Publication:

Knowledge, attitudes and practices regarding modern contraception in a referral hospital in Madagascar

Background Modern contraception is essential for birth spacing and prevention of avoidable maternal and neonatal morbidity. This study assessed knowledge, attitudes and practices regarding modern contraceptive methods among women hospitalized at CHUGOB, Antananarivo, Madagascar.

Methods A descriptive cross-sectional KAP survey was conducted from May to September 2019 among women aged 15-49 years. Data were collected using a structured questionnaire and analysed descriptively.

Results Among 210 women approached, 207 participated, giving a response rate of 98.5%. Mean age was 37.07±8.64 years. Most women were married or cohabiting (70.0%), housewives (56.0%) and multigravidae or grand multigravidae (69.9%). Knowledge of contraception was high: 90.8% defined contraception as birth limitation or spacing and 64.2% knew at least two modern methods. Overall, 50.2% had used a modern contraceptive method, but only 30.0% were regular users. Injectables were the most commonly used method (44.0%), followed by oral contraceptives (25.0%). The main reasons for non-use were fear related to rumours of diseases caused by contraception (41.2%) and fear of side effects (37.1%). Health personnel and media were the main sources of information.

Conclusions Awareness of contraception was high, but regular use remained limited. Patient-centred counselling, correction of misconceptions, better explanation of side effects and continued follow-up are needed to improve informed and sustained contraceptive use.