Influence of contraceptive attributes on women's contraception choices and associated factors

Abstract

Introduction: Contraceptive choices are integral in the provision of family planning services and plays an important role in women’s reproductive rights (Agyei-Baffour, 2015). Contraceptive decision making is very complex and more often requires the user to make trade-offs of some methods over the others. Studies on the subject have mostly focused on enablers to contraceptive uptake and have not comprehensively explored how attributes influence choice of contraception yet evidence shows women navigate through the different attributes before settling for a contraceptive method. Methods: A descriptive cross sectional study was conducted to assess influence of contraceptive attributes on women’s choice of contraception. Interviewer administered structured questionnaire and Discrete Choice Experiment (DCE) cards were used to collect data. Women aged between 15–49 years, who consented and were residents in the study area were included in the study. Descriptive statistics were calculated for explanatory variables after which bivariate analysis was conducted using mixed effects ordinal logistic regression. At bivariate analysis, independent variables that were statistically associated with having the outcome at P<0.20 were included in the final model for analysis. Data analysis was conducted using Stata (version 14) statistical software. Odds ratios were used to measure factors of association. Results: Of the 389 women, 86.68% had stayed in Samia Bugwe South for at least a year, 47.26% had a secondary level of education, 38.12% had their highest level of education as primary and 7.05% had no education. 70.62% were pregnant before, 58.14% had used something to delay getting pregnant, 60.84% were not using anything to delay getting pregnant, 58.68% would not consider using contraceptives. Among current users, 25.71% use Injectables, 14.65% use pills and 11.31% use implants. Effectiveness (24.16%), few side effects (21.08%) and long duration of protection (14.65%) were the three major attributes considered when choosing a contraceptive method. The biggest proportion (70.86%) obtained contraceptive services from Government hospitals and health facilities. Conclusion: Effectiveness, low side effects and long duration of protection are the main attributes that influence women’s choice of contraception. Education level and service provider attitude significantly influence choice of contraception.