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Poverty and InequalitySexual and Reproductive HealthFamily, Maternal & Child HealthMethodology

Unfulfilled need for contraception among women with unmet need but with the intention to use contraception in Rakai, Uganda: a longitudinal study

TitleUnfulfilled need for contraception among women with unmet need but with the intention to use contraception in Rakai, Uganda: a longitudinal study
Publication TypeJournal Article
Year of Publication2018
AuthorsLutalo, T, Gray, R, Santelli, J, Guwatudde, D, Brahmbhatt, H, Mathur, S, Serwadda, D, Nalugoda, F, Makumbi, F
JournalBMC Womens Health
Volume18
Pagination60
Date PublishedApr 27
ISBN Number1472-6874
Accession Number29699548
Abstract

BACKGROUND: Longitudinal data from a rural Ugandan cohort was used to estimate rates of unfulfilled need for contraception, defined as having unmet need and intent to use contraception at baseline but having an unintended pregnancy or with persistent unmet need for contraception at follow up. METHODS: Between 2002 and 2009 (5 survey rounds), a total of 2610 sexually active non-pregnant women with unmet need for contraception at the start of an inter-survey period were asked whether they intended to use any method of contraception until they desired a child. Modified Poisson multivariate regression was used to estimate unadjusted and adjusted prevalence ratios (PR) and 95% CI of unfulfilled need for contraception. RESULTS: The proportion of women with unmet need at the start of an interval who intended to use contraception significantly increased from 61 to 69.1% (p < 0.05). However the majority of women who said they intended to use contraception had unfulfilled need for contraception at the subsequent survey (64.8 to 56.8%). In the adjusted analysis, significant predictors of unfulfilled need for contraception included age 40-49 years (PR = 1.34; 95% CI 1.04-1.74) and those with unknown HIV status (PR = 1.16; 95% CI 1.06-1.26). CONCLUSIONS: There is a significant discrepancy between women's intent to use contraception (> 60%) and subsequent initiation of use (< 30%) with many having unintended pregnancies which might explain the persistent high fertility in Uganda. Future research needs to address unfulfilled need for contraception among women at risk of unintended pregnancies.

PMCID

PMC5921782