Prevalence and Factors Associated with Uptake of Modern Contraceptive Method Post-Abortion at Mbagala Hospital, Temeke, Dar es Salaam, Tanzania

Abstract

Abstract Background: The uptake of modern contraceptives post-abortion care bridges the gap of unmet need for modern contraceptives which can reduce the rate of unintended pregnancies and recurrent abortion, thus improving women's health. Studies have demonstrated variations in the uptake of modern contraceptives, even within the same country. Objective: To assess the factors associated with the uptake of modern contraceptive methods among women who received care at a comprehensive post-abortion care (cPAC) unit at Mbagala Hospital in Temeke, Dar es Salaam, after having an abortion. Methodology: A cross-sectional analytical study involving 234 post-abortion women was conducted at Mbagala Hospital in Temeke, Dar es Salaam, from October 2020 to March 202. The convenient sampling technique was employed to collect data using a pretested structured questionnaire. Subsequently, the data was cleaned and analyzed using SPSS Version 23. A Chi-square test with a significance level set at P-value < 0.2 was used to test associations, and multivariable analysis was employed to identify independent factors associated with the uptake of modern contraceptives, with a P-value of less than 0.05 being significant. Results: The uptake of modern contraceptives post-abortion was 67% among 234 post-abortion women, with the most commonly used method being injectable (35.9%). Higher uptake of modern contraceptives was observed in those aged 15 to 19 years with an Adjusted Odds Ratio (AOR) of 5.97 (95% CI 1.24-28.58), and in those aged 20 to 24 years, with an AOR of 3.55 (95%CI 1.54-8.18). Self-employed individuals also showed higher uptake with an AOR of 2.59 (95%CI 1.13-5.91). On the other hand, nulliparous and primiparous women were less likely to use modern contraceptives, with AORs of 0.12 (95%CI 0.02-0.60) and 0.22 (95% CI 0.16-1.70), respectively. Conclusion and Recommendation: Two-thirds of the women (67%) received modern contraceptives as part of post-abortion care. However, there was a missed opportunity to prevent unwanted pregnancies in 33% of the women who received care. Greater efforts should be made to reach out to older women (aged 25 years or older), those who are employed, and those with four or more children in order to increase the uptake rate.