Impact of contraception use among women seeking tubal ligation in the rural Democratic Republic of the Congo

Abstract

INTRODUCTION: Investing in health is recommended for economic growth and the reduction of inequity in developing countries. Family planning is one such investment that benefits women and children. But resource-constrained environments, such as countries in conflict, present logistical and other challenges to the implementation of health programmes. For this reason even a proven cost-effective health intervention still needs to be contextualised to assess the actual benefit or impact in resource-constrained settings. OBJECTIVES: To describe user characteristics and analyse the impact of reversible contraception use among women who underwent tubal ligation in a rural health district of the Democratic Republic of Congo over a 4-year period. METHODS: A retrospective analysis of family planning programme registers for 4 years (1990 - 1994). During the study period, 400 women underwent tubal ligation. All records except for 76 that were incomplete were included in the study. RESULTS: A sample of 324 women was analysed. Most of the subjects (96%) were older than 30 years and of the Christian protestant faith (85%). Most had an education level less than secondary. Of the participants 99% were married; 98% of participants did not work outside the home. There was no significant difference in the average birth interval between contraceptive users and non-users (p = 0.246), but small families of less than 5 children were significantly more common (p = 0.006) in the small group of contraception users compared with non-users (10.1% and 2.8% respectively). CONCLUSIONS: The demand for surgical contraception comes mainly from married women with low education and economic status. Previous use of contraception did not make a difference in terms of birth spacing, suggesting a high prevalence of inconsistent or incorrect use of contraception.