Introduction
There is an extensive body of literature on family planning and contraceptive use in Uganda. However, hardly any documented study has investigated modern contraceptive use in the period from resumption of sexual intercourse after birth among women in Uganda. This paper therefore provides an analysis of factors associated with time-to-contraceptive use after resumption of sexual intercourse among women in the country.
Methods
Data for the study come from the 2011 Uganda Demographic and Health Survey (UDHS). The assessment was made based on a sample of married women who had a birth in the three years preceding the survey and who had resumed sexual intercourse. A time-to-event approach (time from resumption of sexual intercourse to starting family planning) was adopted in the analysis based on the Kaplan Meier, Log-Rank Chi-square test and Cox Proportional Hazard regression.
Results
The median time-to-contraceptive use (19 months, range 0 - 24) after resumption of sexual intercourse demonstrates a delayed initiation of family planning. The time to adoption of modern contraceptive use was significantly longer among women who delivered at home or with a traditional birth attendant (TBA) rather than a health facility, women in the northern region, women who had 1-3 antenatal care (ANC) visits instead of the recommended four or more, women with no formal education and women in the poorest wealth quintile.
Conclusions
Measures for enhancing modern contraceptive use during and after the postpartum period should focus on: (i) addressing hindrances in accessing family planning, particularly among poor and noneducated women, (ii) integration of family planning service delivery into routine ANC through counseling; and (iii) promoting deliveries in health facilities.