Patient knowledge and intention to use the intrauterine contraceptive device IUCD at a tertiary level hospital

Abstract

Background: The intrauterine device (IUCD) is a highly effective and safe method of contraception. Prevention of unwanted pregnancies has made its use a matter of national priority in certain countries.Despite numerous advantages and suitability the uptake of the IUCD is poor. Patients in South Africa seem to lack knowledge regarding this contraceptive.Objectives: The aim of this study was to determine the quantity and quality of knowledge of the IUCD, and to evaluate its acceptability for future use.Methods: A prospective cross-sectional study was conducted at Pelonomi Tertiary Hospital. 201 consecutive patients were interviewed using structured questionnaires.Results: Awareness of the IUCD was found in almost half (49%, n=95) of our patients. Its use was very low, with only one patient having used it before. Overall qualitative knowledge was poor, even among those that were aware of the IUCD. There was a significant association between level of education and knowledge, with patients having passed Grade 12 or higher significantly more likely to have knowledge of the IUCD than those at lower levels (RR 1.57, 95% CI 1.18-2.08). Forty-five percent (n=86) of patients indicated a desire for future IUCD use.Conclusion: Despite the availability of the IUCD in South African clinics and hospitals, its uptake is still poor. Awareness of this method seemed to have improved over the past few years, but the qualitative knowledge still lacks considerably. Education plays a major role in the knowledge of contraception and better educational aids in all facilities will increase its use and reduce unwanted pregnancies.Â