THE ACCEPTANCE AND PRACTICE OF LONG ACTING REVERSIBLE CONTRACEPTIVES (LARC) AMONG WOMEN OF CHILD BEARING AGE (15-49 YEARS), IN OKE-ARO, AKURE SOUTH LOCAL GOVERNMENT AREA OF ONDO STATE

Family planning is a way of thinking and living that is adopted voluntarily upon the basis of knowledge and responsible decision by couples and individual in order to promote the health and welfare of the family group and thus contribute effectively to the social development of a country (WHO, 1986). Family planning is when a couple decide that they have as many children as they want and use some method to avoid pregnancy (Adesokan, 2017). Family planning is a way by which couples decide the number of children to have by choice and not by chance (Oladipo, 2016).

Long-acting reversible contraceptive are family planning methods that prevent unwanted pregnancy for minimum of between 3years to 10-12years, and when removed, return of fertility is prompt. It includes the implants and intrauterine contraceptive devices. (Mariam et al., 2018). The LARC contraceptive method are suitable for those who wish to space, delay or limit births and it is appropriate for women who are postpartum or post abortion. Long time reversible contraceptive family planning method is the most highly effective, convenient, cost-effective and widely used family planning method (Takele et al., 2012). The reversible long-contraceptive (implants and 100) is a long-acting and effective contraceptive methods appropriate for women wishing to limit child bearing as well as to space births, thus potentially playing an enormous role in reducing maternal morbidity and mortality.

The prevalence of unintended child birth was 14.4% long acting contraceptive method is convenient for users and effectively prevents pregnancy and also cost effective for programs over time. They can result in substantial cost saving for couples, government and contribute directly to reaching national and international health goals. (Birhanu et, al. 2018). Long acting reversible contraceptive (LARC) does not rely on user adherence for effectiveness. Discontinuation of LARC method requires consultation with a medical provider, which allows for additional counseling and discussion regarding side effect and contraceptive options. The sub dermal method available lervnor-gastral 100, the copper 100, and the implant are established as being safe and effective. Prior research found these factors, safety and effectiveness to be the most implant criteria of young women choosing contraception. (Truss et al., 2007)

Methods

Available LARC methods includes the following:

1. Hormonal Intra-uterine device

2. Non-Hormonal intra-uterine device

3. Sub dermal contraceptive implant

The use of LARC contraceptive is all more than 99% effective (Winner et al., 2012). There is a rapid return to usual fertility as soon as LARES are removed, LARCS can be used by most women of reproductive age. including those who can't use contraceptive containing the of hormone oestrogen due to health problems, are heavy smokers, have never had breast feeding or have recently had a baby, have recently had an abortion, are overweight, have diabetes, have epilepsy, are HIV-positive, have inflammatory bowel disease. (Ibrahim, 2017). There are two types IUDS, hormonal IUD (mirena) and copper IUD. There are many types of implants, Implanon. The implant is inserted directly under the skin, on the inner arm above the elbow, where it continually release a low dose of a progesterone hormone into the blood stream over a 3year time frame. Both implant and IUD insertion and removal involves a small procedure, with local anesthetic by a doctor or nurse or health officer trained in this procedure. LARC are gaining popularity due to their high efficacy in preventing unintended pregnancies. LARCS are easy to used and extremely effective once in place (Ibrahim et, al 2017).

Long acting reversible contraceptive methods provide very effective contraception for extended periods that do not depend on client's daily methods for the prevention of the harmful consequences of unintended pregnancies in most women including adolescents. (Insight medical publishing Group 2016). Nigeria in particular remains a focus for increasing contraceptive use. as it is one of the most populous countries in sub-Saharan Africa. Nigeria has a high total fertility rate (TFR), estimated to be between 5.5 and 5.7 for women of reproductive age (15-49), (NDHS. 2013). The effective of LARC method has been shown to be superior to other types of birth control. Long acting reversible contraception (LARC) methods are the most effective reversible methods of pregnancy prevention. The three commonly used LARC method available in the United States (VS) include the copper and levonorgestrel containing intrauterine devices (IUDS) and the sub-dermal etonogestrel implant, LARC uptake has been particularly high within one study demonstrating an increase from 2.4% in 2002 to 8.5% in 2009. (Winner B, et, al 2007).

Low uptake of LARC can be attributed to many factors including cost, patient knowledge and access and lastly, provider knowledge and bias. The contraceptives CHOICE project demonstrated that when these barriers were removed LARC uptake could be as 75%. (Pie et al., 2012). While all forms of contraception are important and should be discussed with patients, improving access to LARC has been identified by the family planning community as one strategy to reduce unintended pregnancy and abortion rates. (Nicholas et al., 2014).

It was observed that women of child hearing age (15-49) years in Oke-Aro community are accepting and accessing family planning methods, Hence the need to look into the acceptance of long acting reversible contraceptive methods among the ones chosen by them.

This study is designed to ascertain the acceptance and practice of long acting reversible contraceptives (LARC) and to discuss the role of LARC in family planning. Also to sensitize the users of the family planning devices to give more recognition to the use of LARC over other methods.

1. To ascertain the acceptance and practice of Long Acting Reversible Contraceptives (LARC) among women of child bearing age (15-49 years) in Oke-Aro community.

2. To access the knowledge and attitude of women of child bearing age (15-49 years) towards LARC in Oke-Aro community,

3. To ascertain the effectiveness of LARC method among women bearing age (15-49 years) in Oke-Aro community.

4. To detect the side effects of LARC among women of child bearing age (15-49 years) in Oke-Aro community.

5. To identify other factors influencing the awareness of LARC method among women bearing age (15-49 years) in Oke-Aro community.

1. Women believe that the use of LARC leads to secondary fertility.

2. Some believes that changes like nausea, protruding stomach, bleeding is as a result of LARC

3. It's often assumed that the insertion of LARC will affect their sexual activities.

4. Information has it that LARC makes users' normal shape i.e. making

them obese. 

5. Most women believe that other methods of family planning are not as effective as LARC.

1. FAMILY PLANNING: is a way of thinking and living that is adopted voluntarily upon the basis of knowledge, attitude and responsible decision by couples and individual in order to promote the health and welfare of the family group and thus contribute effectively to the social development of a country.

2. FAMILY: These are group of people living together usually parents and their children and they share the same culture.

3. ACCEPTANCE: The process of being received as adequate valid or suitable.

4. LARC: Long Acting Reversible Contraceptive

5. WCBA: Women of Child Bearing Age (15-49)

6. COMMUNITY: A community is a small or large social unit (a group of living things who have something in common such as Religion. Norms, Values or Identity).

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