AMBO UNIVERSITY

COLLEGE OF HEALTH SCIENCES AND MEDICINE

DEPARTMENT OF NURSING AND MIDWIFERY

MAGNITUDE OF INTRA UTERINE CONTRACEPTIVE DEVICE UTILIZATION AND

ASSOCIATED FACTORS AMONG REPRODUCTIVE AGE GROUP WOMEN ATTENDING
AMBO UNIVERSITY REFERRAL HOSPITAL, AMBO, ETHIOPIA, 2020

SEPTEMBER,2020
AMBO, ETHIOPIA 1
 Group Members
# Name ID
1. Dereje Bekele PGR/39294/12
2. Megertu Yonas PGR/39299/12
3. Temesgen Daksisa PGR/39302/12
4. Tura Muda PGR/39304/12
5. Yonas Sagni PGR/39305/12

Advisors/Instructors
1. Mr. Mulatu Ayana(Asst. Prof)
2. Mr. Bayisa Abdissa(Asst. Prof)
2
3. Mr. Tufa Kolola(Asst. Prof)
OUTLINE OF THE PRESENTATION
o Introduction o Work Plan
 Background o Budget Plan
 Statement of the problem o Summary
 Significance of the study o References
o Objectives o Acknowledgement
o Methodology

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1. INTRODUCTION
1.1. Background
 Intra-uterine Contraceptive Device (IUCD) is small, flexible and look like T
made of plastic and contains copper or hormone that is inserted into women’s
uterus through her vagina and cervix by trained health personals (Associate
A, 2013)
 There are two types of IUCD; namely copper bearing and Medicated methods
 Copper bearing IUCD are generally licensed for use over 5 to 12 years with
some variation from country to country and most widely used worldwide
 It is available around the world and highly effective, long-acting, reversible,
lower discontinuation rate and safe for all reproductive age group including
breast feeding (Bryant AG, 2015). 4
BACKGROUND…
 IUCD prevents pregnancy primarily by:(USAID,
PPIUCD, 2014)
o Suppressing the growth of the lining of uterus
o Affecting sperm motility and
o Thickening cervical mucus.

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BACKGROUND…
 Globally IUCD is the second most commonly
utilized contraceptive method among
married women of reproductive age, after
female sterilization
 But in sub- Saharan Africa it is very low
(2%) compared to other modern methods in
spite of its many benefits (UNFPA, 2016)
 Worldwide fertility rates, unintended
pregnancy and unmet need for contraception
are high 6
BACKGROUND…

 FMoH has considered the important role of LARC and

aims to increase the availability of these methods to
20 % of all family planning clients
 The most popular methods used are injectable (23
percent), implants (8 percent) and IUCD utilization is
very low which is only 2 percent (EDHS, 2016)

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1.2. STATEMENT OF THE PROBLEM
 World population is increasing over time to time
 In Africa as a whole, about one in five married women
of childbearing age has an unmet need for modern
contraceptives (UNFPA, 2012)
 Ethiopia is the second most populous country in Africa
with an estimated total population of 104.3 million with
annual growth rate of 2.7% in 2017(World Bank Dev’t
Indicators-Ethiopia, 2017)

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1.2. STATEMENT OF THE PROBLEM…

 In Ethiopia, contraceptive prevalence rate of any

modern method among currently married women was
only 35%
 The widely ever used methods were injectabes (23%),
Implants (8%) but Pills and IUCD were only 2% each
(EDHS, 2016)

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1.2. STATEMENT OF THE PROBLEM…
 Total fertility rate(4.6%) and unmet needs(22%) were
still high, and requires quite concrete activities to
increase country’s contraceptive prevalence rate and
also shift the method mix to a greater emphasis on
long acting, safe and highly effective method (EDHS
2011 and 2016)
 The national and local prevalence of IUCD was low
besides its advantage as compared with the other
modern reversible methods (EDHS, 2016)
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1.2. STATEMENT OF THE PROBLEM…
 Despite this low utilization there is no adequate
studies done in West Shoa particularly Ambo town
that identify factors affecting IUCD
 Therefore, the aim of this study is to assess the
magnitude of Intra-uterine Device utilization and
factors affecting its utilization among reproductive
age group women attending Ambo University Referral
Hospital demanding for modern contraceptive
utilization in West Shoa, Ambo, Ethiopia. 11
1.3. SIGNIFICANCE OF THE STUDY
 Ethiopia is the second populous country in Africa and
use of family planning has been widely limited to
short-acting methods
 Long acting reversible contraceptives are more useful
for spacing and limiting than short acting methods
 This study will help to assess the magnitude and
associated factors of IUCD utilization among
reproductive age group women in west Shoa zone
Ambo town attending Ambo University Referral
Hospital for family planning services 12
1.3. SIGNIFICANCE OF THE STUDY
 Little is done on this topic in the study area; therefore, it
is essential to identify the magnitude of IUCD utilization
and associated factors among the study participants
 This research work finding will help to generate ideas for
reducing women’s negative perceptions and attitudes
towards use of IUCD methods
 Addressing this gap in turn helps in the improvement of
awareness on the family planning clients
 The results of this study will help to advance the
utilization of long acting family planning of the area and
also serve as baseline data for program managers and 13
decision makers so as to design and focus on interventions.
2.1. CONCEPTUAL FRAMEWORK

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3. OBJECTIVE
3.1. General Objective
 To assess the Magnitude of Intra-uterine contraceptive utilization
and associated factors among reproductive age women attending
Ambo University Referral and Teaching Hospital, Western
Ethiopia, 2020
3.2. Specific Objective
 To determine the level of Intra-uterine contraceptive utilization
among study participants
 To identify the associated factors of Intra-uterine contraceptive
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utilization among study participants
4. METHODOLOGY
4.1. Study Area and Study Period
 The study will be conducted in Ambo University Specialized
and Teaching Hospital from September 07 to October 20, 2020
4.2. Study Design
 Institutional based cross-sectional quantitative study design
will be conducted.

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4.3. POPULATION
 Source Population: The source population for the study will
be all women of reproductive age group of 15 to 49 years of
age attending Ambo University Referral Hospital
 Study Population: The study population will be all
reproductive age group eligible for family planning and
attending Ambo University Referral Hospital for family
panning service
 Sampling Unit: Sampling unit will be individual participant
who are selected for the study 17
INCLUSION AND EXCLUSION CRITERIA
 Inclusion Criteria: Reproductive age group women
(15-49) who will attend Ambo University referral and
teaching hospital for family planning service
 Exclusion Criteria: Women having a hearing
problem, unable to talk and mentally ill clients will be
excluded

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4.4. SAMPLE SIZE DETERMINATION AND SAMPLING TECHNIQUE
 Sample size is determined based on single proportion formula assuming the
primary level of education as the factor affecting the utilization of IUCD
(P=51.6%) (Amhara, 2018)
 A Z-value of 1.96 was used at 95% CI and d of 5%

n= ((Zα/2)² *P(1-P))/(d²)= 384

Where:
n=desirable sample size required for the study
Z (α/2) = The critical value at 95% level of significance (1.96)
P=Proportion of IUCD method used (13.3%)
d=Absolute precision or tolerable marginal error (5%).
 Based on these assumptions the desired sample size after adding 10% non-19
response rate was 422
4.5. SAMPLING PROCEDURES AND SAMPLING TECHNIQUE
o Systematic sampling technique will be employed to select study
subjects
o According to data from study area, the total number of women that
used modern methods of contraceptive in the previous year similar to
the proposed data collection period will be captured from the hospitals
registration book
o Sampling fraction (Kth-value) will be determined by dividing it to the
sample size
o Then lottery method will be employed to select the first study
participant
o Data collection will be continued at every Kth-value until the sample
size will be reached.
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4.6. STUDY VARIABLES
Dependent variables
o Intra uterine contraceptive device (IUCD) utilization

Independent variables:
o Socio-demographic: Age, marital status, number of living children,
educational status, ethnicity, religion
o Socio-economic: Occupation, family income, family size

o Psychological: Fear of side effects, fear of procedure, privacy issue

o Service related: Access to the method, information about the

method, providers attitude, provide counseling 21
4.7. DATA QUALITY CONTROL
 To ensure quality, data collection tools will be pre-tested on
5% of study participants at Ambo General Hospital and
necessary corrections will be considered
 Principal Investigators will check the data for completeness,
accuracy and clarity before data entry on daily basis
 Supervision will also be done at the spot by principal
investigators
 Data cleaning-up and cross-checking will be done before
analysis 22
4.8. DATA MANAGEMENT AND ANALYSIS
4.8.1. Data Management
 Data will be collected by trained data collectors
through face to face interview using a structured and
pre-tested questionnaire
 Filled questioners will be checked daily by supervisor
and principal investigators for completeness, legibility
and consistency

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4.8.2. DATA ANALYSIS PLAN
o Data entry will be done into Epi-Info-7
o Entered data will be exported into SPSS Version-21 to compute
statistical analysis
o Adjusted odds ratio with 95% CI will be used to assess
association between IUCD utilization and explanatory variables
o Variables with p-value<0.02 in binary logistic regression
analysis will be included in to multivariate logistic regression
model for controlling potential variables
o Finally, statistical significance will be set at p-value<0.05. 24
4.9. ETHICAL CONSIDERATIONS
o Ethical clearance for the study will be obtained from Ethical Review
Committee of Ambo University, College of Health Sciences Department of
Nursing and Midwifery
o Permission to conduct the study also will be obtained from Ambo
University Specialized and Teaching University Hospital and responsible
bodies of the respective department
o The purposes and the importance of the study will be explained & informed
consent will be secured from each participant
o Confidentiality will be maintained at all levels of the study
o Participation in the study will be on voluntary basis
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4.10. DISSEMINATION PLAN
 The finding of this research work will be presented to Ambo
University College of Medicine and Health Science
Postgraduate Program and Ambo University Referral and
Teaching Hospital
 The findings also be presented at various seminars and
workshops and expected to be disseminated to all concerned
bodies
 Publication will be considered by scientific journals for
researchers and others in need 26
5. WORK PLAN

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6. BUDGET

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 SUMMARY
Background:
 Intra-uterine Contraceptive Device (IUCD) is small, flexible and look like T
made of plastic and contains copper or hormone that is inserted into women’s
uterus
 It prevents pregnancy primarily by suppressing the growth of the lining of uterus,
affecting sperm motility and thickening cervical mucus
 In Ethiopia, the utilization of Long-acting reversible contraceptive method is very
low
 The aim of this study is to assess the Magnitude of IUCD Utilization and factors
affecting its utilization among reproductive age women attending Ambo
University Referral Hospital demanding for modern contraceptive utilization29in
West Shoa, Ambo, Ethiopia.
SUMMARY…
Methods:
 Facility based cross-sectional study will be conducted
systematically selected 195 study participants by trained data
collectors at Ambo University Referral Hospital from September 07
to October 20,2020, Ambo, Western Ethiopia
 The data will be collected, coded, cleaned and entered into Epi-Info-
7 and exported to SPSS version 21 for analysis
 Bivariate and multivariable logistic regression analysis will be
performed to identify significant factors
Budget: The total estimated budget for the completion of this study
will be 22,775.50 ETB
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 REFERENCES
1. Amhara NW. Utilization of intra uterine contraceptive device and associated factors among
reproductive age group of family planning users in Han Health Center, Bahir Dar ,. BMC Res Notes
[Internet]. 2018;1–6. Available from: https://doi.org/10.1186/s13104-018-4032-z
2. Associates A, Sector P, One P. Family planning, Global hand book for providers; collaborating and
supporting Organization. Vol. II. 2013. 131-164 p
3. Bryant AG, Hamela G, Gottert A, Stuart GS, Kamanga G. Reasons for Intrauterine Device Use ,
Discontinuation and Non-Use in Malawi : A Qualitative Study of Women and their Partners. African
J Reprod Heal December 2015; 19. 2015;19(December):50–7.
4. Health FDR of EM of. Federal Democratic Republic of Ethiopia National Guide line for Family
planning. Addis Ababa, Ethiopia; 2011. 10-23 p.
5. Survey H. Ethiopia Demographic and Health Survey 2016 Central Statistical Agency Addis Ababa,
Ethiopia The DHS Program ICF Rockville, Maryland, USA. Addis Ababa, Ethiopia; 2016. 16-18 p.
6. UNFPA. Universal Access to Reproductive Health. 2016. 20-22 p.
7. UNFPA. MEETING THE UNMET NEED FOR REPRODUCTIVE Health care. 2012. 1-7 p.
8. United State Agency International Development (USAID). Postpartum Intrauterine Contraceptive
Device (PPIUD) Services. 2014. 1-8 p.
9. (WDI) WBDI. Ethiopia - Population (million ) - World Bank - Development Indicators ... 2017.

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ACKNOWLEDGEMENT
o We, the group members are thankful to ours Mr. Mulatu A.
(Asst. Prof), Mr. Bayisa Abdissa(Asst. Prof) and Mr. Tufa
Kolola(Asst. Prof) for their strong intention to upgrade our
knowledge and skill of research work by teaching us the
concept and conception of research paper writing
o Our gratitude also goes to other instructors and Ambo
University College of Medicine and Health Sciences for their
commitment to equip students with highly experienced and
skillful academic staffs
Thank you all.
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THANK YOU!!!

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