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Contraceptive Counseling at Mizan-Tepi University Teaching Hospital, Southwest Ethiopia

Author(s): Rohana Bruker, Margo Harrison

Background: In Ethiopia, postpartum contraception remains underutilized. Few women receive contraceptive counseling despite the country having the highest rates of unintended pregnancies in Sub-Saharan Africa. This study characterizes the prevalence of contraceptive counseling at Mizan- Tepi University Teaching Hospital (MTUTH) and examines differences in maternal demographic, antepartum, and postpartum characteristics between women who did and did not receive contraceptive counseling.

Methods: A prospective cross-sectional study was conducted in 2019 with a convenience sample of 1000 women delivering at 28 weeks or more from MTUTH. Data were collected through chart reviews and patient interviews upon admission, delivery, and discharge. Purposeful modeling was used to identify significant predictors of contraceptive counseling.

Results: The prevalence of contraceptive counseling was 4.55%. Among those with contraceptive counseling data recorded, receipt of counseling was associated with parity and delivery provider (p < 0.05). Odds of receiving contraceptive counseling among women with no previous births (parity=0) were 0.83 times less likely than women who had given birth at least three times (parity=3+) (OR: 0.17; 95% CI: 0.05-0.57). Odds of receiving contraceptive counseling among women who had an integrated emergency and surgical officer (IESO) or medical doctor (MD) as their delivery provider were 0.67 times less likely than women who had a midwife (OR: 0.33; 95% CI: 0.11-0.97). Health Equity: Inequities were identified to increase contraceptive counseling access for women served by MTUTH.

Conclusion: Most women at MTUTH do not receive contraceptive counseling. This quality improvement project allows hospital leadership to develop targeted interventions to improve rates of contraceptive counseling and contributes to the literature surrounding the characterization of contraceptive counseling and uptake in Ethiopia.

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