Knowledge and Attitude concerning use of Intrauterine Contraceptive Device among Women attending Family Planning at Makambako RCH in Njombe-Tanzania

Background: Intrauterine device is a modern contraceptive method used in family planning process, it prevents conception (pregnancy) and it has duration of 12years. There some women of reproductive age who don’t use this method, which necessitates our concern to why they don’t use it. The aim of this study is to explore the knowledge and attitude toward utilization of IUCD as family planning method among women attending at Makambako RCH. Methods: A descriptive cross-sectional quantitative study was used to assess knowledge and attitude concerning use of intrauterine contraceptive device among 384 women of reproductive age. Random sampling was conducted in which every individual had an equal chance to be selected and structured self-administered questionnaire were used to collect data. Data was entered to Microsoft excel and then exported to SPSS version 20.0 for further analysis. Results: Findings of the study about 333 (86.7%) respondents had knowledge on IUD while 51 (13.3%) they lack knowledge on IUD and they agreed it helps to prevent unwanted pregnancies and they heard it from social media like radio and television, health care providers, friends and school. About 46 (12%) of the respondents had positive attitude and used IUD method of family planning, and they got influence of using IUD from health care providers, 82 (21.4%) got influence of using IUD from their partners and 27 (7.0%) influenced to use IUD due to the side effects of other family planning methods like Depo Provera and pills. 25 (5.7%) were not influenced by anyone to use IUD as family planning method. While 338 (88.0%) participants had negative attitude on IUD method and had never used IUD as family planning method. Conclusion: The findings show that IUD usage was found to be poor and majority of them they didn’t prefer it, despite of having less complications.


INTRODUCTION
The intrauterine device (IUD) is a long term reversible contraceptive method that is suitable for women of reproductive ages and represents the most cost-effective reversible method for preventing unwanted pregnancies ,it is one of the most highly effective, convenient and widely used family planning (FP) methods in some parts of the world. [1] A study done in USA 2013, prior studies of women's knowledge about IUCD it indicated significant discrepancies between the respondent's perception of IUCD and actual IUCD characteristics, overall knowledge about the method was poor. [2] Study done in primary care family planning clinics in Cape Town showed that the knowledge of the IUCD as the contraceptive method was very poor, despite its availability it was underused and not a preferred method to prevent pregnancy, shows that 41% of women had heard about this method but that only 4% had ever used it. [3] The study done in South Africa showed that there was lack of knowledge among the participants in the study regarding IUCD; therefore, despite the availability of the IUCD in SA clinics and hospitals, its uptake was poor. Awareness of this method seemed to have improved over the past few years but the knowledge was considerably lacking. [4,5] A study done in South west Ethiopia

MATERIALS AND METHODS
The research design was a descriptive crosssectional study.

Study Area
Makambako is a medium-sized town and ward in the Njombe Region of the

Study population
The study included all women of reproductive age (15-49) years, seeking for family planning services at Makambako RCH

Inclusion Criteria
This study included all women of reproductive age 15-49 years who attended family planning at Makambako RCH and who were willing to participate were included.

Exclusion Criteria
All women of reproductive age 15-49 years who refuse to participate in the study were excluded.

Study design and Sampling
The study was designed to assess the level of to be selected and also questionnaires used.

Methods of data collections
Data was collected from the participants through structured self-administered

Questionnaire prepared in English and
Swahili language and was used to obtain information from women of reproductive age (15-45 years).

Statistical analysis
The data analysis was planned to include descriptive and inferential statistics; data were   Table 2)    In this study the knowledge on IUD was found to be high among the women though the use of IUD method was low also discussing of family planning choice with partner in this study was not found to be significant in the uptake of IUD. About 63.8% of women reported that they usually discuss their FP choice with their partner but this didn't influence the uptake of IUD as compared to the study done in Vietnam found out that 90% of women made decision regarding FP choice with their partner but it didn't affect the uptake of the device. [13] The study also showed uptake of IUD was found to be 8.1% due to negative attitude therefore uptake of IUD is very low as compared to the study done in Kenya, documented that the uptake of IUD was low (4%) and it was due to limited availability of commodities and lack of supportive policies. [14,15] Utilization of IUD as the method for family planning, from this study about 88% respondents had never used, though they have knowledge about the method but because they possess negative attitudes, they don't prefer this method, as compared to the study done In Dar es salaam, Tanzania. [16] documented that (