Determinants and reasons for low coverage of modern family planning in the Mugonero District Hospital catchment area

Introduction: Effective birth control is a key intervention in developing countries to achieve sustainable development goals. The United Nations (UN) reported that in 2015 the percentage of married couples using any form of contraceptive was 64.0%, and the average in Africa was 33.0%. This study aimed at assessing and determining factors associated with the low uptake of Modern Family Planning (MFP) Methods.

Methods: A mixed method population-based cross-sectional survey; quantitative and qualitative methods were applied. Villages and participants were randomly selected and ethical considerations were respected. Proportions and logistic regression were computed.

Results: Married or cohabitating women were the significant majority in our sample (72.7%). In total, 73.5% had used MFP methods in the past, and 61.3% of them were still using the MFP method. Among MFP methods users, 47.1% experienced side effects and 12.4% discontinued MFP. Over time, 11.8% got pregnant despite using the MFP method. A proportion of 8.5% among respondents missed MFP sessions and 53.0% reported that they would use MFP methods despite the unwillingness of their husbands. Women aged 25-34 years were highly likely to use MFP method (71.0%) and married women (70.5%) were also highly likely to use MFP. Not cohabiting with a partner (aOR=4.4[95% CI:3.855-5.071] was associated with using MFP. Ignorance, religion, unfaithfulness to marriage vow, side effects, poverty, and a lack of MFP for men were reported as the main reasons behind low uptake of MFP.

Conclusion: Side effects and faith are barriers to MFP. Unfaithfulness can jeopardize MFP use. Sensitization to MFP use is needed.