Effects of long-term utilization of hormonal modern contraceptives on fertility among women of child bearing age in Blantyre
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Date
2022-03-16
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Kamuzu University of Health Sciences
Abstract
Type of research study: A quantitative cross sectional study using structured interviewer
administered questionnaires.
Problem: Use of long acting reversible contraceptives has become increasingly common owing
to their notable positive impact on women’s reproductive health. However, less epidemiologic
studies on their effect on return of fertility have been done and results have been varying and
inconclusive. Practically, fertility return after discontinuation of contraception remains one of the
major concerns for women and negatively impacts utilization of modern contraceptives.
Infertility is a common experience among women and men worldwide, but remains on the
margins of public health and medicine in low-resource settings. However, in African countries,
which have a cultural preference for high fertility it can lead to stigma, social ridicule, stress and
even divorce which in turn can cause mental health problems. The prevalence of
primary infertility rate is at 2%, but secondary infertility rate is at 17% in couples between 20
and 44 years old. This rate is considerable and falls in the upper middle range of infertility rates
in sub Saharan Africa, which range from 5% to 23%. Although infertility has an impact on social
and mental well-being, the effects of modern contraceptives on fertility in women of
childbearing age in Malawi is not known.
Objectives: The broad objective of the study is to assess, the effects of modern contraceptives on
fertility among women of child bearing age in Blantyre, Malawi. The specific objectives are : to
estimate prevalence of women who have had a child before and fail to conceive 2 years after
discontinuation of injectable contraceptive method, to estimate prevalence of women who have
had a child before and fail to conceive 2 years after discontinuation of oral contraceptive
methods, determine child spacing among women who do not use modern contraceptives and
compare time taken from discontinuation of contraception to conception between women using
oral contraceptives and injectable contraceptives.
Methodology: The study will be conducted in Blantyre, at Queen Elizabeth central hospital
which is a referral hospital for most clients with infertility problems from all health centers in the
district as well as neighboring district hospitals. A total of 246 women of child bearing age
between 25 – 49 will be enrolled from gynecology outpatient clinic. Verbal and written consent
will be sought from participants before data collection and confidentiality will be maintained
throughout by use of codes. Social distancing shall be practiced and face masks shall be worn
throughout the interview session. Data will be analyzed using STATA version 14. Descriptive
analysis will be used to compute proportions along with their 95% confidence intervals. Expected findings and dissemination:
The findings of the study have the potential of informing safety of modern contraceptive
methods and allowing informed decision making on choice and duration of use for contraceptive
methods. Results from this study will be presented to the College of Medicine Research and
Ethics Committee (COMREC) secretariat. The findings will also be communicated to the
Blantyre District Health Office and Queen Elizabeth Hospital reproductive health departments
/units. In addition, the findings will be disseminated at college and national research
dissemination conferences.
Description
Type of research study: A quantitative cross sectional study using structured interviewer
administered questionnaires.