Abstract
Background
The levonorgestrel intrauterine system (LNG IUS) may become more available in the
public sector of resource-poor countries, but it is unclear what product features
might be attractive to users and what factors will influence uptake.
Study design
We recruited 671 women in Kenya who were seeking contraception at 6���12 weeks postpartum
and gave them an opportunity to try the LNG IUS. We asked why they did or did not
choose it, relative to the alternative options. ��2 tests of association were done to examine participant characteristics and decision-making
associated with choice.
Results
Participants chose the following methods: LNG IUS (16%), injectable (36%), subdermal
implant (30%), progestin-only pills (15%) and copper intrauterine device (IUD) (3%).
Reasons for not choosing the LNG IUS included fear of pain/injury/discomfort (34%),
modesty issues regarding insertion (33%) and fear of hormonal/health side effects
(31%). Nearly a third of LNG IUS acceptors said they would have chosen a short-acting
method if the LNG IUS were not available, and only 21% would have chosen the copper
IUD.
Conclusions
The LNG IUS could be an ideal method for increasing uptake of long-acting methods
among recent postpartum women. Product attributes and comparisons to other contraceptive
options are important factors in decision-making. Even among women comfortable with
intrauterine contraception, great distinctions and preferences are apparent. Addressing
specific misconceptions and fears with better information can help women make the
best personal choices.
Keywords
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Article info
Publication history
Published online: March 13, 2013
Accepted:
March 5,
2013
Received in revised form:
March 1,
2013
Received:
December 14,
2012
Footnotes
���Funding for this project was provided to FHI 360 by the US Agency for International Development [GPO-A-00-08-00001-00, Program Research for Strengthening Services (PROGRESS)]. The views expressed in this publication do not necessarily reflect those of FHI 360, the ICA Foundation or USAID.
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
