Premature removal of Jadelle implant among women of childbearing age in Ndola district, Zambia.
Date
2020
Authors
Mwafulirwa, Agnes C.
Journal Title
Journal ISSN
Volume Title
Publisher
The University of Zambia.
Abstract
Many women do not fully utilize the Jadelle contraceptive implant, despite it being available in most health institutions. In Ndola District, there had been reports of Jadelle users going back for premature removals. Records analyzed from health facilities from 2009 to 2012, revealed a high number of users going back for premature removal of Jadelle implant. During the period under review, records revealed that 2,650 clients out of 9,439 insertions went back for premature removal of the implant. Statistics from the District health office also showed an increase in the number of unplanned pregnancies, indicating the need for contraception. This study, therefore, aimed at determining the factors contributing to premature removals among its users in Ndola District. The study used a cross section format based in six health centers, namely, Chifubu, Chipulukusu, Kawama, Kabushi, Lubuto and New Masala. These were purposively selected. It was conducted between the months of June- August 2016. A total of 303 Jadelle users who were selected by Systematic sampling method were interviewed. A structured interview schedule was employed for data collection. SPSS software version 23 on windows 8 was used to analyze the said variables and cross tabulations. Chi-square and fisher exact tests were then used to determine the association between the independent variables and the outcome variable. Significance level was set at 0.05 and
Binary logistic regression model was used as it adjusts for confounders. The findings showed that, majority (71.6%) of the respondents had Jadelle removed before the end of five-year period. Binary logistic regression analysis indicated; that the age groups, 15 – 34 to 35 – 44, impacted significantly on the outcome variable (p =0.003), Adjusted odds ratio = 0.320, 95% CI = [0.151, 0.677]). Similarly, changes in parity from two children and below to three children and above contributed significantly to the model outcome (p = 0.047), Adjusted odds ratio = 0.500, 95% CI = [0.252, 0.992]). Jadelle users who were between 15 and 34 years and those who had two or more children were the predictors of premature removal of Jadelle. Clients in the predictive variables should be properly counselled to determine their reproductive goals.
Description
Thesis of Master of Science in Nursing, Maternal and Child Health.