Evidence map›Paper›PMID 39636829›Full record

ArticlePloS one2024

Healthcare providers' perceptions on post abortion intrauterine contraception: A qualitative study in central Uganda.

Herbert Kayiga, Emelie Looft-Trägårdh, Amanda Cleeve, Othman Kakaire, Nazarius Mbona Tumwesigye, Josaphat Byamugisha, Kristina Gemzell-Danielsson

Abstract read
In one paragraph

Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Herbert KayigaDepartment of Obstetrics and Gynecology, Makerere University College of Health Sciences, Kampala, Uganda.ORCID 0000-0002-4707-1282
Emelie Looft-TrägårdhDepartment of Women's and Children's Health, Karolinska Institutet, and WHO Collaborating Centre, Karolinska University Hospital, Stockholm, Sweden.
Amanda CleeveDepartment of Women's and Children's Health, Karolinska Institutet, and WHO Collaborating Centre, Karolinska University Hospital, Stockholm, Sweden.
Othman KakaireDepartment of Obstetrics and Gynecology, Makerere University College of Health Sciences, Kampala, Uganda.
Nazarius Mbona TumwesigyeMakerere University School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.
Josaphat ByamugishaDepartment of Obstetrics and Gynecology, Makerere University College of Health Sciences, Kampala, Uganda.
Kristina Gemzell-DanielssonDepartment of Women's and Children's Health, Karolinska Institutet, and WHO Collaborating Centre, Karolinska University Hospital, Stockholm, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite access to post abortion intrauterine contraception, the uptake of Intrauterine devices (IUDs) in Uganda remains low. Whether the perceptions of healthcare providers towards IUDs have a role in the provision of post abortion IUDs remains unclear. We explored perceptions on post abortion IUD provision among healthcare providers in Uganda, focusing on barriers and facilitators in regards to provision and uptake.

methodsBetween 1st August 2022 and 30th September 2022, forty-five in-depth interviews were conducted among healthcare providers of different cadres at sixteen public health facilities in central Uganda. We used the case study design to explore the healthcare providers' perceptions. The interviews were primarily to help us understand the perceptions of healthcare providers towards IUDs. All interviews were audio-recorded and transcribed verbatim. Themes were identified using the conventional inductive content analysis.

resultsFrom the analysis, three themes emerged. Theme one covered health system related barriers in regards to IUD provision such as healthcare providers' and health facility challenges. The second theme focused on the challenges in post abortion contraceptive counselling focusing on IUDs. The third theme covered the motivating factors and participants' views on how to scale up IUD uptake and provision within post abortion care in Uganda. We found that lack of appropriate knowledge and skills on IUD provision, and heavy workloads, negatively impacted IUD provision. Inadequate facilities, IUD stock-outs, and minimal community sensitization also limited the utilization of IUDs. Furthermore, language barriers, community misconceptions around IUDs, long travel distances to the health facility, and partner refusal, contributed to the low uptake of post abortion IUDs. To address the identified barriers and scale up post abortion IUD provision, participants recommended addressing health system barriers, regular in-service refresher trainings, mentoring and supervision. They emphasized the importance of addressing contraceptive misconceptions and men's opposition to IUDs through community sensitization.

conclusionIn this study we identified several barriers to post abortion IUD provision, highlighting an urgent need to address health system barriers including healthcare providers' skills and knowledge gaps, supply chain challenges, and to ensure that facilities are conducive to quality contraceptive counselling. Provision of on-job refresher trainings, mentoring and supervision, are key motivators that can be utilized in supporting healthcare providers towards post abortion IUD provision. To further increase uptake, efforts are needed to dispel contraceptive myths and misconceptions at the community level.

Indexed as

Abortion, InducedHealth PersonnelIntrauterine DevicesQualitative ResearchAdultAttitude of Health PersonnelContraceptionFemaleHealth Knowledge, Attitudes, PracticeHumansMaleMiddle AgedPregnancyUganda

Identifiers

PMID39636829
PMCPMC11620438

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.