Determinants of use of long acting reversible contraceptive (LARC) methods among women residing in low income areas of Karachi, Pakistan : a comparative cross-sectional study

Date of Award


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Degree Name

Master of Science in Epidemiology & Biostatistics (MSc Epidemiology & Biostats)


Community Health Sciences


Among various reasons for huge projected increase in the population, one of the main reasons is sl ow pace of fertility decline. Despite the fact that the Long Acting Reversible Contraceptive (LARC) methods are easy in application and utilization its fewer uptakes is due to the fact that a number of misconceptions abound the users and the providers in the country. It is imperative to understand the factors that lead woman living in the low socio-economic areas of Karachi to opt for LARC so that recommendations can be made to increase its use METHOD This was a community based study that was supported by the existing study sites of the SUKH initiative a project on family planning run under the aegis of by Aman foundation. These SUKH sites are located in Bin Qasim, Malir, Korangi and Landhi towns. A comparative cross- sectional study was carried in which comparison of two population proportion with independent samples as done i.e. women using long acting reversible method were compared with the group of omen using short acting reversible method. Applied logistic regression was used to identify the determinants of the LARC use. BJECTIVE: The objective of the study was to examine the demographic, economical, and social determinants associated with the long-term modern contraceptive method use as compared to those using short term modem contraceptive methods. RESULTS There was no difference between the mean age LARC user and SARC user that is 29.0 ±5.7 years and 30.16±5.9 years respectively. The final logistic regression model included ethnicity, socio-economic status, and discussion with the husband about the LARC method, decision taken by for the current method, woman age, and distance of contraceptive method source. After the adjustment for the effect of other variables in the model we were able to concluded that the odds of belonging to Sindhi ethnic group among LARC were 2.59 times as compared to continued user [OR: 2.59; 95% CI (1.375- 4.904)]. Moreover LARC user had higher odds of discussion with the husband about the LARC method as compared to the SARC user [OR: 12.32; 95% CI 6.893-22.037]. Furthermore odds of decision taken by wife about the current method were insignificant while controlling for other variable [OR: 1.09; 95% CI (0.713-1.690)]. Moreover age at of the woman was associated with LARC that is with one year increase in the age of woman, the odds of LARC use increased by 0.96 times as compared to SARC user after adjusting for other variables. [OR: 0.96; 95% CI, (0.931-0.995)]. Regarding the socioeconomic status, the odds of having low socioeconomic status among LARC user was 2.24 times as compared to the SARC user [OR 2.24; 95 % CI (1.146-4.395). With respect to the distance to the source of contraceptive, the odds of having the sources far among LARC user was 5.46 times as compared to SARC user [OR 5.46; 95% CI(3.16-9.43)].

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