"I just love it - I know there is something which has not given me worry when I am with my partner": acceptability of hormonal intrauterine device among clients in two districts in Tanzania.

چکیده اصلی

BACKGROUND: Hormonal intrauterine device (IUD) is an effective contraceptive method with high user satisfaction rates. To guide the introduction of hormonal IUD into the public sector in Tanzania, an operational research study was conducted to assess client acceptability of hormonal IUDs. OBJECTIVE: To explore clients' perspectives on contraceptives and experiences with hormonal IUDs. METHODS: This observational mixed-methods study (2023-2024) used focus group discussions with current or future contraceptive users (N = 58, baseline), plus facility register reviews, a structured quantitative survey (N = 100, endline) and semi-structured in-depth qualitative interviews (N = 18 at midline 2, N = 15 at endline) with hormonal IUD clients. Register and survey data were analysed for descriptive statistics. Qualitative data was analysed thematically and triangulated with quantitative data. RESULTS: In total, 1,198 clients chose hormonal IUD during the eight-month study. At baseline, women had limited knowledge and several concerns about IUDs and emphasised the importance of good contraceptive counselling. Client satisfaction with hormonal IUD at six months post-insertion was high (93% were strongly or somewhat satisfied). Most (92%, 83% and 100%) clients were strongly satisfied with the counselling, follow-up care and removal services received, respectively. Hormonal IUD clients found the characteristic of localised release of hormones possibly offering a better side-effect profile than other hormonal methods appealing. CONCLUSION: Hormonal IUD clients showed high satisfaction with the method and care received throughout the study. The authors recommend introduction of hormonal IUD into the public sector in Tanzania, with investments in community awareness, male engagement, and strengthening the quality of contraceptive counselling and side effects management.

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