Desire for female sterilization among women wishing to limit births in rural Rakai, Uganda
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: Uganda has an unmet need for family planning of 34% and a total fertility rate of 6.2. We assessed the desire for female sterilization among sexually active women who wanted to stop childbearing in rural Rakai district, Uganda. Study design: 7,192 sexually active women enrolled in a community cohort between 2002 and 2008 were asked about fertility intentions. Those stating that they did not want another child (limiters) were asked whether they would be willing to accept female sterilization, if available. Trends in desire for sterilization were determined by Chi-square test for trend, and Modified Poisson regression was used to estimate prevalence rate ratios (PRR) and 95% confidence intervals of the associations between desire for sterilization and socio-demographic characteristics and HIV status. Results: From 2002 to 2008, the proportion of limiters dropped (47.2% to 43.7%; p<0.01). Use of pills and injectables among limiters significantly increased, 38.9% to 50.3% (p<0.0001), while use of IUDs and implants declined from 3.3% to 1.7% (p<0.001). The desire for sterilization significantly increased from 54.2% to 63.1% (p<0.0001), and this was consistently higher among the HIV-positive (63.6% to 70.9%, p<0.01) than HIV-negative women (53.3% to 61.2%, p<0.0001). Factors significantly associated with the desire for sterilization included higher number of living children (>=3), being HIV-infected and having received HIV counseling and testing. Conclusion: There is latent and growing desire for sterilization in this population. Our findings suggest a need to increase permanent contraception services for women who want to limit childbearing in this setting.
- Medical and Health Sciences