TOPIC: UPTAKE OF LONG-ACTING REVERSIBLE

CONTRACEPTION (LARC) AMONG ATTENDEES OF FAMILY

PLANNING CLINIC AT UNIVERSITY OF NIGERIA
TEACHING HOSPITAL ITUKU/OZALLA, ENUGU, NIGERIA:
A FIVE-YEAR REVIEW (2017-2021)
AUTHORS: DR. NWEZE ANTHONY, PROF. IJEOMA
V EZEOME, DR. NWEZE UFUOMA ELIZABETH,
DR C.I ONWUKA

CONFERENCE: 4TH INTERNATIONAL SCIENTIFIC

CONFERENCE
VENUE: MAIN HALL, UNEC ENUGU
 INTRODUCTION

• Long-acting reversible contraception (LARC) are methods of birth control that are
highly effective and reliable in preventing pregnancies and reducing maternal
morbidity/mortality.
• Its Utilization improves women reproductive health outcomes by allowing women to
space birth, avoid unintended pregnancies and abortion, and stop child bearing when
they achieve their preferred family size. They includes sub-dermal implants and IUDs.
They act by inhibiting ovulation and fertilization.
• Aimed to determine prevalence of LARC as well as factors promoting and affecting
the uptake of LARC in University of Nigeria Teaching Hospital Enugu.
• The findings will help inform government on the need to increase supply of these
commodities, ensure training of more health care providers. These will reduce
likelihood of unwanted pregnancies and unsafe abortions.
• STUDY POPULATION: This was a retrospective study of all the
clients who received contraceptive services from the family planning
clinic of UNTH Ituku/Ozalla, Enugu, from January 1 st 2017 to 31st
December 2021.
• The data was obtained from family planning register of all women who
receive contraception services during this period. The register was used
to identify clients who accepted LARC and non-LARC during the study
period, followed by retrieval of their case files
• ANALYSIS: Data was analyzed by descriptive statistics of frequency
and percentage using the Statistical Package for Social Sciences
Software version 20.0 (SPSS lnc, Chicago, Illinois)
 RESULTS
Table 1: Uptake of LARC and Non LARC

Types Option Frequency Percent %

Implant 628 53.8
LARC IUDs 206 17.6
Total for LARC 834 71.4

Injectable 183 15.6

Non-LARC Oral Pills 130 11.0
Condom 21 2.0
Total for Non 334 28.6
LARC
Overall Total 1168 100.00
From Table 1, the sub-dermal implant accounted for 53.8% while the IUCD accounted for 17.6%. The shorting acting contraception
accounted 28.6% of the acceptors, with the injectable having 15.6%, oral pill 11.0% and condom 2.0%. The uptake of long-acting
contraception in this study was 53.8% for implant and 17.6% for IUCD, and both amounted to 71.4%.
 Table 2: Showing yearly distribution of LARC from 2017 to 2021
Commodity Years of LARC from 2017 to 2021
Table 2: Showing yearly distribution
2017 2018 2019 2020 2021 Total

IUCD 34 42 60 32 38 206

Implant 129 139 143 101 116 628

Total 163 181 203 133 154 834

Table 3: Showing those who discontinued LARC one time in the past and the reasons behind it
Variable Frequency (N=87) Percent (%) 100

Want to get pregnant 27 42.5

Duration has elapsed 18 20.7

Pelvic infection 3 3.4

Missing string of IUCD 5 5.8

Husband refusal 11 12.6

Menstrual irregularities 13 15.0

Total 87 100
 DISCUSSION

• Uptake of LARC was 71.4%. The rate was close to 70% in Kumasi, Ghana by Dassah et al,
72.6% in Asaba by Ossai et al, and 75% by ACOG among American women 19, 23,7,
• The rate is however much higher compared to the reported rate of 38.7% in Kaduna, 8
52.1% in Maiduguri,13 and 10.6% in Nnewi20 respectively.
• The increase in uptake of LARC may be as a result of increased public awareness as well as
increase in skills of health care providers on the insertion and removal of these
commodities. Also, routine counseling of pregnant women on post partum contraception
and family planning during their ante-natal care visit may have contributed to this surge.

• From the study sub-dermal implants contributed 75.3% while IUCD accounted for 24.7%.
These are similar to study in ESUTH, Enugu24 and Lagos28 but at variance with that done in
Kaduna8 where IUCD contributed the majority.
• Acceptors chose sub-dermal implants for child spacing since the return of fertility is rapid
after removal. Moreso, the usual pelvic exam associated with IUCD insertion often
discomfort women. Thirdly, the complaint by their spouses that the string of IUCD
interferes with excitement of sexual intercourse discourages them.
• About 96.5%(805) of the clients aged 26-45 years are significantly associated with use of LARC while ages
≤25 and ≥46 are less likely at 3.5%. This was in keeping with study done by Mohammed et al, in Kaduna 2017
and Ossai et al, in Asaba.8,23

• This may be due to the fact that older and multiparous women have completed their desired family size and
may not desire pregnancy again..

• LARC uptake were dominated by women with secondary and tertiary education at 48.8% and 44.0%
compared to primary and those with no formal education at 6.5% and 0.7%. This was similar with National
Demographic Health Survey (NDHS)7 2013 and Bilkisu13 et al 2020.

• This is because educational status was the most significant predictors of women’s use of contraception and the
fact that LARC is the most effective contraception. Secondly, the fact that majority of them still desire future
fertility since the return of fertility is very rapid with LARC.

• In conclusion, the overall uptake of LARC in this study was 71.4%. This was shown by an upward rise in the
uptake of LARC, with sub-dermal implants contributing 75.3%. The findings will help inform government on
the need to increase supply of these commodities and ensure training of more health care providers. These will
reduce likelihood of unwanted pregnancies and unsafe abortions.
REFERENCES
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