Increasing Desire for Permanent Family Planning Methods among Women in a High HIV-Prevalence Rural Setting in Uganda

Tom Lutalo, Rakai Health Sciences Program

High fertility and unmet need for family planning (FP) are health challenges in Uganda. We assessed the desire for childbearing, use of modern FP and desire for tubal ligation (TL) among women in rural Rakai, SW Uganda. We used longitudinal analysis of sexually active women aged 15-49 yrs, enrolled in an open community cohort between 2002 and 2008. Women’s desire for childbearing increased from 54.7% to 57.8% (p<0.01). Use of FP increased from 38.4% to 46% (p<0.0001). Among limiters, there was increased use of short acting FP methods (p<0.0001) while long acting method use declined (p<0.001). Willingness to adopt TL method among limiters increased from 53% to 62% (p<0.0001), with consistently higher proportions among HIV positives (62% to 71%) compared to HIV negatives (53% to 60%). There is a latent demand for tubal ligation and a need to increase these services for women who want to limit child bearing.