Browsing by Author "Sempeera, Hassard"

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    Family planning counseling during antenatal care and postpartum contraceptive uptake in Africa: a systematic review protocol
    (JBI Evidence Synthesis, 2016) Sempeera, Hassard; Kabagenyi, Allen; Anguzu, Ronald; Muhumuza, Christine; Hassen, Kalkidan; Sudhakar, Morankar
    omen in low-income countries face a greater risk of unwanted pregnancy and unsafe abortions compared with women in developed countries. This increased risk has been attributed to the high demand and limited access to family planning services by women in this setting. Research shows that one in every four women aged 15–49 years who are married or in a relationshipwould wish to timeor control their child bearing but are not using any method of family planning. Despite the fact that contraceptive use has a direct and positive impact on reducing global maternal deaths by almost a third each year, this opportunity has not been fully exploited in lowincome countries particularly those in Africa.
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    High parity predicts use of long-acting reversible contraceptives in the extended postpartum period among women in rural Uganda
    (Contraception and reproductive medicine, 2018) Anguzu, Ronald; Sempeera, Hassard; Sekandi, Juliet N.
    The use of implants and Intra-uterine devices (IUD) during the post-partum period is very low in Uganda especially in rural settings. Long-acting reversible contraceptives (LARC) are known to be the most cost-effective for prevention of unintended pregnancy and unsafe abortions. This study aimed at determining the factors associated with long-acting reversible contraceptive use among women in the extended postpartum period in rural Uganda. We conducted a household-based, cross-sectional study among 400 women in two rural communities in Mityana district, central Uganda. Eligible women were aged 15 to 45 years who had childbirth within 12 months of study enrollment in September 2014. The outcome variable was self-reported use of a LARC method, either IUD or implants in the extended postpartum period. The main independent variables were previous childbirths (parity), fertility desire, willingness to use modern contraception, duration of postpartum period and previous pregnancies (gravidity). A logistic regression model was run in STATA v12.0 to compute adjusted odds ratios (AOR) for factors that predicted LARC use statistically significant at p < 0.05. Four hundred respondents had a mean age of 27 years (SD = 12) and only 8.5% reported using a LARC method. Use of IUD and implant was 1.8% and 10.4% respectively. Most women using LARC (44.1%) had five or more childbirths (p = 0.01), 70.8% of non-LARC users were willing to use modern contraceptives (p = 0.07) and 2.5% ever had an induced abortion. Having five or more childbirths was independently associated with LARC use in the extended postpartum period (AOR = 4.07, 95%CI 1.08–15.4). Willingness to use modern contraception, desire for more children and postpartum duration had no significant association with LARC use in the extended postpartum period. This study revealed low use of LARC within twelve months of child birth despite women’s willingness to use them. High parity (≥5 childbirths) predicted LARC use. The next logical step is to identify barriers to using LARC in the extended postpartum period and design appropriate interventions to increase access and use especially in multi-parous women.