INTRODUCTION

1.1 Background information

Hormonal contraceptives, such as birth control pills, patches, and implants, are widely used by women of reproductive age to prevent unintended pregnancies. However, there is evidence that these medications can cause a range of adverse effects, including nausea, bloating, weight gain, and headaches. In some cases, these effects can be severe and may lead women to discontinue use of hormonal contraceptives. (1) (2) Previous research showed that the prevalence of adverse effects among women using hormonal contraceptives varies depending on the type of contraceptive used and the individual woman's health and genetic factors. For example, study done in the United States in 2020 have found that women using combination hormonal contraceptives, which contain both estrogen and progestin, are more likely to experience adverse effects such as breastfeeding complications and blood clots than women using progestin-only contraceptives (3).

Another study done by the department of clinical epidemiology in Leiden Netherlands have found that certain genetic factors, such as variations in hormone metabolism genes and genetic markers, can influence the risk of venous thrombosis from hormonal contraceptives (4).
A study done in Morogoro Tanzania 2015 showed that majority of women (73.5%) reported concerns regarding side effects of hormonal methods of contraceptives, which they consistently described as a major deterrent to use which discouraged the uptake and encourage discontinuation of the hormonal contraceptives methods (5).

In addition to the individual-level factors that influence the prevalence of adverse effects, there was also evidence that the quality of care provided at reproductive and child health clinics can affect the prevalence of adverse effects among women using hormonal contraceptives. For example, the
World Health Organization (WHO) found that clinics that provide comprehensive counseling and support to women using hormonal contraceptives are more successful in helping women manage and mitigate adverse effects (6).

Overall, the existing research on the prevalence of adverse effects among women using hormonal contraceptives at reproductive and child health clinics highlighted the importance of providing high-quality care and support to women using these medications. Further research is needed to better understand the factors that influence the prevalence of adverse effects and to develop strategies to help women manage and mitigate these effects.

1.2 Problem statement

Despite the widespread use of hormonal contraceptives among women of reproductive age, little was known about the prevalence of adverse effects among women using these medications at reproductive and child health clinics in Tanzania. The aim of this study was to determine the prevalence of adverse effects among women using hormonal contraceptives at reproductive and child health clinics at Makongoro Health Center in Mwanza Tanzania and to identify factors associated with an increased risk of adverse effects.

1.3 Rationale of the study

This study fill the gap in knowledge by determining the prevalence of adverse effects among women using hormonal contraceptives at reproductive and child health clinics at Makongoro Health Center in Mwanza Tanzania. By identifying the factors associated with an increased risk of adverse effects, and also it has provided valuable information to healthcare providers and policymakers, enabling them to develop strategies to help women manage and mitigate these effects. In addition, the findings of this study provide valuable information to women using hormonal contraceptives, helping them to make informed decisions about their health and wellbeing

1.4 Research question

What is the prevalence of adverse effects among women using hormonal contraceptives at reproductive and child health clinic at Makongoro Health Center in Mwanza Tanzania, and how does this prevalence compare to the prevalence of adverse effects among women using other forms of contraception or no contraception?

1.5 Research objectives

1.5.1 Broad objective

To determine the prevalence of adverse effects among women using hormonal contraceptives at reproductive and child health clinic and to identify any potential risk factors associated with the development of these adverse effects clinic at Makongoro Health Center in Mwanza Tanzania

1.5.2 Specific objectives

• To assess the prevalence of adverse effects among women using hormonal contraceptives at reproductive and child health clinic at Makongoro Health Center in Mwanza Tanzania
• To identify potential risk factors associated with the development of the adverse effects of hormonal contraceptives at Makongoro Health Center in Mwanza Tanzania

1.6 Variables

1.6.1 Dependent variables

• prevalence of adverse effects among women using hormonal contraceptives
• the risk factors associated with the development of these adverse effects

1.6.2 Independent variables

• type of hormonal contraceptive being used, the duration of use, the age of the women using hormonal contraceptives, and their medical history