TIMELY INITIATION OF POSTPARTUM CONTRACEPTIVE AND ASSOCIATED FACTORS AMONG WOMEN OF EXTENDED POSTPARTUM PERIOD IN PAWE DISTRICT, NORTH WEST ETHIOPIA, 2019.

Abstract

Background: Worldwide, 9 out of 10 women want to avoid pregnancy for 2 years after having a baby. However, the absence of priority for birth spacing and lower uptake of postpartum modern contraceptive results in poor maternal and newborn health outcomes. Hence, this study aimed to determine the magnitude of timely initiation of postpartum contraceptive and associated factors among extended postpartum women in Pawe district, Northwest Ethiopia. Methods: Community based cross sectional study design was employed from February to March, 2019 in Pawe district. Multistage stratified sampling technique was used to select a total of 820 extended postpartum women. Data were collected using a pretested interviewer administered questionnaire. Bivariable and multivariable logistic regression model was fitted to identify determinants of timely initiation of postpartum contraceptive among extended postpartum women. Adjusted Odds ratio(AOR) with was 95%CI computed to assess the strength of association. Variable with less than p-value 0.05 considered as a significant determinant of contraceptive initiation. Results: The magnitude of timely initiation of postpartum contraceptive was found to be 37.2 [ 95% CI (34.0,40.5)]. Time return of menses [AOR=18.32, 95%CI(11.66,28.80)], postnatal care [AOR=7.8, 95%CI(3.98,15.44)], Knowledge level regarding benefit of modern contraceptive methods [AOR=3.0, 95%CI(1.40,6.59)], time of resumption of sexual intercourse [AOR=2.1, 95%CI(1.327,3.21), husband approval to use contraceptive [AOR=2.45, 95%CI(1.42,4.22), antenatal care [AOR=2.1,95% CI(1.13,3.76), place of delivery [AOR=2.0, 95%CI(1.22,3.39)], and got family planing counseling at delivery [AOR=2.34, 95%CI(1.22,4.49)] were factors associated with timely initiation of postpartum contraceptive. Conclusion and recommendation: The magnitude of timely initiation of postpartum contraceptive was low. This suggests strengthening integration of postpartum contraceptive use with other basic maternal health services and improving knowledge of women in practicing timely initiation of postpartum contraceptive before engagement to risk activities of unintended pregnancy is important. Key words: Postpartum, timely initiation,contraceptive, factors, Pawe district, Ethiopia