1 Influence of Knowledge, Attitudes and Access of Contraceptive Methods on Unmet Need for Family Planning Among Women of Reproductive Age in Rubavu District, Rwanda.

Abstract : ABSTRACT Background: While achievements have been gained with modern contraceptive use rising from 10% in 2005 to 47.5% in 2015 with a resultant fall in fertility from 6.1 children per woman to 4.2 children in Rwanda, there remain some challenges. The current study identified the influence of knowledge, attitude, accessibility and availability of contraceptive methods on unmet need for family planning among women of reproductive age in Rubavu District, Rwanda. Methods: A cross-sectional study was carried among 270 women (15–49 years) attending public health facilities in western province, Rubavu district. Semi-structured questionnaires were used to measure knowledge, attitudes and accessibility of contraceptive methods. The outcome variable was unmet need for family planning (unmet need for spacing and limiting births).Bivariate analysis was done for the independent variable with the dependent variable then multiple logistic regressions was computed. To identify the independent effects of independent variables to unmet need for contraception, the Odds Ratio (OR) with 95% confidence interval was computed and statistical significance was defined when p-value was less than 0.05. Results: The overall prevalence of unmet was 46.6% (Unmet need for spacing 27.78% and unmet need for limiting 18.9%). After adjusting for other variables, contraceptive methods improve standard of life (OR = 0.445, 95 % CI =0.222-0.092 , P =0.023 , Family Planning (F P) methods cause weakness (OR = 2.879, 95 % CI =1.428-5.805, P =0.003; joint decision to use FP (OR =0.472 , 95 % CI =0.286-0.778 , P =0.003 ), decision to use FP taken by husband (OR =2.703 , 95 % CI =1.320-5.536 , P =0.007 , were significantly associated with unmet for spacing . While FP methods cause headache (OR = 2.240, 95 % CI =1.068-4.696, P =0.033 joint decision to use FP (OR =0.561, 95 % CI =0.367-0.858, P =0.008), decision to use FP taken by husband (OR =2.283, 95 % CI =1.078-4.856, P =0.032 for unmet need for limiting) Conclusion: The attitudes that FP methods cause weakness, FP methods cause headache and decision to use FP taken by husband increase unmet need for family planning.

Keyword : Knowledge, Attitude, Access, Contraception, Unmet Need for Family Planning, Women of Reproductive Age.