Method-specific Attributes Associated with the Choice of Future Contraception among Women Aged 15-45 Years in Refugee Settlements in Uganda

George O. Odwe, Population Council-Kenya
Francis Obare, Population Council
Yohannes Dibaba Wado, African Population and Health Research Center (APHRC)
Peter Kisaakye, Makerere University
Bonnie Wandera, African Population and Health Research Center
Stella Muthuri, Population Council
Gloria Seruwagi, Population Council
Chi-Chi Undie, Population Council

Factors associated with reproductive decisions, including contraception, are poorly understood in humanitarian settings. We examined method-specific attributes associated with the choice of future contraception among women in refugee settlements in Uganda. We analyzed representative household baseline data on 2264 women and girls aged 15–45 years conducted in April 2024 in Kiryandongo and Kyangwali refugee settlements. We used conditional logit analysis to examine associations between method attributes and intention to use injectables, pills, or implants among 263 non-users. Concerns about interference with menstruation, unpleasant side effects, and safety for long-term use were common across all three methods (range 58%-90%). The likelihood that a woman intended to use injectables, pills, or implants in the future was positively associated with her perception that it is easy to access (AOR=2.06), easy to use (AOR=4.00), safe for longer use (AOR=4.85), satisfaction with past use (AOR=2.84), and social network satisfaction (AOR=1.94). Contraception intentions among non-users in refugee settlements is low, coupled with widespread negative perceptions of methods. Future method choice is shaped by perceived convenience, long-term safety, social network satisfaction, and past experiences. There is need to improve counseling to counter erroneous negative beliefs and to expand access to a range of contraceptive methods.

Keywords: Family Planning and Contraception, Sexual and Reproductive Health and Rights

See paper.