Common Methods of Contraception Used at Monkey Bay Community Hospital in Mangochi District, Malawi

摘要

To determine commonly used methods of contraception at Monkey Bay Community hospital, to compare different methods of contraception used by people of various age groups, parity, Human Immunodeficiency Virus (HIV) and Marital status, a clinical audit of family planning methods used by clients at Monkey Community hospital from January 2018 to June 2019 was done. Data was collected from the registers. A total number of 1734 clients reported at family planning clinic of Monkey-Bay Community Hospital between January 2018 and June 2019. All the clients were females. Most of these clients were in the age range of 15 - 34 years (83.33%). There were 1,486 (87%) HIV negative clients, 208 (12%) HIV positive clients and 24 (1%) had unknown HIV status. Most clients had a parity of 1 - 2 (905, 52.71%) followed by 3 - 4 (540, 31.45%) and 5 or plus (272, 15.84%). There were more married people (1641, 97.23%) than unmarried ones (46, 2.73%). There was only one person who was divorced (1, 0.05%). Education status was not recorded. The five commonly used contraceptive methods were: Intramuscular (IM) injectable Depo-IM (1366, 79.51%), Jadelle (122, 7.10%), Subcutaneous (SC) injectable Depo-SC (65, 3.78%), Combined Oral Contraceptives (COC) (60, 3.49%) and Implanon (40, 2.33%). None of the clients was used female condoms as a method of contraception. The contraceptive use was common between the age group of 15 - 24 (707, 44.92%) and 25 - 34 (709, 45%). Depo-IM was most used in age group 25 - 34 (44.5%) while Jadelle was mostly used by 15 - 24 years old (48%). 1181 clients (79.5%) of HIV negative clients used Depo-IM as the contraceptive method while 164 clients (78.8%) of HIV positive clients used Depo IM as a method of contraception. More HIV negative clients used Jadelle and COC as compared to HIV positive clients. The choice of a particular method of contraception was influenced by many factors. Parity, marital status, age as well as HIV status did have some association with the preferred method of contraception. Our study shows that there could be varied reason for women chose types of contraception in this part of Malawi. Interventions that aim to increase access to family planning methods, should consider exploring the reasons why clients use some methods more than the other for better planning of these services. Absence of male clients accessing vasectomy at the hospital raises concern and more studies will be needed to determine the reason why men do not come forward for family planning services at Monkey Community Hospital.