Professional Documents
Culture Documents
Teferi Resalt
Teferi Resalt
n= 384
since the total population of reproduction of age group is less than 10,000 finite correction
formula was employed.
Nf=
with this 10% of non-response rate was added. Therefore, the total final sample
size was 371.
4.4.2 Sampling technique
Non probability convenience sampling method was conducted
4.5. Study Variables
4.5.1. Independent Variables
Age
Religion
Marital Status
Income
Sex
Occupation
Education
Literacy Status
20
Parity
Attitude
Practice
4.5.2. Dependent Variable
Utilization of implant contraceptive methods
4.6. Data Collection Method and Instruments
A cross sectional survey was conducted by interviewing each family planning clients attending
Serbo health center using structured questionnaire by face to face interview. The data collection
tool were prepared in simple and understandable English language. The data were collected by
interviewing those legible clients for the study, training was given for the data collectors about
data collection and questionnaire were pretested . The English version questionnaire was
translated into local language which were understandable to the respondents during the
interview, and data collection was run over accordingly.
4.7. Inclusion and Exclusion Criteria.
Inclusion Criteria: All family planning clients attending Serbo health center was included in
the study.
Exclusion criteria: clients who not volunteer to participate in the study were excluded from the
study.
4.8. Data analysis and Processing
After data collection, the data were cleared, categorized, and checked for completeness before
analysis. Then the collected data were sorted manually using electronic calculators and compiled
accordingly. Later the finding was presented using frequency and percentage distribution and
statistical test was done using chi-square to determine association between implant service
utilization and different variables.
4.9 Result Dissemination Plan
After the end of the finding, the report will be given to JimmaUniversity CBE office, school of
nursing and midwifery, Serbo health center and other concerned bodies. It will also expected
that the result of this study will be disseminated to the public through media. Additionally, the
result may be presented on scientific conferences and published in scientific journals.
4.10. Ethical Considerations
21
Official letter was obtained from CBE office of JimmaUniversity to Serbo health center to ensure
voluntary participation. Then participants were clearly informed about the purpose of the study
and their right to participate or refuse was respected. The privacy and confidentiality of the
respondents relating to their information was kept accordingly.
4.11. Data Quality Control
In order, to ensure the quality of data, interviewers were trained before starting data collection.
The collected data were cross-checked by principal investigator as well as supervisors, at the end
of each days of data collection and invalid or incorrectly filled or collected data were recollected
correctly by respective data collectors. A week before the actual survey pre-test study was
carried out at MCH unit on FP clients 10% of the study subjects in Jimma University specialized
hospital to maintain accuracy of information and make necessary modification.
4.13. Operational definition and Definition of terms
Attitude: Way of feeling perception about something which influences behavior.
Positive Attitude: In this study attitude labels positive if a client strongly agrees greater than or
equal 60% to the positively stated attitudes questions in favor of implant method.
Negative Attitude: If a client strongly agree to the negatively stated or strongly disagree greater
than 60% to the positively stated attitude question in favor of implant method.
Contraceptive Implants: Are hormone releasing sub dermal implant which inserted under
skin,of womens upper arm.
Unintended Pregnancy: Is a pregnancy which occurs before having a plan to have a baby.
Unmet Need: Is the discrepancy between womens stated reproductive preference and their use
of contraception.
Need for Spacing: Is when women say they want to wait at least 2 years before having other
child.
Need for limiting: Is when they say they want to wait no more children.
Practice: Is previous and current Utilization of any available implant contraceptive method
.Good Practice: If the client answers greater than or equal to 60% implant questions correctly
she will be considered having good practices.
22
Poor Practices: If the client answers less than 60% implant questions she will be considered as
having poor practice.
CHAPTER FIVE:
RESULTS
23
A total of 371 study subjects were interviewed and that gave a response rate of 100%. Out of the
total 371 study participants ,119 (32.08%) were between the age of 25-29 years and 87 (23.45%)
were between the age of 20-24 years. Concerning religion, the majority 176 (47.44%) of the
respondents were Muslim followed by orthodox Christian which account for 93 (25.06%).
regarding marital status of the respondents, about 196(52.83%) were married and 78 (21.02%)
were single. Regarding educational status, majority 144(38.81%) of the clients were illiterate
followed by read and write accounts 99 (26.68%).
With regard to ethnicity, the majority 136 (36.66%) were Oromo followed by Amhara which
stand for 112 (30.19%).In connection to occupational status, large number 168(45.28%) of study
subjects were house wives and 52 (14.02%) were farmers .As to monthly income, the majority
122(32.88%) of the clients obtained between 501 -1000 birr per month. Concerning parity status,
the large proportion 141(38.01%) of the study participants had between 3-4 alive children in the
house hold and 128 (34,50%) had between 1-2 children (see table -1 below).
Table 1: Distribution of family planning Clients by socio demographic characteristics in Serbo
health center, Jimma zone, south west Ethiopia, June, 2014.
Variables Characteristic N
o
%
Age
(in Years)
15 19 63 16.98
20 24 87 23.45
25 29 119 32.08
30 34 57 15.36
>34 45 12.13
Total 371 100
Religion
Muslim 176 47.44
Orthodox 93 25.06
Protestant 78 21.03
Others(catholic, free thinkers) 24 6.47
Total 371 100
Marital Status Married 196 52.83
Single 78 21.02
Divorced 46 12.40
Widowed 51 13.75
Total 371 100
Ethnicity
Oromo 136 36.66
Amahra 112 30.19
24
Gurage 71 19.14
Others (yem, Dawero, Sidama) 52 14.01
Total 371 100
Monthly Income
(in birr)
< 300 birr
70 18.87
300-500 105 28.30
501-1000 122 32.88
1001-1500 46 12.41
>1500 28 7.54
Total 371 100
Educational status
Can read and write 99 26.68
Illiterate 144 38.81
Grade 1-6 46 12.40
Grade 7-12 54 14.56
College/University 28 7.55
Total 371 100
Occupation Status
House wife 168 45.28
Student 44 11.86
Government employ 51 13.75
Merchant 43 11.59
Farmer 52 14.02
Other(servants,
bartender)
13 3.50
Total 371 100
Parity
<1 47 12.67
1-2 128 34.50
3-4 141 38.01
5+ 55 14.82
Total 371 100
II. Practice of implant among study subjects
With regard to practice of implant, the overall prevalence of implant was 78
(21.02%). Among them, the majority 60(76.92%) were currently using implanon
25
followed by jadelle 18 (23.08%).There were no clients who used Sino-plant. The
prevalence of implanton and jadelle users among the total 371 study clients
were (16.2%) and (4.9%) respectively.
Moreover, from the total 78(21.02%) respondents who were currently practicing
implant 63(80.76)% of the respondents were satisfied with the method , while
few 15(19.24)% complained discomfort .The main reasons cited for satisfaction
with implant were; Due to its long acting 24(38.09%),highly effective
14(22.22%) ,no routine follow up are required 13(20.63%) ,easy to use
9(14.29%) and 3 (4.77%) others like easy to use ,failure of other methods.
In contrast, regarding practice out of the total 371 family planning clients 75
(20.21%) had practiced implant before but were no longer using the method.
The major reason mentioned for discontinuation was; irregular
bleeding29(38.66%), desire to have more children23(30.67%) and 9 (12.02%)
developing other side effects such as continuous head ache, general body
weakness, depression, hungriness and weight loss.
Furthermore, more than eighty percent of the study participants were not
currently using implant. The major reason cited for non-use was the use of
other methods of contraceptive, fear of procedure during insertion and removal
,fear of developing side effects ,un availability of the services ,and not allowed
by husband which account for 42.23%, 20.60%, 14.53%, 12.50% and
10.14%respectively ( see table- 2 below).
Table 2:Distribution of family planning clients by practice of implant in Sero
health center, Jimma zone, south west Ethiopia, June, 2014
Practices Responses No %
Discontinued implant
practice
Yes 75 20.21
No 296 79.79
Total 371 100
Reason of non-use
implants
Fear of procedure during insertion
and removal
61 20.60
Using other method of contraceptive 125 42.23
Husband refusal 30 10.14
Un availability in near by 37 12.50
26
Fear of developing side effects 43 14.53
Total 296 100
Reason of
discontinuation of
implant
Developing other side effects 9 12.02
Desire to have more Children 23 30.67
Fear of infertility 13 17.33
Irregular uterine bleeding 29 38.66
Others 1 1.32
Total 75 100
Currently Using
implants
Yes 78 21.02
No 293 78.98
Total 371 100
Reason to prefer other
methods
Un available 43 14.53
It short period 46 15.54
Less side effect 78 26.35
Fear of infertility 99 33.44
Other(head ache back pain surgery) 30 10.14
Total 296 100
Source of information
to use implants
Husband 17 22.67
Media 23 30.67
Friends 7 9.33
Health workers 28 37.33
Total 75 100
Types of implants
Used
Implanon 60 76.92
Jaddle 18 23.08
Sino plant 0 0
Total 78 100
Satisfaction
Yes 63 80.76
No 15 19.24
Total 78 100
Reasons of
satisfaction
Easy to use 9 14.29
High effectiveness 14 22.22
Long acting 24 38.09
No Routine Follow up 13 20.63
Other 3 4.77
Total 63 100
III. Attitude towards implant utilization
With regard to attitude towards implant utilization among study clients ,more
than two-third of the total respondents wrongly believed that using implant
27
can result in; irregular uterine bleeding 114 (52.77%),cause pain during
insertion and removal 114(52.77% ), cause sterility 114 (52.77% ),cause low
birth weight babies in future pregnancies 114( 52.77% ),negatively affects
breast milk 97 (44.91%),available implants are effective to prevent pregnancy
114 (52.77%) and cause spontaneous abortion 114 (52.77%).
Concerning the level of attitudes, not more than one fourth of the total study
subjects had positive attitude towards practicing implant contraceptive.
They were asked for feeling and perception they had about side effects of
Implant and their future option of contraception use they told that irregular
bleeding due to the use of implant is severe 16 (38.64%), insertion and removal
of implant is highly painful 12 (27.5%) and 14 (33.86%) stated that using the
method causes general body weakness, dizziness, global head ache,
hungriness, got depression. Among the total 58 (85.29%) users of implant who
were satisfied, 40 (69.o5%) of them stated that they will continue using the
method.
Concerning source of information, the majority 19 (45.23%) of the clients
obtained information from health workers, 13 (30.95%) from mass media, 10
(23.80%) from husband and 3 (7.14%) from friends.
Table 3: Distribution of Family planning clients by attitude toward using
implant in Serbo health center, Jimma zone, south west Ethiopia, June,2014.
S.
N.
Attitude
Agree Neutral Disagree
NO %
N
O
%
N
O
%
1 Implants cause
sterility
11
4
52.77 16 7.4
1
86 39.81
2 Implants cause
spontaneous abortion.
11
4
52.77 18 8.3
3
84 38.89
3 The available implants
are effective to prevent
pregnancy.
96 44.44 6 2.7
8
11
4
52.77
4 Implants cause low
birth weight babies in
future pregnancy.
11
4
52.77 11 5.0
9
91 42.13
28
5 Insertion and removal
of implant causes
pain
11
4
52.78 2 0.9
3
10
0
46.38
6 Implants do not cause
users thin.
97 44.91 5 2.3
1
11
4
52.78
7 Implants do not
negatively affect
breast Milk.
97 44.91 5 2.3
1
11
3
52.31
8 Implant help a mother
regain strength before
her next baby.
99 45.83 3 1.3
9
11
3
52.32
9 Using implant causes
irregular bleeding.
11
4
52.77 7 3.2
4
95 43.99
Although, there is no significant association (p>0.05) between family planning
clients attitude towards implant utilization and (monthly income, ethnicity,
age, religion parity and occupation). There is statistically significant association
(p<0.05) with their marital status and education (see table4 below).
29
Table 4: Association of attitude towards implant usage by selected socio
demographic characteristics among family planning clients attending Sebo
health center, Jimma zone, south west Ethiopia, June, 2014.
Va
ri
ab
le
s
Charac
teristic
No %
Positive
Attitude
Negative
Attitude
X
2
P=V
alue
No % No %
Ag
e
(in
Ye
ar
s)
15 19
20 24
25 29
30 34
>34
Total
63
87
119
57
45
371
16.98
23.45
32.08
15.36
12.13
100
17
22
30
18
13
100
26.98
25.28
25.21
31.57
28.88
26.95
46
65
89
39
32
271
73.02
74.72
74.79
68.43
71.12
73.05
1.17
0.88
4
Re
lig
io
n
Muslim
Orthodo
x
Protesta
nt
Others(
Chatolic
)
Total
176
93
78
24
371
47.44
25.06
21.03
6.47
100
41
27
19
9
96
23.29
29.03
24.35
3.75
25.87
135
66
59
15
275
76.71
70.97
75.65
96.25
74.13
2.88 0.41
1
M
ari
tal
St
at
us
Married
Single
Divorce
d
Widowe
d
Total
196
79
46
50
371
52.85
21.23
12.43
13.49
100
40
22
13
23
98
20.4
28.2
28.26
45.09
26.41
156
57
33
27
273
79.6
71.8
71.74
54.91
73.59
13.7
0.00
3
Et
hn
ici
ty
Oromo
Amhara
Gurage
Others
Total
136
112
70
53
371
36.65
30.19
18.87
14.29
100
31
31
18
20
100
22.79
27.67
25.71
37.73
26.95
105
82
52
32
271
77.21
72.33
74.29
62.27
73.05
4.76
0.19
0
M
on
thl
y
In
co
m
e
(in
bi
rr)
< 300
birr
300-
500
501-
1000
1001-
1500
>1500
70
105
122
46
28
18.87
28.31
32.88
12.37
7.55
22
17
39
13
8
31.42
16.19
31.96
28.26
28.57
48
88
83
33
20
68.58
83.81
68.04
71.74
71.43
8.57
0.07
3
Total 371 100 99 26.68 272 73.32
30
Ed
uc
ati
on
al
st
at
us
Can
read
and
write
Illiterat
e
Grade
1-6
Grade
7-12
College
/Univer
sity
Total
99
144
46
54
28
371
26.68
38.81
12.39
14.56
7.54
100
18
38
10
23
11
99
18.18
26.38
21.73
42.59
39.28
26.68
80
106
36
32
18
272
81.82
73.62
78.27
57.41
60.72
73.32
11.3
0.01
5
O
cc
up
at
io
n
St
at
us
House
wife
Student
Govern
ment
employ
Mercha
nt
Farmer
Other
Total
168
44
51
43
52
13
371
45.28
11.85
13.75
11.59
14.02
2.51
100
54
10
15
13
9
5
106
32.14
22.72
29.41
30.23
17.3
38.46
27.43
114
32
36
31
44
8
265
67.86
77.28
70.59
69.77
82.7
61.54
72.57
5.67
0.34
0
Pa
rit
y
<1
1-2
3-4
5+
Total
46
128
141
56
371
12.39
34.5
38.02
15.09
100
10
31
39
19
99
21.73
24.21
27.65
33.92
26.68
36
97
101
38
272
78.27
75.79
72.35
66.08ss
73.32
2.36
0.50
1
31
This finding showed that the existence of significant association between
practice of implant among family planning clients and their level of education
(p=0.015), and highly significant association with their marital status
(p=0.003).However, there is no significant association (p>o.o5) between the
clients and their (age, religion, occupational status, parity status and ethnicity
(see table 5 below).
Table 5: Association of practice of implant by selected socio demographic
characteristics among family planning clients attending Serbo health center,
Jimma zone, south west Ethiopia, June, 2014.
Variab
les
Characte
ristic
No %
Good
practice
Poor
practice X
2
P=Va
lue
No % No %
Age
(in
Years)
15 19
20 24
25 29
30 34
>34
Total
63
87
119
57
45
371
16.98
23.45
32.08
15.36
12.13
100
17
22
30
18
13
100
26.98
25.28
25.21
31.57
28.88
26.95
46
65
89
39
32
271
73.02
74.72
74.79
68.43
71.12
73.05
1.17 0.884
Religio
n
Muslim
Orthodox
Protestant
Others
Total
176
93
78
24
371
47.44
25.06
21.03
6.47
100
41
27
19
9
96
23.29
29.03
24.35
3.75
25.87
135
66
59
15
275
76.71
70.97
75.65
96.25
74.13
2.88 0.411
Marital
Status
Married
Single
Divorced
Widowed
Total
196
78
46
51
371
52.83
21.03
12.39
13.75
100
40
22
13
23
98
20.4
28.2
28.26
45.09
26.41
156
57
33
27
273
79.6
71.8
71.74
54.91
73.59
13.7 0.003
32
Ethnici
ty
Oromo
Amhara
Gurage
Others
Total
136
112
70
53
371
36.65
30.19
18.87
14.29
100
31
31
18
20
100
22.79
27.67
25.71
37.73
26.95
105
82
52
32
271
77.21
72.33
74.29
62.27
73.05
4.76 0.190
Monthl
y
Income
(in
birr)
< 300 birr
300-500
501-1000
1001-
1500
>1500
Total
70
105
122
46
28
371
18.87
28.31
32.88
12.37
7.55
100
22
17
39
13
8
99
31.42
16.19
31.96
28.26
28.57
26.68
48
88
83
33
20
272
68.58
83.81
68.04
71.74
71.43
73.32
8.57 0.073
Educat
ional
status
Can read
and write
Illiterate
Grade 1-6
Grade 7-
12
College/U
niversity
Total
99
144
46
54
28
371
26.68
38.81
12.39
14.56
7.54
100
18
38
10
23
11
99
18.18
26.38
21.73
42.59
39.28
26.68
80
106
36
32
18
272
81.82
73.62
78.27
57.41
60.72
73.32
11.3 0.015
Occup
ation
Status
House
wife
Student
Governme
nt employ
Merchant
Farmer
Other
Total
168
44
51
43
52
13
371
45.28
11.85
13.75
11.59
14.02
2.51
100
54
10
15
13
9
5
106
32.14
22.72
29.41
30.23
17.3
38.46
27.43
114
32
36
31
44
8
265
67.86
77.28
70.59
69.77
82.7
61.54
72.57
5.67 0.340
Parity
<1
1-2
3-4
5+
Total
46
128
141
56
371
12.39
34.5
38.02
15.09
100
10
31
39
19
99
21.73
24.21
27.65
33.92
26.68
36
97
101
38
272
78.27
75.79
72.35
66.08
73.32
2.36 0.501
33
CHAPTER SIX
6. DISCUSSION
An estimated358, 000 maternal deaths occurred worldwide in 2008, a 34%
decline from the levels of 1990. Despite this decline, developing countries
continued to account for the 99 % (355,000) of the deaths. Sub-Saharan Africa
and South Asia account for 89% (313,000) of global maternal deaths.
Fortunately, the vast majority of maternal newborn deaths can be prevented
with proven interventions to ensure that every pregnancy is wanted using
modern contraceptive and everybody is safe(10).
According to this study, the result showed that implant contraception
utilization among study participants in the study area was 21.02%. This is
relatively higher comparing with other studies conducted in three different
areas in Ethiopia which account (12%) for Mekele, (17%) for Jinka and (5%) for
ButaJira (26, 27).This might be due to the difference in the nature of study
area and access to information .The study was conducted in Serbo town,
Jimma zone where there is relatively good access to the health facilities. Jimma
towns community may have awareness of various health related issues due to
repeated awareness creation sessions by students of Jimma University over the
years through community based education.
However, despite cited prevalence of implant contraceptive utilization observed
among study subjects, large proportion (79.98%) of the study participants
contraception was depended on short acting method .The main reasons cited
for non-use was; using other methods of contraceptive, fear of procedure, fear
of developing side effects and non-availability which is similar with findings of
community based study done in rural areas of Jimma by Kaba M. (6, 29). There
was a significant association between poor practice of implant and socio-
demographic variables like educational status and marital status. The possible
reason why non-users were illiterate, those who had below 2 children, above 4
children and farmers was that illiterate women do not know the benefit of
implant contraceptive. While those who were farmer and may have a fear of
side effects and lack of information. Similar finding was reported by other
researchers (25).
34
Unlike the high prevalence of request for reinsertion of implant after 3 to 5
years of use, in other developing countries like Singapore (53%), this results
show almost zero rate. In connection to this the degree of satisfaction was very
high (77%). The main reasons mentioned for switching to implant contraceptive
among those Singaporean were contraception failure (11%) and experienced
side effects with other method of contraceptives (36%), (18). The possible
reasons for this differences might be due to the fact that in this study large
number of study subjects (74.54%) had negative attitudes towards the method
and misconceptions about its side effects for instant, they were believed that
implant delays pregnancy, insertion and removal of implant is painful, it
causes spontaneous abortion, and also it might be due to the nature of the
study area and access of information. Conversely, the findings were relatively
higher compared with finding from Jinka and EDHS, 2005reports (8, 26, and
27). This might be due to the difference in the study areas, access to the
information and the services. The main reason perceived for not practicing
implant was the use of other methods of contraceptives, fear of side effects, and
non-availability of service at the time of need and husbands disapproval which
is supported by reports from Pakistan (25).
Although statistically not significant, clients with positive attitude towards
implant and those who had good practice had the highest intention to use
implant contraception which is supported by another study that showed that
positive attitude of women to contraceptive was an important factors for
promoting use of long acting contraceptive (24).
The main source of information to use implant among family planning clients
in study area was community health workers which means most of study
participants had discussion with their health workers. Comparing with other
studies this result is consistent with findings from Butajira and Jinka (2
Limitation of the Study
Nature of the study design has its own limitation.it does not show the cause and effects of
the study
35
CHAPTER SEVEN
7. CONCLUSION AND RECCOMENDATION
7.1. Conclusion
It is evident that the contraceptive implant was not fairly accepted by
this group of family planning clients.
The majority of the women possessed misconception and rumors about
the method in that they believe that using implant causes spontaneous
abortion, causes infertility, because low birth weight babies in future
pregnancy and they agreed that insertion and removal of the method
causes pain.
The main reasons cited for discontinuation and nonuse were irregular
bleeding and the use of other methods contraceptive
The majority of the study subjects have negative attitude towards
practicing implant.
Study subjects who were non users of implant service were likely to be
illiterate, those who had below two children and above four and those
who were farmers who had poor understanding about the benefits and
effectiveness of the method and those who were disapproved by their
husband.
Negative attitude towards utilization of implant, clients who had two and
below children and clients educational and occupational status were
significantly associated.
36
7.2. Recommendations
The findings have implications for family planning programs to increase
contraceptive use for those specifically on implant. As to this finding, it
indicated that utilization of implant contraception is in adequate .To bring a
measurable impact based on these findings the following measure of
interventions are worth recommending.
1) Adequate counseling, early warning on possible side effects, and follow
up with an experienced health workers to manage any side effects that
arise are an important to achieve optional contraception.
2) Clients awareness on implant contraceptive service is to be improved
through health education communication and integration with health
workers
3) Health workers effectiveness and efficiency with in health facility is
recommended to improve misconceptions toward the method.
4) Refresher course for health workers regarding implant contraception
should be given regularly regarding reproductive issues
5) Client counseling particularly about side effects of the method has to be
given regularly.
In general adequate implant service utilization can be achieved through
an integrated effort with active involvement of the community and
collaboration of different sectors such as local NGOs working on
reproductive health and stake holders in the area.
Furthermore, further study should be conducted to produce better evidence
focusing on the service providers, male partners, service delivering institutions
and to identify factors affecting or hindering utilization of implant.
37
REFERENCE
1. Ram chand ran D and up adhyay UD. Implants the next generation.
Population reports series k. No 7. Balti more johns Hopkins bloom berg
school of public health(2007).
2. Hoh man H. Examining the efficacy safety and patient acceptability of
the etonogestrel Implantable contraceptive patient prefer adherence
(2009) Nov 33 205-11
3. Ishley mm, Edel man A. contraceptive implants an over view and update:
obstet and Gynaeco. Notrh am. (2007). 341 (1).73-20
4. Gracsslin of implanon. A review of cilinilaltrals and marketing of
implanon. A review of clinical trials and marketing experiences.
European journal of contraception and reproductive health care.(2008).
13 (supp 1): 4-12.
5. Jacobsitin (Rs, and pile, is). Hormonal implants service delivery
consideration for and improved and increasing popular method. New
York Endanger-health (the respond projects. (2007). 16,(2) 341-349
6. Family health international: us agency for internal development Pharm.
access Africa maries topes international. Endanger health (the
respondents project; (2010) comparison of contraceptive.
7. Central statistical authority and ORC Macro Ethiopia demographic and
health surveys 2007, Addis Ababa, Ethiopia and Calverton, marry land,
USA, 2008
8. Central statistical authority. The family and fertility survey, Ababa,
Ethiopia.2007,
9. Bhargara A, Desire of family size family planning and fertility in Ethiopia,
journal of Bi o social, (2007), 39, 367-38.
10. WHO. International planned parenthood federation http/www.
enwekiedia. org/wikj/ International planned parenthood federation.
11. ORC macro Calverton,. Evaluation of program options to meet un met
need for family in Ethiopia, Addis Ababa, marry land USA November
2006.
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12. Center of statistical authority. The family and fertility survey Addis
Ababa, Ethiopia, (1993).
13. Power T, French, R, and Covoan, F, sub dermas implantable
contraceptives Versus other form of reversible contraceptive or other
implantable as effective methods of preventing pregnancy. Co charane
data base of systematic reviews (2007) 3(31 1-3)
14. Steven Clements, Angela Baschri. Explaining a real varation in
contraceptive, use in east Africa letter presented at TJE UAPS
conference, thumb is December 2004.
15. Tannes WH. Existing demand for birth spacing in developing countries
perspectives from house surveys data. Int Gynaco -obstet 2005 8-9
suppl. 1.550-60.
16. Ishley mm, Edelman. Contraceptive implant an overview and updated
data obstet and Gynaeco North am. (2007) 341 (1). 73-40
17. Hubacher D. Lopez, L. Steiner M and Dorfinger L. menstrual pattern
changes from levongestrelsubdermal implants and DMPA systematic
review and evidence based comparisons. (2009) Contraception (2). 113
118.
18. Lekine, J, Sin of Sky, F and Christ M, Assessment of implant insertion
and removal contraception.(2008) 78 (15). 409-417.
19. Dancy PD, At nin son E, Tanners, et al. acceptance and perception of
implants among users in san Francisco, USA study fam -plan .(2008)
21, 152,
20. Who making designs about contraceptive introduction A guide for
conducting assessment to broader contraceptive choice and improve
quality of Broader contraceptive choice and improve quality of care. (The
strategic approach) world health organization, Jeneva .(2005).
21. Rivera R, Chem-mok m. analysis of a client characteristics that may
affect early discontinuation of the TCU 380, IUD contraception. (2003).
22. Tolly E, loza S, kafafi L, and Wmmings S, the impact of menstrual; side
effects on contraceptive discontinuation, finding from a longitudinal
39
study in Cairo Egypt internal national family planning perspective.
(2005) 31 (1):15-19.
23. Harrison wool rych M, and Hill R. unintended pregnancies with the
etonogestrel implant. A case series from post marketing experiences in
Austria :(2005) contraception 71 (41; 306-308.
24. Bas nakake S. Thapas s. Balogh SA: e valuation of safety efficacy, and
acceptability of implants in stilanka, stud farm plan: (2004) 19:39,
25. Johns B, caster line Zabar A. Sather and Ninghul has given obstacle to
contraceptive use in Pakistani, studies family planning USA, (2005), vol.
32 Nov pp 25-209
26. Temesgen A. Assessment of factors affecting utilization of implantable
contracentive among married women in Jinka town, Omo zone SPPNS .
Ethiopia .2008 sub mitted to AAU.
27. Kebede y contraception prevalence and factors associated with usage of
contraceptive around MEKELE town, Tigray north Ethiopia .2009. town.
Ethiopia journal of health dev.t August (2006) 14 (3) 327-334.
28. Tasfaye F. Assessment of factors influencing utilization of modern
contraceptive method among women ButtaJira town Guragezone
,national regional state (2010). MPH.
29. Kaba M: fertility regulation among women in rural communities around
Jimma, western Ethiopia. Journal of health development august (2003)
14 (2) 117-124.
40
QUESTIONNAIRE
JIMMA UNIVERSITY, COLLEGE OF PUBLIC HEALTH AND
MEDICALSCIENCESDEPARTMENT OF NURSING
Questionnaires on attitude and practice of implant contraceptives among
family planning Client attending Serbo health center, Jimma zone, south west
Ethiopia .
This questionnaire is designed to assess the level of attitude and practices of
implants among family planning Clients attending Serbo health center
The results of survey will be utilized in future planning and health services.
Investigator: TeferiGebru 4
th
year midwifery Student.
1. Do not leave any items of information without answer (for data
collectors).
2. You are kindly requested to run through each questions for (both
respondents and data collectors)
3. Your confidentiality will be kept accordingly (for respondents).
4. Put x mark to answer for corresponding prepared box (for data
collectors).
5. At the end of the questions ask comments (for data collectors).
41
PART I:Socio Demographic Characteristics.
1. Respondents age (in years)
2. N
o
of children ever born to you a, m b, f _______
3. What is your ethnicity?
a. Oromo
b. Amhara
c. Dawro
d. Gurage
e. Others specify
4. What is your educational status?
a. Illiterate
b. Can read and write
c. Elementary school (1-6)
d. Junior high school (7-12)
e. College/University
5. Current marital status
a. Single
b. Married
c. Divorced
d. Widowed
e. Other specify
6. If married what is your husbands educational status?
a. Illiterate
b. Can read and write
c. Elementary school (1-6)
d. Junior high school (7-12)
e. College/University
7. What is your main occupation
a. House wife
b. Farmer
c. Government employee
d. Student
e. Merchant others specify
8. What is your religion?
a. Muslim
b. Orthodox
c. Protestant
d. Others specify
e.
9. What is your monthly income in Birr?
42
PART II: Practice of Contraceptive
1. Are you currently using any contraceptive method?
a. Yes b. No
2. If yes what method of contraceptive are you using?
a. Oral pills
b. inject able
c. Implantable
d. IUDS, other specify_____
(If the answer is C go to Q. 9)
3. If you are using oral pills or inject able why you do prefer it?
a. Because, it causes no
infertility
b. Its short period
c. Less side effects
d. Other method is
unavailable
e. Other specify________
4. If Q. 1 is no have you ever used any modern contraception?
a. Yes b. No
5. If yes what method of contraception?
a. Oral Pills
b. Injectable
c. Implant
d. IUSD
e. Other specify
6. If used implant which type?
a. Implanon used for three years
b. Janelle effective for five years
c. Sino implant (II) effective
for four years
7. If ever used implant what was the main reason that you stopped using the
method?
a. Its expiry time
b. Desire to have more
children
c. Fear of infertility
d. Irregular or prolonged
uterine bleeding
e. Rumors they are not good
f. Other specify______
8. If never used implant what was the reason?
a. Fear of procedure during
insertion and removal
b. It cause users arm loss
c. Negatively affects breast
milk
d. It causes user thin
e. Un availability in the nearby, others specify_______.
9. If you are currently using Implants which method are you using?
a. Implanon one rod system
b. Jadelle (two rod system)
c. Sino implant (two rod system )
10. If yes you are using Implants who is your source of information to use
it?
a. Health workers
b. Husband
c. Friends
d. Others specify
11. Are you satisfied with this method?
a. Yes
b. No
12. If yes, what made you satisfied?
a. Easy of use
b. High effectiveness
c. Prevent pregnancy for extended period
d. No routine follow up are required
13. If no, what make you dissatisfied/Explain?
_____________________________________________________________________
_____________________________________________________________________
14. What do you suggest regarding Implant/Explain?
____________________________________________________________________
____________________________________________________________________
15. What is your future option concerning contraceptive?
____________________________________________________________________
_____________________________________________________________________
44
Part III: Questions to assess the attitude of Family planning Clients
toward contraceptive implants.
Instruction for the following question you will answer from the choice put
according to your answer in the box. (For data Collectors).
1. Agree
2. Neutral
3. Disagree
S.N Questions 1 2 3
1 Hormonal implants cause sterility
2 Hormonal implants causes spontaneous
abortion
3 The available hormonal implants are effective
to prevent pregnancy
4 HI cause low birth weight babies in pregnancy
future
5 Hormonal implants do not make users thin
6 Hormonal implants dont negatively affective
breast milk.
8 Implants cause irregular Uterine bleeding
9 Contraceptive implants help a mother regain
strength before her next baby.
10 Implants do not cause user arm loss