Predictors of Time-to-Contraceptive Use from Resumption of Sexual Intercourse after Birth among Women in Uganda

Abstract

Globally, there is extant literature on patterns and dynamics of postpartum contraceptive use with hardly any evidence examining time-to-contraceptive use from resumption of sexual intercourse after birth among women in Uganda. Methods. The analysis was based on data from 2011 Uganda Demographic and Health Survey on a sample of 2983 married women with a birth in the past three years preceding the survey and had resumed sexual intercourse. A time-to-contraceptive use was adopted in the analysis using life tables based on the Kaplan-Meier estimates, while the Log-Rank Chi-square tests assessed the variables to be included in regression analysis. Cox-Proportional Hazard regression was run to identify the predictors of time-to-contraceptive use among postpartum women in Uganda. Sampling weights were applied in the analysis to ensure representativeness. Results . The median time-to-contraceptive use was 19 months (range 0–24). Time to adoption of modern contraceptive use was significantly longer among women with no formal education, residing in northern region, who (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mi mathvariant="normal">H</mml:mi><mml:mi mathvariant="normal">R</mml:mi><mml:mo>=</mml:mo><mml:mn mathvariant="normal">0.56</mml:mn></mml:math>, CI: 0.40–0.78) had delivered at home/traditional birth attendant (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:mi mathvariant="normal">H</mml:mi><mml:mi mathvariant="normal">R</mml:mi><mml:mo>=</mml:mo><mml:mn mathvariant="normal">0.75</mml:mn></mml:math>, CI: 0.60–0.93), had 1–3 antenatal care visits (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:mi mathvariant="normal">H</mml:mi><mml:mi mathvariant="normal">R</mml:mi><mml:mo>=</mml:mo><mml:mn mathvariant="normal">0.83</mml:mn></mml:math>, CI: 0.70–0.98), and were in poorest wealth quintile. Conclusions. Measures for enhancing modern contraceptive use during and after the postpartum period should focus on (i) addressing hindrances in accessing family planning, particularly among poor and noneducated women; (ii) integration of family planning service delivery into routine ANC through counseling; and (iii) promoting deliveries in health facilities.