RESUMO
Introduction: The recent introduction of modern contraceptive methods in resource-limited countries is confronted with the occurrence of undesirable effects that hinder their use in the long term. This study conducted among the users of the Ivorian Association for Family Well-Being in Korhogo describes the libido-sexual problems associated with the discontinuation of injectable contraceptives in former users. The objective of the study was to identify the factors that led to the abandonment of injectable contraceptives among female users of the Ivorian Association for Family Well-Being in Korhogo between 2018 and 2019. Materials and methods: Qualitative data were collected from 15 former users (24-38 years old) of injectable contraceptives duration of 2-3 months. Additional data were collected from five health workers aged 35-60 years. In-depth interviews were conducted to explore the experience with injectable contraceptives and reasons for discontinuation. Following data collection, audio-recorded data were transcribed, translated, and coded using thematic analysis through an inductive approach. Results: Side effects identified as associated with injectable contraceptives include libido-sexual disorders, unusual bleeding, and weight gain. The most common reason for discontinuation were libido-sexual disorders, which impacted the households' intimacy and provoked their abandonment or the change of contraceptive methods among injectable contraceptive users. Conclusion: Adverse events were dominated by libido-sexual disorders, unusual bleeding, and weight gain leading to the abandonment or change of the contraceptive. These results suggest points of intervention for increasing continuation among users. This intervention should include training of health workers to investigate and manage adverse events related to the use of injectable contraceptives and the improvement of communication between health workers and users on adverse events of injectable contraceptive use.
RESUMO
OBJECTIVE: Identify the predictors of the use of antenatal care in Burundi. DATA AND METHODS: This were an analysis of secondary data from the 2016 - 2017 demographic and health surveys in Burundi. The survey population was women who gave birth in the last five (05) years prior to the survey and gave their informed consent. Our sample consisted of 7,372 women. The data were analyzed with Stata 15.1 software. In bivariate analysis, the Chi-2 test, and simple logistic regression allowed us to identify the candidate variables for modelling at the 20% threshold. Multilevel ordinal logistic regression identified individual and contextual predictors of prenatal care use. RESULTS: The use of antenatal care by women who gave birth in Burundi was influenced by the area of residence (rural area : OR=1.25; 95% CI [1.05 - 1.49]), level of education (secondary level: OR=1.36; 95% CI [1.12 - 1.65]), parity (OR=0.77; 95% CI [0.68 - 0.87]), HIV transmission during pregnancy (OR=1.22; 95% CI [1.06 - 1.41]) and internet use frequency (OR=1.60; 95% CI [1.16 - 2.20]). The intraclass correlation coefficient was (Ii 3 = 0.0050083). CONCLUSION: Consideration of these determinants in the development of strategies to improve antenatal care utilization is necessary.
OBJECTIF: Identifier les facteurs prédictifs du recours aux soins prénatals au Burundi. DONNÉES ET MÉTHODES: Il s'agissait d'une analyse de données secondaires provenant des enquêtes de démographie et de santé 2016 2017 du Burundi. Notre échantillon était constitué de 7372 femmes. Les données ont été analysées avec le logiciel stata 15.1. La régression logistique ordinale multiniveau a permis d'identifier les prédicteurs individuels et contextuels du recours aux soins prénatals. RÉSULTATS: Le recours aux soins prénataux par les femmes ayant accouché au Burundi était influencé par le milieu de résidence (milieu rural : OR=1.25 ; IC 95% [1.05 1.49]), le niveau d'éducation (niveau secondaire : OR=1.36 ; IC 95% [1.12 1.65]), la parité (OR=0.77 ; IC 95% [0.68 0.87]), la transmission du VIH pendant la grossesse (OR=1.22 ; IC 95% [1.06 1.41]) et la fréquence d'utilisation de l'internet (OR=1.60 ; IC 95% [1.16 2.20]). Le coefficient de corrélation intraclasse était (Ii 3 = 0.0050083). CONCLUSION: La prise en compte de ces déterminants dans l'élaboration des stratégies d'amélioration de l'utilisation des soins prénataux s'avère nécessaire.
