligion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eChristian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e110(41.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e158(59.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMoslem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12(60.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8(40.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.46(0.184\u0026ndash;1.173)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.1047\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBisaka\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2(6.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27(93.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9.39(2.189\u0026ndash;40.342)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.0026\u003c/b\u003e*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eEducation level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo formal education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9(20.0% )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36(80.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24(36.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42(63.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.44(0.180\u0026ndash;1.061)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.0675\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecondary and higher\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e91(44.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e115(55.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.32(0.145\u0026ndash;0.689)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.0038\u003c/b\u003e*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15(26.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41(73.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.51(0.269\u0026ndash;0.968)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e0.0395\u003c/b\u003e*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e109(41.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e152(58.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTotal monthly family income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;300,000 Ugx\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e91(48.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e97(51.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.0001\u003c/b\u003e*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;300,000 Ugx\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33(25.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e96(74.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.73(1.675\u0026ndash;4.446)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGravidity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimegravida\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12(22.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42(77.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.39(0.194\u0026ndash;0.765)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e0.006\u003c/b\u003e*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMultigravida\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e112(42.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e151(57.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGestational age\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;12 weeks\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e86(41.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e124(59.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.3485\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;12 weeks\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38(35.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e69(64.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.26(0.778\u0026ndash;2.039)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eNumber of abortions so far\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e103(40.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e151(59.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.2944\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21(33.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42(66.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.36(0.763\u0026ndash;2.438)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eType of abortion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInduced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27(31.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e59(68.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.0869\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSpontaneous\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e97(42.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e134(58.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.63(0.374\u0026ndash;1.069)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eNumber of living children\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e72(42.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e98(57.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.4984\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52(38.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e83(61.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.17(0.739\u0026ndash;1.859)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePrevious history of LARC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28(54.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23(45.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.16(1.176\u0026ndash;3.951)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e0.0129\u003c/b\u003e*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e96(36.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e170(63.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePrevious use of any other contraceptives not LARC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e91(44.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e112(55.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.99(1.222\u0026ndash;3.256)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e0.0058\u003c/b\u003e*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33(28.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e81(71.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eFear of complications\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e84(31.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e187(69.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.07(0.028\u0026ndash;0.165)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.0001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40(87.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6(13.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eUnsure of future family plans\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e91(39.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e140(60.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.04(0.628\u0026ndash;1.736)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.868\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33(38.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e53(61.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHas heard about LARC before?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18(17.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e87(82.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.0001\u003c/b\u003e*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e106(50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e106(50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.21(0.117\u0026ndash;0.368)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eFear of process of insertion or removal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e66(27.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e175(72.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.12(0.064\u0026ndash;0.213)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.0001\u003c/b\u003e*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e58(76.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18(23.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHave another satisfying method of contraception\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9(10.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e76(89.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.12(0.058\u0026ndash;0.252)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.0001\u003c/b\u003e*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e115(49.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e117(50.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eFriend, relative or neighbor has had bad experiences with LARC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25(19.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e106(80.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.21(0.123\u0026ndash;0.349)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.0001\u003c/b\u003e*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e99(53.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e87(46.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePartner opposed to it\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70(57.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51(42.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.0001\u003c/b\u003e*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54(43.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e142(73.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.61(2.238\u0026ndash;5.821)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003cp\u003e*p\u0026thinsp;\u0026lt;\u0026thinsp;0.05, UOR\u0026thinsp;=\u0026thinsp;Unadjusted Odds Ratio, CI\u0026thinsp;=\u0026thinsp;Confidence Interval, Ugx\u0026thinsp;=\u0026thinsp;Uganda shilling\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMultivariable analysis of the influencing factors for uptake of LARC among post abortion patients admitted at HRRH (N\u0026thinsp;=\u0026thinsp;317)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAOR(95%CI)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003ep-\u003c/em\u003evalue\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eReligion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eChristian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMoslem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.41(0.261\u0026ndash;5.315)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.448\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBisaka\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.16(1.031\u0026ndash;7.244)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.131\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.19(0.208\u0026ndash;6.765)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.848\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eEducation level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo formal education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.07(0.011\u0026ndash;1.389)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.073\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecondary and higher\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.25(0.072\u0026ndash;0.389)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.127\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTotal monthly family income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;300,000 Ugx\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;300,000 Ugx\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.65(2.594\u0026ndash;15.862)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGravidity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimegravida\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMultigravida\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.72(0.418-7.100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.451\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePrevious history of LARC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.8(2.828\u0026ndash;8.054\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.0001\u003c/b\u003e*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePrevious use of any other contraceptives not LARC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.1(1.57\u0026ndash;5.39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.004\u003c/b\u003e*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eFear of complications\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.29(0.176\u0026ndash;0.732\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.0001\u003c/b\u003e*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHas heard about LARC before?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.37(0.129\u0026ndash;1.077)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.068\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eFear of process of insertion or removal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.53(0.213\u0026ndash;0.961)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.0001\u003c/b\u003e*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHave another satisfying method of contraception\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.04(0.014\u0026ndash;0.370)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.101\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eFriend, relative or neighbor has had bad experiences with LARC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.36(0.161\u0026ndash;0.688)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.410\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePartner opposed to it\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.10(1.90\u0026ndash;6.910)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.006\u003c/b\u003e*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec10\" class=\"Section3\"\u003e \u003cp\u003e*p\u0026thinsp;\u0026lt;\u0026thinsp;0.05, AOR\u0026thinsp;=\u0026thinsp;Adjusted Odds Ratio, CI\u0026thinsp;=\u0026thinsp;Confidence Interval, Ugx\u0026thinsp;=\u0026thinsp;Uganda Shilling\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003e The current study results have revealed that the level of uptake of long acting reversible contraceptive methods among post abortion patients admitted at Hoima Regional Referral Hospital was 38.9%. These women were able to take up one of the LARC methods; that is, either an IUCD or Implant following abortion. This finding was found to be comparable with the findings of Goldstone et al (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e) in Australia which showed an increased uptake of LARC after abortion among women presenting for abortion of 38.0%. The current uptake for LARC among post abortion patients at HRRH was much higher than the overall uptake in developing countries of 28% as reported by Darroch and Singh (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e) and one reported in New Zealand by Mehata et al (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e) (17%) and in Northern Ethiopia by Mittiku et al (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e) where the overall uptake of LARC following abortion was 16.76%. It was however lower than one reported in China by Luo et al., (2018) (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e) (42.5%) and in Enugu, Nigeria by Okafor (2016) of 50% (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). As was noted in their study report, post abortion contraception uptake was higher in facilities that offered contraceptive services in the same structures where the abortion services were offered than others. This difference among the different study settings probably explains this discrepancy in the level of uptake.\u003c/p\u003e \u003cp\u003eThis study found that the implant was the most commonly taken up long acting reversible contraceptive method among post abortion patients at 79%. This was consistent with previous researchers such as Mittiku et al., (2021) in Ethiopia of 82.46% (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e) and Ampt et al., (2019) in Kenya of 1.3% (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e) and Twesigye, Buyungo and Kaula, (2016) in Uganda (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). Discrepancy however was noted with Luo et al., (2018) in China where up to 35.2% of the post abortion women chose IUCDs. A lot of myths and misperceptions have been raised in regard to the use of IUCDs especially in Africa (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Here in Uganda for example, as suggested by Twesigye et and colleagues (2016) (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e) and Celik, (2016) (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e), a good number of women have associated IUCDs with future infertility, perception that it can disseminate into the blood circulation and subsequently \u0026lsquo;migrate\u0026rsquo; to certain organs such as the heart and lungs, that it can cause cancer, among others. These associated myths towards certain contraceptive methods such as the IUCD probably explains the observed low uptake of this particular method as compared to the implants in this setting where the research was conducted.\u003c/p\u003e \u003cp\u003eThe current study has also established that women with a total monthly family income of more than 300,000Ugx (about 80 US dollars) were more than fivefold likely to take up LARC compared to those whose earning was less than 300,000Ugx (85 US dollars) (AOR\u0026thinsp;=\u0026thinsp;5.65, CI: 2.594\u0026ndash;15.862, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001). This result was in agreement with the one reported by Anguzu and colleagues (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e) where uptake of long acting reversible contraceptive methods was highest among women from richest households and that an increase in wealth index steadily improved the use of long acting reversible contraceptive methods from 2.2% among women from poorest households to 3.84% among women from richest households. Similarly, Gujo and Kare, (2021) (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e) in Ethiopia observed a higher odds of utilization of LARC among women who earned high monthly income. The Uganda Demographic and Health Survey (2016) has stressed this factor before, noting that contraceptive use increases with wealth. According to their countrywide survey, women with no education were less likely (26%) than women who have any education (38%-51%) to use a method (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). It is possible that women of high socioeconomic status are able to acquire long acting reversible contraceptive methods after an abortion without difficulty and therefore has a positive relationship with their uptake. Also, women of higher socioeconomic status have higher chances of being educated, a factor which has been raised by several scholars as a predictor of increased uptake of LARC methods.\u003c/p\u003e \u003cp\u003eIn this study, women with a prior history of using long acting reversible contraceptive method before were 4.8 times likely to use any LARC method again (AOR\u0026thinsp;=\u0026thinsp;4.8, CI: 2.828\u0026ndash;8.054, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.0001). Same observation was noted for women with previous history of use of any other contraceptives besides LARC. These were 3.1 times likely to use long acting reversible contraceptive methods following an abortion (AOR\u0026thinsp;=\u0026thinsp;3.1, CI: 1.57\u0026ndash;5.39, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.004). These were consistent with findings of Anguzu et al., (2018) in Uganda (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). However, these findings were not in agreement with those by Luo et al., (2018) (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e) regarding long-acting reversible contraceptive use in the post-abortion period among women seeking abortion in China where previous use of long acting reversible contraceptive methods had reduced odds for an intention to use long acting reversible contraceptive methods. Fears of complications associated with LARC and fear of process of insertion or removal of the LARC method was associated with 0.29 times (AOR\u0026thinsp;=\u0026thinsp;0.29, CI: 0.176\u0026ndash;0.732, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.0001) and 0.53 times (AOR\u0026thinsp;=\u0026thinsp;0.53, CI: 0.213\u0026ndash;0.961, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.0001) less likelihood to take up the LARC method following abortion at this hospital respectively. As has been noted before by Samuel et al., (2016), an increase in the uptake of post-abortion LARC can be achieved by a double counseling strategy which is a continuum of counseling after an abortion is done to patients to sensitize them and get informed consent. Moreover, in China, Luo et al., (2018) (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e) found out that barriers to the use of LARC methods were anxiety relating to impaired future fertility (56.2%), long acting reversible contraception being harmful to health (45.2%), irregular bleeding (44.3%), risk of intrauterine contraceptive device failure (41.6%) and lack of awareness with respect to long acting reversible contraception (36.1%). This literature provides an insight into searching for barriers to uptake of post abortion long acting reversible contraception in various other settings including HRRH. For long, various researchers have emphasized the importance of counseling regarding the associated pain during both insertion and removal of the contraceptive method. For example, in Kenya, some women stopped using contraceptives after they experienced purportedly perceived side effects of the contraceptives (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). Such effects may therefore justify the less likelihood to take up the long acting reversible contraceptive methods in certain parts of the world including HRRH where our study was conducted.\u003c/p\u003e \u003cp\u003eThe study observed that post-abortion women whose spouses were not opposed to LARC were more than four times likely to use the method at HRRH (AOR\u0026thinsp;=\u0026thinsp;4.10, CI: 1.90\u0026ndash;6.910, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.006). We noted a similar observation by Gashaye et al., (2020) (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e) and Gujo and Kare, (2021) (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e) in Ethiopia where the odds of the utilization of long acting reversible contraceptive methods were increased among women discussed contraceptive methods with their husbands. This study result clearly suggests the importance of actively engaging men in reproductive health and family planning programs in this study setting, the entire country and world over. As suggested by Gashaye et al., (2020) (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e), male involvement in the counseling and decision making process regarding the advantages of using LARC may improve the negative influence of partners on LARC utilization. Male involvement in contraceptive use particularly in LARC methods is a key strategy towards the success of family planning programs and women\u0026rsquo;s empowerment and has been associated with better outcomes in reproductive health such as contraceptive acceptance, continuation, and safer sexual behaviors (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). According to Jonas, Kalichman, Kalichman, Morroni, and Mathews, (2020) (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e); improving men\u0026rsquo;s knowledge of, and attitudes toward the contraceptive implant (and perhaps all other LARC methods) might therefore increase their support for their partner\u0026rsquo;s use of the method(s), which in turn might promote uptake of the method(s) among women.\u003c/p\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eStudy limitation\u003c/h2\u003e \u003cp\u003eThis being an institutional based study may not generalize the entire population and this could have impacted on our overall level of uptake.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe level of uptake of LARC remains low in this area. Improving family incomes, partner involvement and mass sensitization regarding LARC will go a long way in promoting LARC use among post abortion women in this area.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eCOVID-19\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCorona Virus Disease 19\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eLARC\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eLong Acting Reversible Contraceptive\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eUBOS\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eUganda Bureau of Statistics\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eHRRH\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHoima Regional Referral Hospital\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eIUCD\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eIntrauterine Contraceptive Device\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no conflict of interest in regard to the publication of this work\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval and consent of participants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Research Ethics Committee of Kampala International University, approval number KIU-2021-43\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was obtained for this study\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eSkiles, M. P., Cunningham, M., Inglis, A., Wilkes, B., Hatch, B., Bock, A. \u0026amp; Barden-O\u0026rsquo;fallon J. The effect of access to contraceptive services on injectable use and demand for family planning in Malawi. Int Perspect Sex Reprod Health. 2015;41(26):20\u0026ndash;30.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSecura, G. M., Allsworth, J. E., Madden, T., Mullersman, J. L. \u0026amp; Peipert JF. The Contraceptive CHOICE Project: reducing barriers to long-acting reversible contraception. Am J Obstet Gynecol. 2010;203(115):e1\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUganda Demographic and Health Survey. Key Indicators Report. 2016;\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePrada, E., Atuyambe, L. M., Blades, N. M., Bukenya, J. N., Orach, C. G. \u0026amp; Bankole A. Incidence of induced abortion in Uganda: new estimates since 2003. PLoS One. 2016;11(8):e0165812.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKakaire, O., Nakiggude, J., Lule, J. C. \u0026amp; Byamugisha JK. Post Abortion Women\u0026rsquo;s Perceptions of Utilizing Long Acting Reversible Contraceptive Methods in Uganda. A Qualitative Study. Open J Obstet Gynecol. 2014;4:1087.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCoomson, J. I. \u0026amp; Manu A. Determinants of modern contraceptive use among postpartum women in two health facilities in urban Ghana: a cross-sectional study. Contracept Reprod Med. 2019;4(1):1\u0026ndash;11.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Health Organization. Packages of interventions for family planning, safe abortion care, maternal, newborn and child health. 2010;\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePenfold, S., Wendot, S., Nafula, I. \u0026amp; Footman K. A qualitative study of safe abortion and post-abortion family planning service experiences of women attending private facilities in Kenya. Reprod Health. 2018;15(10):1\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDaniel WW. Biostatistics. A Foundation for Analysis in the Health Sciences. John Wiley \u0026amp; Sons, Inc.; 2009.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGoldstone, P., Mehta, Y. H., Mcgeechan, K., Francis, K. \u0026amp; BlacK KI. Factors predicting uptake of longacting reversible methods of contraception among women presenting for abortion. Med J Aust. 2014;201:412\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDarroch, J. E. \u0026amp; Singh S. Trends in contraceptive need and use in developing countries in 2003, 2008, and 2012: an analysis of national surveys. Lancet. 2013;381:1756\u0026ndash;62.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMehata, S., Bhattarai, N., Menzel, J., Shah, M., Khanal, P., Tofigh, S., Khanal, M. N., Regmi, S. C. \u0026amp; Andersen K. Prevalence and correlates of postabortion long-acting reversible contraceptive (LARC) use among young women (24 and below) in Nepal: Strategy in the search for improvements. Reprod Health. 2019;16:1\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMittiku, Y., Tamiru, A. T. \u0026amp; Rade BK. The significant influence of history of induced abortion on the utilisation of long-acting reversible contraceptive methods in the immediate post abortion period, Northern Ethiopia. Eur J Contracept Reprod Heal Care. 2021;12(9):1\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLuo, Z., Gao, L., Anguzu, R. \u0026amp; Zhao J. Long-acting reversible contraceptive use in the post-abortion period among women seeking abortion in mainland China: intentions and barriers. Reprod Health. 2018;15(11):1\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOkafor II. Uptake of long-acting reversible contraceptive methods in Enugu State University Teaching Hospital Enugu, South-East, Nigeria. Divers Equal Heal Care,. 2016;13(9):1\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAmpt, F. H., Lim, M. S., Agius, P. A., Chersich, M. F., Manguro, G., Gichuki, C. M., Stoov\u0026eacute;, M., Temmerman, M., Jaoko, W. \u0026amp; Hellard M. Use of long-acting reversible contraception in a cluster‐random sample of female sex workers in Kenya. Int J Gynecol Obstet. 2019;146(66):184\u0026ndash;91.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTwesigye R, Buyungo P, Kaula H. Ugandan Women\u0026rsquo;s View of the IUD: Generally Favorable but Many Have Misperceptions About Health Risks. Glob Heal Sci Pract. 2016;4(2):73\u0026ndash;82.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePATH. Countering myths and misperceptions about contraceptives. Outlook Reprod Heal. 2015;6(4):1\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCelik LDC. Access to contraceptives in Uganda: Approachability, acceptability, and users\u0026rsquo; abilities. Heal Action Int. 2016;60(8):1\u0026ndash;31.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAnguzu, R., Sempeera, H. \u0026amp; Sekandi JN. High parity predicts use of long-acting reversible contraceptives in the extended postpartum period among women in rural Uganda. Contracept Reprod Med. 2018;3(2):1\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGujo AB, Kare AP. Utilization of Long-Acting Reversible Contraceptives and Associated Factors Among Reproductive Age Women Attending Governmental Health Institutions for Family Planning Services in Wondo Genet District, Sidama, National Regional State, Southern Ethiopia. Heal Serv Res Manag Epidemiol. 2021;8(3):1\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWendot, S., Scott, R. H., Nafula, I., Theuri, I., Ikiugu, E. \u0026amp; Footman K. Evaluating the impact of a quality management intervention on post-abortion contraceptive uptake in private sector clinics in western Kenya: a pre-and post-intervention study. Reprod Health. 2018;15(8):1\u0026ndash;10.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGashaye KT, Tsegaye AT, Abebe SM, Woldetsadik A, Ayele TA, Gashaw ZM. Determinants of long acting reversible contraception utilization in Northwest Ethiopia: An institution-based case control study. PLoS One [Internet]. 2020;15(10):1\u0026ndash;19. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://dx.doi.org/10.1371/journal.pone.0240816\u003c/span\u003e\u003cspan address=\"10.1371/journal.pone.0240816\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbera A, Girmay A, Yadeta D. Assessment of Male Involvement in Long-Acting and Permanent Contraceptive Use of Their Partner in West Badewacho, Southern Ethiopia. Open Access J Contracept. 2021;21(12):63\u0026ndash;72.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJonas K, Kalichman M, Kalichman S, Morroni C, Mathews C. Factors affecting men\u0026rsquo; s support for the use of the contraceptive implant by their female intimate partners. Contracept Reprod Med. 2020;5(36):1\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Kampala International University Western Campus","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Contraception, contraceptive, LARC, abortion, family planning, unintended pregnancy","lastPublishedDoi":"10.21203/rs.3.rs-3546455/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3546455/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eWomen in sub-Saharan Africa often fail to obtain or use modern contraceptives, particularly Long Acting Reversible Methods (LARC), for many reasons. Women rely primarily on traditional and short-acting contraceptives which are prone to incorrect or inconsistent use and failure. In Uganda, utilization of modern contraceptives has steadily increased from 8\u0026ndash;35% over the last decade. However, LARC use has remained as low as 7.8% and could be worse in specific sites. Whereas unsafe abortions contribute up to 26% of all maternal deaths in Uganda, there is limited use of effective contraceptive methods such as LARC.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eAn institutional based cross-sectional study involving 317 post abortion patients admitted at the gynecology ward of Hoima Regional Referral Hospital (HRRH) in western Uganda were enrolled between January 2022 and April 2022. Interviewer-administered questionnaires were used to collect data. Descriptive statistics and binary logistic regression analyses to assess for factors influencing uptake of LARC among post abortion women were conducted using STATA 14.2. Variables in final multivariate model were significant when p\u0026thinsp;\u0026lt;\u0026thinsp;0.05. The measure of association was reported as odds ratios with corresponding 95% confidence interval and p-value.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe level of uptake of LARC was 38.9%. The most commonly taken up LARC was implant at 79%. Family income (AOR\u0026thinsp;=\u0026thinsp;5.65, CI: 2.594\u0026ndash;15.862, p\u0026thinsp;=\u0026thinsp;0.001), previous history of LARC (AOR\u0026thinsp;=\u0026thinsp;4.8, CI: 2.828\u0026ndash;8.054, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001), previous use of any other contraceptives other than LARC (AOR\u0026thinsp;=\u0026thinsp;3.1, CI: 1.57\u0026ndash;5.39, p\u0026thinsp;=\u0026thinsp;0.004), fear of complications (AOR\u0026thinsp;=\u0026thinsp;0.29, CI: 0.176\u0026ndash;0.732, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001), fear of process of insertion or removal (AOR\u0026thinsp;=\u0026thinsp;0.53, CI: 0.213\u0026ndash;0.961, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001) and an opposing partner to the method (AOR\u0026thinsp;=\u0026thinsp;4.10, CI: 1.90\u0026ndash;6.910, p\u0026thinsp;=\u0026thinsp;0.006) were found to independently influence uptake of LARC among post abortion women admitted at HRRH\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThe level of uptake of LARC remains low in this area. Improving family incomes, partner involvement and mass sensitization regarding LARC will go a long way in promoting LARC use among post abortion women in this area.\u003c/p\u003e","manuscriptTitle":"Level of Uptake and Influencing Factors of Long Acting Reversible Contraception among Post-abortion Women in Uganda","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-11-03 12:09:15","doi":"10.21203/rs.3.rs-3546455/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"85b6036e-e531-45a4-8a83-7f3ff19634f4","owner":[],"postedDate":"November 3rd, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":25905841,"name":"Sexual \u0026 Reproductive Medicine"}],"tags":[],"updatedAt":"2023-11-03T12:09:15+00:00","versionOfRecord":[],"versionCreatedAt":"2023-11-03 12:09:15","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3546455","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3546455","identity":"rs-3546455","version":["v1"]},"buildId":"zQwnuV7TCBrMSSSToR1PI","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}