Dynamics of Long-Acting and Reversible Contraceptive Adoption During the First Year Postpartum: A Secondary Analysis of the Yam Daabo Cluster Randomized-Controlled Trial in Burkina Faso and DR Congo

Abou CoulibalySéni Kouanda


Background: an earlier adoption of contraceptive methods during the postpartum period could help women to extend the inter-pregnancy interval. This article aimed to determine and compare the timing and dynamics of long-acting and reversible contraceptives (LARC) use (i.e., intra-uterine device and implant) in Burkina Faso (BF) and the DR Congo (DRC).Methods: Study participants were followed up to 12 months postpartum. We used Royston-Parmar's semi-parametric model to estimate the effect of the interventions. All multivariate results were adjusted for covariates found to be imbalanced between the intervention and control groups. We used a Mantel-Haenszel-type method to compare adjusted hazard ratios (aHR) between the two countries. We computed the median time of contraceptive adoption in each group by country.Results: Our analysis included 567 postpartum women in BF (284 in the intervention group and 283 in the control group) and 553 in the DRC (274 in the intervention group and 279 in the control group). Interventions had an effect in LARC use in BF (aHR 1.85; p=0.001) as well as DRC (aHR 2.78; p<0.001), but no difference between the two countries adjusted rate ratios (p=0.344). In both countries, median time to LARC adoptio...Continue Reading

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