Uptake and Predictors of Long-Acting Reversible Contraceptives among Women in a Tertiary Health Facility in Northern Nigeria Amina Mohammed-Durosinlorun * , Joel Adze, Stephen Bature, Amina Abubakar, Caleb Mohammed, Matthew Taingson and Lydia Airede Department of Obstetrics and Gynaecology, Kaduna state university, Kaduna Nigeria Received date: May 10, 2017; Accepted date: August 24, 2017; Published date: September 20, 2017 INTRODUCTION Nigeria has a total fertility rate of 5.5 births, and this is higher in the North-west zone with 6.7 births [1] . Unfortunately, this is accompanied by a high maternal mortality ratio of 560:1. Contraception is one of the strategies that can be used to significantly reduce maternal mortality [2] . While knowledge of contraception is generally high in Nigeria, contraceptive uptake is still low. About 85 percent of Nigerian women and 95 percent of men report knowing about at least one contraceptive method, yet only ten percent of currently married women report using a modern contraceptive method. The median birth interval in Nigeria is 31.7 months [1] , so LARC (long acting reversible contraceptives) would be an ideal choice for Nigerians. Typically, LARC refers to intrauterine devices IUD (effective for 5-10 years) and implants (effective for up to 3 years). However, the most commonly used modern contraceptive methods in Nigeria are short acting reversible contraceptives (SARC); Injectables (3 percent), male condoms (2 percent), and the pill (2 percent) are 1. Knowledge of IUD is 31.8% and of implant is 24.7% [1] . Uptake of LARC is low; the use of IUD increased slightly from 0.8% in 1990 to 1.1 in 2013 [1]. The use of LARC methods offers a lot of advantages. They are very effective [3] . Their effectiveness is independent of user age or compliance and is more than most other forms of contraception; the unintended pregnancy rate within a year of typical use for oral contraception, hormonal patch, rings, injectables, intrauterine devices, levonorgestrel intrauterine device, subdermal implant and sterilisation are 9%, 9%,9%, 6%, 0.8, 0.2, <0.1 and <0.5 respectively [4,5] . Unlike sterilization, LARC has no requirement for surgery [6,7] . They also generally require little intervention on the part of the user and do not interfere with sex, are very cost-effective allaying high upfront costs through long-term benefits, have limited contraindications for use, can be inserted right after delivery or abortion and fertility is rapidly restored following removal [3,7,8] . Offering LARC after 1st trimester abortion leads to a greater reduction repeat abortions than with other forms of contraception [9] . Design improvements have improved their side effect profile, improved patient acceptability and made insertion/removal simpler [3] . However, the effectiveness of the devices such as IUD remains dependent on proper insertion technique, which varies in complexity by individual device [7] . Expulsion of IUDs is reported in 1 in 20 women, with a higher frequency observed within the first 3 months after insertion and during menstruation [7] . Despite barriers and myths among health care providers, LARC has been found to be easy to insert and is well tolerated among nulliparous women, and does not increase the risk for pelvic inflammatory diseases (PID) [10] . Despite the benefits of LARC methods they continue to be used less frequently than user-dependent methods in many regions [6,7,11] . LARC methods may be underused for several reasons, including misperceptions and misinformation about them, higher initial cost, ‘provider dependence’ and requirements for specific clinical skill, and provider bias against the method [7] . Thus, a lack of education and training by health care professionals may result in significant barriers to LARC access [3,12] , though counselling increases LARC use as shown in the United States Contraceptive CHOICE project [13] . The objective of this study was to determine the uptake and predictors of long-acting reversible contraceptives among women in our setting so that strategies can be put in place to maximise their benefits. MATERIALS AND METHODS The study setting was a tertiary hospital located in Kaduna, northern Nigeria and catering for the metropolis and its environs. Approval for the study was gotten from www.jbcrs.org Research paper Corresponding Author: Mohammed .D.A, Department of Obstetrics and Gynaecology, Kaduna state university, Kaduna, Nigeria. E- mail: aminamhmd4@gmail.com DOI: 10.4103/2278-960X.194504 © 2017 Journal of Basic and Clinical Reproductive Sciences This is an open access artcle distributed under the terms of the Creatve Commons Atributon-NonCommercial-ShareAlike 3.0 License,which allows others to remix, tweak,and build upon the work non-commercially,as long as the author is credited and the new creatons are licensed under the identcal terms. For reprints contact: editor@jbcrs.org Copyright: © 2017 Mohammed.D.A, et al. This is an open-access artcle distributed under the terms of the Creatve Commons Atributon License, which permits unrestricted use, distributon, and reproducton in any medium, provided the original author and source are credited. 177