DETERMINANTS OF INTENTION TO USE CONTRACEPTIVES AMONG SURVIVORS OF SEVERE ACUTE MATERNAL MORBIDITIES, KADUNA STATE, NIGERIA

Abstract

Nigeria is the second highest contributor to maternal mortality globally and women who survive severe acute maternal morbidities (SAMMs) are at increased risk of repeated SAMMs and death. The use of modern contraceptives which has been shown to reduce maternal mortality by 35 to 58% remains low about 10%. Research has shown that behavioral change is a continuum from knowledge to intention and practice. A descriptive cross sectional survey of 330 survivors of severe acute maternal morbidities, recruited consecutively over a period of 4 months frorn 10 referral health facilities in the state offering maternal health services. Data analysis was carried out and frequencies, chi squares and odds ratios of predictors and outcome variables were generated as well as logistic regression performed. Respondents had a mean age of 29 ± 7.5 years and 119 (35.9%) of respondents were Christians while 210 (63.8%) were Muslim. Women with no education, were 27 (8.2%) of respondents while 79 (24%) had quaranic education only, 81 (24.6%) had primary education, 93 (27.9%) secondary education and 50 (15.2%) higher education. Less than half of respondents 139 ( 42.1 %) were found to have good knowledge of modern contraceptives, 64 (19.4%) had fair knowledge of modem contraceptives while 127 (38.5%) had poor knowledge of modem contraceptives. We observed that a high proportion of respondents (69.9%) intend to use modem contraception in future and women with more than 5 children living children were 4 times more likely to intend to use modern contraceptives (OR = 3.87, CI= 1.05 - 14.07), women with proposed birth interval of greater than 2 years were twice more likely to intend to use modern contraceptives (OR = 1.88, CI= 1.05 - 3.37) and finally women who have ever used modem contraceptives before were 4 times more likely to intend to use modem contraceptives (OR=3.85, Cl=1.93 -7.76). The main reasons given for not wanting to use modem contraceptives in future include religious reasons (45.9%), fear of side effects (21.8%) and to a lesser extent spousal approval (14.9%). Modern contraceptive use intention is high among survivors of SAMMs presenting an opportunity to scale up postpartum family planning use and furthermore behavioral change communication strategies in the state need to be more comprehensive to ensure women have adequate knowledge about modern contraceptives and are well informed to make informed choices about the range of methods available.