Prevalence and factors predictive of long-acting reversible contraceptive use in a tertiary hospital in urban Ghana

Objective To determine the prevalence, socio-demographic and reproductive factors associated with long-acting reversible contraceptive (LARC) use among clients resorting to reversible birth control methods in a tertiary hospital in Ghana. Methods Retrospective review of records of clients who opted for reversible family planning (FP) methods at Komfo Anokye Teaching Hospital, Kumasi, Ghana, from 1 July 2003 to 30 June 2008. We recorded data on their contraceptive history, and socio-demographic- and reproductive characteristics. Categorical variables were compared using the chi(2) test and factors associated with LARC uptake examined by binomial regression with a log-link function to estimate relative risks (RRs) and 95% confidence intervals (CIs). Results Of 5946 clients who opted for reversible contraception, 71% chose LARCs, and the remaining 29% chose shorter-acting contraceptives. LARCs were employed mainly by women with more living children (p trend <0.001) who had previously used LARCs (adjusted RR: 1.49; 95% CI: 1.39-1.60). Over half of non-contraceptive users started with LARCs while 27% of women switched from shorter-acting contraceptives to LARCs. Conclusion The prevalence of LARC uptake was much higher than the national average. Significant factors associated with current LARC use were the number of surviving children and previous LARC use.