Date of Award

11-25-2021

Degree Type

Thesis

Degree Name

MS in Epidemiology & Biostatistics

First Advisor

Dr. Sarah Saleem

Second Advisor

Dr. Shafquat Rozi

Third Advisor

Dr. Shiyam Sunder

Department

Community Health Sciences

Abstract

Introduction: Worldwide contraceptive compliance is affected by service delivery, biological and socioeconomic factors. Service delivery factors such as the distance from households to family planning centers, the types of methods available and transportation to most equipped family planning center that influence contraception continuation. The aim of study was to determine the association between the distance from home to the nearest FP center and continuation of hormonal contraceptive methods among married women of reproductive age for at least six months after initiating it in Gilgit, Pakistan
Methods: The study was conducted in community settings of three union councils of district Gilgit from April 2021 to July 30, 2021. A structured questionnaire was used to collect data on sociodemographic, contraceptive use, and service delivery factors. This was an unmatched case control (1:2) study design where cases were married women of reproductive age who were currently using a hormonal method of contraception for at least last six months, and controls were married women of reproductive age who had ever used hormonal method but now are using a non-hormonal method for at least last six months.
Results: We screened 520 married women of reproductive age from the record of LHWs and clinics and after verification and eligibility assessment enrolled 141 cases (continued users) and 282 controls (discontinued users). The mean age of cases was 34.8 years (SD 5.9) whereas mean age of controls was 31.5 years (SD5.3). All the women in both the groups knew about the nearest family planning center of their area. The side effects were mostly mentioned by the women in the continued users group. Final multivariable logistic model for continuation of a method for at least six months after the initiation included closer distance from home to family planning center (AOR 6.33, 95% CI 3.74-10.71), age of women (years) (AOR 1.07, 95% C.1 1.02-1.12), formal education (AOR 0.27 , 95% CI 0.12-0.58), satisfaction with current method (AOR 3.64 ,95% C.I 2.06-6.44) and visits to the family planning center to avail services (AOR 1.86, 95% C.I 1.07-3.45).
Conclusion: In our sampled women from Gilgit, despite experiencing side effects hormonal users continued to use the method of their choice for at least six months after initiating it. The continuation of hormonal method was associated with easy access to family planning centers, satisfaction with the current method use and visits to FP centers. Moreover, continuation of hormonal method use was also observed more in women with low education status.

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1

Last Page

87

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