Postpartum intrauterine contraceptive device use and its associated factors in Ethiopia: systematic review and meta-analysis.

BACKGROUND: The intrauterine contraceptive device, a type of long-acting reversible contraception, is one of the most effective and safe contraceptive methods. In Ethiopia, intrauterine contraceptive device is little known and practised to delay pregnancy. Therefore, this study aimed to assess post-partum intrauterine contraceptive device utilisation and its associated factors among women in Ethiopia. METHOD: In the current meta-analysis, variables were searched from different electronic database systems, including PubMed, Google Scholar, EMBASE, HINAR, Scopus, Web of Sciences, and Grey literature. Data were extracted using a standardised data collection measurement tool. The data were also analysed by using STATA 16 statistical software. I2 tests assessed heterogeneity between the studies. A random-effect model was used to forecast the pooled utilisation of postpartum intrauterine contraceptive device. RESULTS: Twelve full-article studies were included. The pooled prevalence of post-partum intrauterine contraceptive device among women in Ethiopia was 21.63%. Occupation (OR = 4.44, 95% CI, 2.24-8.81), educational level of college and above (OR = 5.93, 95% CI, 2.55-13.8), antenatal care (OR = 2.09, 95% CI, 1.4-3.12), age (OR = 4.8, 95% CI, 2.3-10.04), good knowledge (OR = 4.16, 95% CI, 1.65-10.49), counseling (OR = 3.05, 95%CI, 1.41-6.63), husband support (OR = 11.48, 95% CI, 6.05-21.79) and awareness about IUCD (OR = 3.86, 95% CI, 1.46-10.2) were positively associated with utilization of postpartum intrauterine contraception device. CONCLUSIONS: Utilisation of post-partum intrauterine contraceptive device was significantly low. Scaling up women's educational status and ANC use has paramount importance in increasing post-partum IUD use, which further improves maternal and child health in general. This finding may be useful in both reproductive health promotion at an individual level and policy-making regarding this issue.

Family planning (FP) is widely recognised as a life-saving and health-improving intervention for women and children. An IUCD is a small, "T-shaped" intrauterine contraceptive device inserted into a woman's uterus. It is also referred to as an IUD, a loop, or a coil. Post-partum IUCD is an intrauterine contraceptive device inserted during the post-partum period. Although several primary studies have been conducted in various regions of Ethiopia, there is no nationally representative evidence on the PPIUCD utilisation and the pooled effects of its determinants in Ethiopia. In this review, some of the factors associated with the post-partum intrauterine contraceptive device were pooled quantitatively, and some were not because of inconsistent classification (grouping) of the exposures concerning the outcome (post-partum intrauterine contraceptive device).This systematic review and meta-analysis used the following electronic database; PubMed, Google Scholar, EMBASE, HINAR, Scopus, Web of Sciences, and Grey literature to search the primary articles. A total of 12 primary studies assessing the utilisation of postpartum intrauterine contraceptive device (PPIUCD) were included based on study eligibility criteria.And also, in this study we found that the pooled prevalence of post-partum intrauterine contraceptive device among women in Ethiopia was 21.63%. Occupation, educational status, good knowledge, husband support, age, counselling, antenatal care follow-up, and awareness about IUCD were factors that affect the use of post-partum intrauterine contraceptive devices.This systematic review and meta-analysis report that utilisation of post-partum intrauterine contraceptive device was significantly low. Therefore, scaling up women's educational status, and ANC use has paramount importance in increasing post-partum IUD use, which further improves maternal and child health in general. Beside this health professional also should be give health education and promotion about the importance of PPIUCD.

Youth Reproductive Health Service Utilization and Associated Factors among Amhara Region Female Night Students, Ethiopia.

INTRODUCTION: Youth is a decisive age to shape the direction of their life and that of their family. However, due to the host of biological, social, and economic factors, adolescent females can be at high risk of adverse sexual and reproductive health outcomes. Therefore, assessing youth reproductive service utilization and associated factors among female night students is very crucial for timely intervention to their gaps. METHOD: An institutional-based cross-sectional study design was conducted in Amhara region among 2,050 female night students from September 15 to November 15, 2018. A self-administered pretested questionnaire was used to collect the data. Bivariate and multivariable logistic regression models were used. Odds ratio with 95% confidence interval was computed to determine the strength of association between predictor and outcome variables. P value less than or equal to 0.05 is considered as the level of significance. RESULTS: Out of the total respondents, about 54.6%(CI: 52.5%-56.8%) of them utilized reproductive health services. Respondents who were attending secondary education (AOR = 2.55, 95%CI = 1.97-5.62), attitude towards youth reproductive health services (AOR = 2.74, 95%CI = 2.07-5.30), those who had a habit of communicating on sexual and reproductive health issues with their family (AOR = 3.66, 95%CI = 3.59-7.41), discussion on sexual and reproductive health issue with peers/friends (AOR = 1.43, 95%CI = 1.01-2.02), respondents with good knowledge on youth reproductive health services (AOR = 2.03, 95%CI = 1.49-2.75), and those who had faced reproductive health problems (AOR = 2.03, 95%CI = 1.49-2.75) were significantly associated with youth reproductive health service utilization. CONCLUSION: Youth reproductive health service utilization among female night students was not satisfactory. Therefore, special focus should be given to female night students by providing accessible, acceptable, confidential, flexible, and friendly reproductive health service utilization. Finally, community health promotion and education are mandatory to promote the practice of discussing youth reproductive health issues with their children.