FACTORS AFFECTING ORAL CONTRACEPTIVE USE AND DISCONTINUATION AMONG MARRIED WOMEN IN IBADAN NORTH LOCAL GOVERNMENT AREA, IBADAN, OYO STATE

Abstract

Contraceptive use has been documented as an important factor in improving women’s health. However, the level of use is sub-optimal in many low and middle income countries. In particular, oral contraceptive (OC) use has been reported to be low among Nigerian women and there is a relatively high rate of discontinuation among users. There is a dearth of information from Nigerian studies on factors affecting the rate of OC discontinuation. This study was therefore designed to investigate the factors affecting OC use and discontinuation among married women in lbadan North Local Government area, Ibadan. Using a descriptive cross-sectional design, a three-stage random sampling technique was used to select 416 consenting respondents who had ever used OC or were currently using OC from 6 wards and 12 communities. A semi-structured, interviewer-administered questionnaire was used to collect information on socio-demographic characteristics of the respondents' knowledge, acceptance, and attitude towards OC use. Other information collected include factors influencing use and subsequent discontinuation of OC. Knowledge of OC was measured on a 15-point scale and attitude on a 12-item scale. Knowledge scores of ≥14 and <14 were rated as good and poor, respectively. Attitude scores of ≥9 and <9 were rated as positive and negative attitude, respectively. Data were analysed using descriptive statistics and Chi-square test at p= 0.05. Respondents age was 35.6± 7.8 years, 46.4% % were muslims while others were Christians. Most of the respondents were yoruba (80%), married (94.2%) while only 58.0% had completed secondary school education. More than a quarter (28.1%) of the respondents had poor knowledge of OC. The sources of information on OC were health workers (38.8%), friends (29.6%), television (16.5%) and radio (15.1%). A total of 124 (29.8%) respondent were currently using oral contraceptive while 70.2% of the respondents had discontinued the use of OC at the time of the study. A significantly higher proportion (77.4%) of respondents aged ≥25 years had discontinued the use of OC compared with younger respondents. Significantly, more muslims (36.8%) than christians (23.8%) were currently using OC. More than half (58.0%) of the respondents were satisfied with the last OC used. The most common reason for satisfaction was drug effectiveness (83.9%) in the prevention of pregnancy. Reasons given for dissatisfaction include headache (38.0%) and irregular menstruation (19.6%). Only 27.2% of the respondents had negative attitude towards OC use. Side effects (51.6%) and missing pills (28.7%) were the major reasons reported for discontinuing the use of OC. Twenty-one percent of the respondents had the intention of resuming OC use in the future. The use of oral contraceptive was low among married women despite good knowledge, and attributed adverse side effects was the major factor responsible for discontinuation. Public enlightenment programmes on its advantages and any possible side effects can help to increase oral contraceptive use for family planning.