Association of contraceptive knowledge and attitude with intention to use family planning among primegravidae attending antenatal care in Kayunga Hospital

Abstract

Introduction and background: Family planning (FP) services were introduced in Uganda in 1957 by Reproductive Health Uganda (RHU), formally known as Family Association of Uganda and were actively implemented in 1963. However, the contraceptive prevalence rate of 24% is low with a high unmet need for FP of about 41%. The 5th Millennium Development Goal (MDG) aims at improving maternal health and reducing MMR by 75% by the year 2015. Family planning is one of the important pillars of safe motherhood and failure to practice contraception has led to early pregnancies, high rate of school drop outs, high fertility rate, a big population and unintended pregnancies. This has as well enhanced both maternal morbidity and mortality and poor fetal outcomes in Uganda. Objective: The study was carried out to determine the proportion of primegravidae having intention to use FP after delivery and to establish the association of contraceptive knowledge and attitude with intention to use family planning among PGs attending ANC in Kayunga hospital. Justification: Most women would like to avoid unintended pregnancies and plan their families. There is fear of side effects which have contributed to a high unmet need and low Contraceptive Prevalence Rate (CPR) in Uganda worse among the youths and unmarried. Youths make the biggest percentage of primegravidae attending ANC with poor knowledge and negative attitude to FP methods, hence a huge burden to health services. Methodology: A cross-sectional study targeting primegravidae attending ANC. Quantitative data was collected using pretested questionnaires and data was entered into a computer using EPIDATA version 3 and then exported to STATA version 11 for analysis. Results: A total of 390 PG were interviewed in a period of 4 months. About 78.7% had intention to use FP with 74.1% having a positive attitude. An average of about six participants who had come for antenatal was interviewed per day by research assistants and principle investigator. PGs were aged between 14-33 years. The majority (69.7%) were between 17 and 21 years with a median age of 19 years. Over 50% of the interviewed primegravidae were less than 19years hence the burden of teenage among PGs being high in Kayunga. Contraceptive Knowledge was quite high, as 98% knew at least a method of FP and 99 % having ever heard of Family planning. A positive attitude was noted as a significant factor for intention to use FP. Educated primegravidae had a higher intention compared to their counterparts with lower education level Students contributed a big number of primegravidae implying that they could probably drop out school and become young mothers. Conclusion and Recommendations: Higher level of education, previous history of use of FP and spousal approval will enhance the intention to use FP among the primegravidae. Appropriate FP counseling be offered to all primegravidae during ANC and PNC period so as address their intentions. There is need to target primegravidae with FP messages and their spouses. Many primegravidae had got pregnant while in school resulting in their dropping out of school, so a need for vigorous health education and men in involvement is very important young mothers’ family planning use as the study showed a high intention.  Providers of ANC and post partum care should be made aware of the high need of FP among the PGs and they should provide services continuous training  Students need to be educated about family planning as a substantial number had unintended pregnancies and also had less intention to use FP after delivery.