Initiation of postpartum modern contraceptive methods: Evidence from Tanzania demographic and health survey

Abstract

Background Postpartum contraceptive use is vital to improve maternal and child survival. It helps to have optimal child spacing, prevent unplanned pregnancies and associated adverse birth outcomes. However, postpartum contraceptive use in Tanzania remains low. Short median interval for resumption to sex after birth among African women has been associated with adverse maternal and child health wellbeing. This study aimed to assess optimal time to contraceptive use and predictors of time to contraceptive use after birth among women of reproductive age in Tanzania. Methods A cross section study using the TDHS 2015-16 data was used. A total of 3775 postpartum women were analyzed. Information on pregnancy, births and contraceptive use were recorded over the previous 5 years with the focus on most recent birth from the contraceptive calendar. Data analysis was performed using Stata 14.0. Analysis accounted for complex survey design. Time to modern contraceptive use after birth was computed using Kaplan Meier estimate. Adjusted time ratios with 95% CI were estimated using Weibull accelerated failure time models. Results A total weighted sample of 3775 women was analyzed. The median time to contraceptive use after birth was 7(IQR: 4-13) months, while for resumption to sex afterbirth was 2(IQR: 1-5) months. Factors such as never been married (TR: 1.63; 95%CI: 1.26-2.11) and breastfeeding (TR: 5.50; 95%CI: 4.12-7.35) were associated with longer time to postpartum contraceptive use. Belonging to richest wealth quintile (TR: 0.73; 95%CI: 0.54-0.99) and adopting long acting methods (TR: 0.70; 95%CI: 0.60-0.82) increased women's likelihood of having shorter time to postpartum contraceptive use. Conclusion There was a time lag of five months from resumption of sex and initiation of postpartum contraception use. The interceptive measures to facilitate timely availing methods of women's choice and promotion of utilization of maternal health care services may reduce delays in postpartum contraceptive use.