The Level and Factors Associated With the Uptake of Long-acting Reversible Contraceptive Methods Among Women of Reproductive Age at Kuajok State Hospital (KSH) in Warrap State, Republic of South Sudan

Abstract

The level and factors associated with the uptake of long-acting reversible contraceptive methods among women of reproductive age at Kuajok State Hospital (KSH) in Warrap State, South Sudan Long-acting reversible contraceptive methods (LARC), such as Intrauterine Devices (IUDs) and Implants, are among the most effective family planning methods used to delay pregnancy by women of reproductive age who desire future fertility. In Sub-Saharan Africa, there are 48.8 million women of reproductive age (15-49 years). Nearly half of married women want to space their births. However, 22 million fewer than half currently use any contraceptive method, and less than one in seven use a technique. In South Sudan, the total fertility rate is 4.4 children per woman, and family planning usage remains very low, with only 3% of women using any contraceptive method. As a result, the unmet need for family planning remains high at 29.7%. To determine the level and factors associated with the uptake of LARC methods among women of reproductive age at Kuajok State Hospital We conducted an analytical cross-sectional study, and reproductive-age women were randomly enrolled. A structured questionnaire was administered to obtain data on demographic, socio-cultural, and socio-economic factors, as well as facility-based factors. Clinical chart reviews were done to obtain the level of uptake of the long acting reversible contraceptive method. We determined the level of uptake as a percentage of all reproductive-age women and used Multivariate analysis to identify the factors associated with the use of long-acting reversible contraceptive methods. The level of significance was set at a p-value <0.05. The findings revealed that the majority of respondents, 230 out of 288 (79.9%), aged between 20 and 39 years, were significantly more likely to use LARC methods compared to other age groups (p=0.001 and 0.004). Socio-demographic factors were not statistically significant in influencing LARC uptake. However, several socio-cultural and health facility factors, including accessibility and cost of services, were significantly associated with LARC uptake (p<0.000). Additionally, income level was a significant socio-economic factor, with 202 out of 288 respondents (70%) reporting income-related influence on their contraceptive choices (p<0.000). In summary, age, income, cost, and accessibility of services were key determinants of LARC uptake. The study recommends strengthening family planning education and community sensitization, expanding mobile outreach services, integrating reproductive health services into routine care, and improving training for health workers using standardized Ministry of Health curricula. The development and dissemination of culturally appropriate information, education, and communication (IEC) materials are also essential for increasing contraceptive uptake among women of reproductive age (15-49 years).