Knowledge, Attitudes and Practices of LARC Methods: A Survey of Postpartum Kigali Couples Open Access

Hills, Katherine Eleanor (2014)

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Abstract Introduction: Couples Voluntary Counseling and Testing (CVCT) for pregnant couples has been integrated into PMTCT programs at the majority of Rwanda clinics. With a newly emerging emphasis on couple-centered health programming in Rwanda, understanding couples' knowledge, attitudes and practices around family planning and LARC in particular can contribute to better family planning programming and the provision of methods in keeping with a couple's fertility intentions. Methods and Materials: 117 couples were surveyed from 13 government health centers during July and August 2013. Separately, men and women were asked questions about their fertility intentions (number of children and timing) and the intentions of their partners. Together, couples were questioned about demographic characteristics, family planning use and perceptions, safer conception and LARC-specific concerns. Results: There is a high level of concordance between couples in regards to their personal fertility desires, and accurate predictions of the desires of their partners. High levels of modern contraceptive use were observed, predominantly short term methods. There was a significant difference between Catholic and non-Catholic clinic clients in terms of modern contraceptive uptake. Discussion: The majority of couples defined as LARC-eligible by their stated fertility desires expressed a willingness to consider LARC methods for their future contraceptive needs. Many participants expressed concerns about the side effects of LARC methods, with high levels of medically inaccurate concerns, especially about the IUD. Conclusion: The results of this couples-based survey suggest the need for data on the integration of evidence-based family planning counseling and education for men and women as the unit of reproductive decision-making.

Table of Contents

Table of Contents Chapter 1: Introduction 3 Chapter 2: Literature Review: Couples and Family Planning in Sub-Saharan Africa 8 Family Planning in the Context of the HIV Epidemic 9 Predictors and Barriers to LARC Uptake in Sub-Saharan Africa 13 Men in Family Planning 16 Chapter 3: Manuscript 20 Abstract 21 Contribution of Student 22 Introduction 23 Methods and Materials 24 Results 27 Discussion 30 Conclusion 32 Tables 34 Figures 40 Chapter 4: Conclusion and Recommendations 46 Works Cited 52 Appendices 56 Appendix 1: Individual Questionnaire for Men and Women 56 Appendix 2: Couple's Survey Instrument 59

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