DECISION-MAKING FOR USE OF INJECTABLE CONTRACEPTIVES IN ALEXANDRIA, EGYPT: A COMPARATIVE STUDY

Abstract

Injectable contraceptives are considered one of the modern methods that help in the rapid increase of the prevalence
of family planning methods all over the world. In the past few years their use has increased considerably. To identify the potential factors affecting the decision to use injectable contraceptives in Alexandria, Egypt. A cross-sectional
study was carried out in 26 family planning clinics affiliated to the Ministry of Health (MOH), Alexandria, Egypt.
The study was conducted for seven months during October 2006 - April 2007. Alexandria has seven health districts;
each district was represented by one clinic selected randomly from each type of the following 4 types of facilities:
rural units, urban maternal and child health centers, hospitals, and health offices. They were selected by using the
multistage stratified random sample technique. Totally 26 clinics were selected as two districts had no rural units.
The sample size was 790 clients. All clients (new acceptors, current users, continuers and discontinuers of all methods) were interviewed using two predesigned questionnaire. The use of all methods was affected by the positive
attitude of the husband towards the use of contraceptive methods. Refusal of husbands to use methods led to the
covert use of injectable contraceptives in only 2.3% of clients. Nearly all current users discussed family planning
with their husbands and, nearly 75% of wives expected that their husbands would discuss use freely. A higher proportion of new users expected refusal of use of family planning methods by their husbands than current users (25%
versus 5.4%). None of new users expected their husbands would be aggressive during the discussion or to refuse
discussion from the start. A considerable proportion of new users of injectable contraceptives changed to other
methods after being counseled by health providers. Service providers (physicians and leaflets) were not the main
source of information; they represented only 6% of information sources. The main sources of knowledge about the
injectables were friends and peers (65%) and television (29%). The main rumor heard about injectables was that
they cause infertility (56.9%) followed by causing breast tumors (10.8 %). Decision to use injectable contraceptives
depends not only on women acceptability of the method but also on husbands’ and health providers’ attitudes and
beliefs, as well as friends’ opinion about injectables and also on rumors.