నైరూప్య

Contraceptive Preference Changed after Free-LARC Program for the Teenagers

Sathaphone Inthavong

Background: Adolescent pregnancy is an important issue, which can cause social, educational and health problems to female adolescents. Thai government has launched the free-of-charge for long-acting reversible contraception (LARC) prevention in 2014 for Thai female adolescence. However, the acceptance of this program has not been reported.

Objective(s): The study aims to describe the contraceptive use among reproductive age women before and after the free-of-charge LARC program.

Study design: This retrospective cross-sectional study was conducted among reproductive age women who attended to the family planning clinic at Maharaj Nakorn Chiang Mai Hospital between 2009 and 2018. The data were collected from the medical records. The chi-square test was used to compare the contraceptive methods used before and after the program and the binary logistic regression was used to find the factors associated with implant use after the program.

Results: The data of 9536 women were enrolled in the study. The rates of subdermal implant, progestin-only pills and condom use were increase significantly after the program (2.3% to 9.5%, 27.8% to 30.4% and 9.9% to 12.4%; p<0.005), while the rate of depot medroxyprogesterone acetate injection were decrease significantly after the program (44.0% to 35.3%; p<0.001). The implant users aged under 20 years increased from 7.0% to 34.1%. Factors significantly associated with the implant use after the program included the age group, job, educational level, race, and number of pregnancies. The adjusted odds ratio (aOR) for age < 20 years = 4.36 (CI: 2.02 - 9.43); p<0.001) and nulligravida; = 5.53 (CI: 2.65 - 11.52); p<0.001).