RESUMO
BACKGROUND: The main public health problem that has a significant impact on the high fertility rate, unintended pregnancies, and induced abortion is Implanon cessation. In addition to Implanon being underutilized in Ethiopia, the rate of cessation is higher among women who started using it. Nevertheless, little is known about the factors that lead to Implanon cessation. OBJECTIVES: The study was aimed to determine the factors that led women to discontinue Implanon in Gedeo Zone, Southern Nation Nationalities and Peoples Region, southern Ethiopia, 2019. METHOD: A community-based unmatched case-control study design was carried out. Cases and controls were selected by a multi-stage sampling with a 1:2 case-to-control ratio. Data was entered into EPi-data version 3.1 and exported to Statistical Package for Social Sciences (SPSS) version 20 for analysis. A bivariate and multivariable logistic regression was used to identify the factors affecting Implanon discontinuation. The adjusted odd ratio (AOR) with 95% Confidence Interval (CI) was used to determine the precision of estimates, and statistical significance was declared at a p-value of 0.05. RESULT: From 516 women included in to the study, 495 (cases = 166 and controls = 329) women have responded to the questionnaires making a response rate of 96%. Monthly income 500-1000 birr [AOR: 0.3; 95% CI (0.2-0.5)], above 1000 birr [AOR: 0.2; 95% CI (0.1-0.4)], history of abortion [AOR: 2.0; 95% CI (1.0-4.1)], birth spacing [AOR: 0.6; 95% CI (0.3-0.9)], partner objection [AOR: 2.4; 95% CI (1.4-4.2)] were significantly associated factors. CONCLUSION: This study identified that monthly income, having abortion history, birth spacing, partner objection were the factors that affect Implanon discontinuation. To reduce implanon discontinuation, reducing abortion, involving partner and increasing the birth spacing, appropriate counseling before the insertion and appropriate follow-up by a health care practitioner are highly recommended.
RESUMO
Background: Male involvement during antenatal care is an influential strategy for improving maternal health service utilization, especially institutional delivery. In Ethiopia, only one-fifth of pregnant women were accompanied to antenatal care. It is among those neglected issues, as it is not well studied, specifically determinant factors of male involvement during antenatal care are not known. Objective: This study aimed to identify the determinants of male partner involvement during antenatal care among pregnant women in Gedeo Zone, South Ethiopia. Methods: Community based unmatched case-control study was carried out from January to March 2019 among 804 (cases-402 and controls-402) selected pregnant women having antenatal follow up in Gedeo zone by stratified sampling technique. Data was collected using a pretested, structured, interviewer-administered questionnaire. A survey was conducted in the 22 selected kebeles in the Gedeo zone to identify cases and control. The data was entered using Epi-data and exported to SPSS (Statistical Package for Social Sciences) for analysis. Descriptive analysis like frequency, percentage, rates, and inferential analysis such as binary logistic regression are used. Statistical significance is declared at α < 0.05. The result is presented using text and tables. Results: Husband and maternal age difference (AOR = 1.12, 95% CI [1.06, 1.18]), maternal age at marriage (AOR = 0.86, 95% CI[0.81,0.93]), women empowerment (AOR = 0.20, 95% CI[0.13, 0.30]), type of nearby health facility (AOR = 4.94, 95% CI[1.67, 14.60]) and provider invitation of male partner to antenatal care examination room (AOR = 0.32, 95% CI[0.20, 0.51]) were determinants of male partner involvement during antenatal care. Conclusions: Age difference between husband and wife, age at marriage, women empowerment, type of nearby health facility and male invitation by health providers to antenatal care examination room determines male partner antenatal care involvement. Promoting women empowerment and inviting a male partner to antenatal care are recommended to encourage male involvement during antenatal care.
