Prevalence and factors predictive of long-acting reversible contraceptive use in a tertiary hospital in urban Ghana.

OBJECTIVE: To determine the prevalence, socio-demographic and reproductive factors associated with long-acting reversible contraceptive (LARC) use among clients resorting to reversible birth control methods in a tertiary hospital in Ghana.

METHODS: Retrospective review of records of clients who opted for reversible family planning (FP) methods at Komfo Anokye Teaching Hospital, Kumasi, Ghana, from 1 July 2003 to 30 June 2008. We recorded data on their contraceptive history, and socio-demographic- and reproductive characteristics. Categorical variables were compared using the χ(2) test and factors associated with LARC uptake examined by binomial regression with a log-link function to estimate relative risks (RRs) and 95% confidence intervals (CIs).

RESULTS: Of 5946 clients who opted for reversible contraception, 71% chose LARCs, and the remaining 29% chose shorter-acting contraceptives. LARCs were employed mainly by women with more living children (p trend < 0.001) who had previously used LARCs (adjusted RR: 1.49; 95% CI: 1.39-1.60). Over half of non-contraceptive users started with LARCs while 27% of women switched from shorter-acting contraceptives to LARCs.

CONCLUSION: The prevalence of LARC uptake was much higher than the national average. Significant factors associated with current LARC use were the number of surviving children and previous LARC use.