Abstract:

Background: Injectable contraceptives are fast becoming the method of choice among married women in Sub-Saharan Africa. In several countries in the region, the proportion of women using injectable methods had surpassed the proportion of women using other methods especially the Intra-Uterine Contraceptive Devices. The IUCD represents only 2% of modern method of contraceptive use in Sub-Saharan Africa, revealing the under-utilization of this method in the region despite the IUCD being such an important choice for women elsewhere in the world.

Methodology: A quantitative cross sectional study on contraceptives was conducted in Shinyanga district council in Shinyanga region Tanzania from August to October 2015. A total of 201 women of reproductive age (15-49 years old) participated in the study. The Kiswahili questionnaire was used to interview the respondents. Data collected included age, marital status, level of education, number of children, types of contraceptives methods used, factors contributing to high uptake of injectable contraceptive, factors affecting uptake of IUCD, source of information about contraceptives, traditional support and husband/partner support on the use of contraceptives. The information obtained was processed and analysed using SPSS statistic version 20 software.

Results: The most common contraceptive method reported to be used was injectable 34.4% followed by condoms ((both male and female condoms) 30.5%, followed by implants (16.4%) while the least reported contraceptive was the IUCD (1.6%). The majority of women (82.6%) reported to have heard about contraceptives at the health facility. 70.5% of users of injectables reported that they prefer injectables due to its relative safety, 16.6% of users preferred it because it was easy to use, while 9.1% of users preferred it because of its effectives while the rest (6.8%) were not aware as to why they preferred it. 43% of participants who ever heard of IUCD reported that they did not choose IUCD because they lack knowledge about it, 27.7% had fear of side effects, 15.4% reported to have fear of how to insert it, while others 13.8% reported myths about the ICUDs. The myths that were mentioned by large number of women concerning the IUCD were: they get lost inside the uterus, cause cancers and rotten the uterus. Male dominance is still a problem, since majority of women reported that it is the husband only who can decide about the number of children to have in the family and also he is the one who decides about whether a women should use contraceptives or not. Majority of women (59.4%) reported that tradition do not support/favor the use of contraceptives.

Conclusion: Lack of awareness and knowledge about the IUCD has been a major factor affecting its uptake by women. Factors like education and occupation were found to affect use of contraceptives. Large number of non-users of contraceptives reported it is because of husband refusal. Although family planning is supposed to involve both husband and wife, still men are dominant and they are the ones to decide about the number of children to have and whether a wife should/should not use contraceptives.

Recommendation: Women should be educated about the IUCD to encourage its uptake as well as other contraceptive methods. This study has shown that women have incorrect beliefs (myths) about the use of IUCD. Education should include denouncing myths that women have on their minds about the IUCD that lead them not to use the IUCD. Since majority of contraceptives users reported to have heard about contraceptives at the health facilities, more efforts should be put by the council health management team to the health workers to increase the awareness of contraceptives to women. Education to men should be offered concerning family planning including contraceptive methods since a large number of women reported that it is the husband who decides about the number of children to have and also decide about whether a wife should use contraceptives or not.