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n South African Journal of Obstetrics and Gynaecology - Impact of contraception use among women seeking tubal ligation in the rural Democratic Republic of the Congo : research article
Introduction. Investing in health is recommended for economic growth and the reduction of inequity in developing countries. Family planning is one such investment that benefits women and children. But resource-constrained environments, such as countries in conflict, present logistical and other challenges to the implementation of health programmes. For this reason even a proven cost-effective health intervention still needs to be contextualised to assess the actual benefit or impact in resource-constrained settings.
Objectives. To describe user characteristics and analyse the impact of reversible contraception use among women who underwent tubal ligation in a rural health district of the Democratic Republic of Congo over a 4-year period.
Methods. A retrospective analysis of family planning programme registers for 4 years (1990 - 1994). During the study period, 400 women underwent tubal ligation. All records except for 76 that were incomplete were included in the study.
Results. A sample of 324 women was analysed. Most of the subjects (96%) were older than 30 years and of the Christian protestant faith (85%). Most had an education level less than secondary. Of the participants 99% were married; 98% of participants did not work outside the home. There was no significant difference in the average birth interval between contraceptive users and non-users (p = 0.246), but small families of less than 5 children were significantly more common (p = 0.006) in the small group of contraception users compared with non-users (10.1% and 2.8% respectively).
Conclusions. The demand for surgical contraception comes mainly from married women with low education and economic status. Previous use of contraception did not make a difference in terms of birth spacing, suggesting a high prevalence of inconsistent or incorrect use of contraception.
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