Family Planning Knowledge, Attitudes, and Practices of Postpartum Malawian Women

University of North Carolina, Chapel Hill634 enrolled

Overview

The purpose of this study is to understand the family planning needs and practices of postpartum Malawian women, with a focus on long-acting reversible contraception (LARC). Hypotheses: 1. Postpartum women who are older, who have a history of unintended pregnancy, who do not desire another child within 2 years, and who were counseled about LARC during their pregnancy are more likely to have interest in using LARC. 2. Postpartum women who are older are more likely to be aware of LARC methods. 3. HIV+ postpartum Malawian women will have similar knowledge about LARC as postpartum Malawian women who are HIV-.

This study is a prospective cohort study of 630 postpartum Malawian women. Since our focus is on HIV+ women, HIV+ participants will be recruited in a 1:2 ratio, with a total of 210 HIV+ women and 420 HIV- women. We will recruit in the postpartum ward of Bwaila Maternity Hospital in Lilongwe, Malawi. Participants will complete a baseline survey about demographics, reproductive health history, and family planning knowledge, attitudes, and practices. At 3, 6, and 12 months postpartum, we will complete follow-up phone calls to determine what family planning methods they are using and if they encountered any barriers to receiving LARC if they had been interested in using them.

Study Type

OBSERVATIONAL

Enrollment

634

Conditions

Contraception

Eligibility

Sex: FEMALEMin age: 18 YearsMax age: 45 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Admission to the postpartum ward at Bwaila Maternity Hospital 2. Live birth ≥28 weeks gestational age within past 4 weeks 3. Fluent in English or Chichewa 4. Age 18-45 years 5. Access to a working phone number 6. Willingness to be contacted by phone for up to one year postpartum Exclusion Criteria: 1. History of female sterilization via tubal ligation or hysterectomy 2. Prisoner 3. History of mental disability 4. Serious illness that would prevent participation in the opinion of the Principal Investigator

Outcomes

Primary Outcomes

Knowledge about the intrauterine device (IUD) and contraceptive implant

A 14-question test about the IUD and implant will be administered to all study participants upon enrollment.

Time frame: Upon enrollment

Secondary Outcomes

Proportion of women using intrauterine device (IUD) and contraceptive implant

We will compare the proportions of HIV+ and HIV- women who are using the IUD and implant at 3, 6, and 12 months postpartum.

Time frame: 3, 6, and 12 months postpartum

Barriers to receiving intrauterine device (IUD) and contraceptive implant

Descriptive statistics will be used to analyze the reasons given for not receiving the IUD or implant at 3, 5, and 12 months postpartum if a woman had wanted to use it.

Time frame: Up to 12 months postpartum