A mixed-methods study of factors influencing postpartum intrauterine device uptake after family planning counseling among women in Kigali, Rwanda

Rwanda has high unmet need for family planning (FP), especially in the postpartum period when women are advised to space pregnancies at least two years for improved maternal-child health. Despite interest in the copper intrauterine device (IUD), a highly cost-effective method, access and uptake rema...

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Bibliographic Details
Published in:	PloS one 2022-11, Vol.17 (11), p.e0276193-e0276193
Main Authors:	Tounkara, Mariama S, Ingabire, Rosine, Comeau, Dawn L, Karita, Etienne, Allen, Susan, Nyombayire, Julien, Parker, Rachel, Haddad, Lisa B, Da Costa, Vanessa, Tichacek, Amanda, Mazzei, Amelia, Mukamuyango, Jeannine, Wall, Kristin M
Format:	Article
Language:	eng
Subjects:	Care and treatment Childbirth & labor Clients Community health aides Counseling Data analysis Data collection Decision analysis Decision making Family planning Health counseling Health facilities Immunization Intrauterine contraceptives Intrauterine devices IUD Males Maternal & child health Medical personnel Methods Mixed methods research Postnatal care Postpartum Pregnancy Regression analysis Sociodemographics Surveys Transplants & implants Women Women patients
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Summary:	Rwanda has high unmet need for family planning (FP), especially in the postpartum period when women are advised to space pregnancies at least two years for improved maternal-child health. Despite interest in the copper intrauterine device (IUD), a highly cost-effective method, access and uptake remain low. This study aimed to determine factors associated with postpartum IUD (PPIUD) uptake after postpartum family planning (PPFP) counseling as well as provider perceptions of facilitators and barriers to clients' PPIUD uptake. Postpartum women who received PPFP counseling and were less than 6 weeks postpartum were recruited for a case-control study in Kigali, Rwanda in 2018. We recruited n = 74 women who had accepted and n = 91 women who had declined the PPIUD. Multivariate logistic regression analyses evaluated associations between women's socio-demographics, FP knowledge and decision-making, and the outcome of PPIUD uptake. Six focus groups (FGs) were conducted with FP providers (n = 24) and community health workers (n = 17) trained to deliver PPFP counseling to assess perceptions of PPFP counseling and facilitators and barriers to PPIUD uptake. FG discussions were recorded, translated, and analyzed for themes. Factors associated (P
ISSN:	1932-6203 1932-6203