Reasons for not Utilization of Intrauterine Device among Short Term Modern Contraceptive Users in Hossana Town, Southern Ethiopia: A Qualitative Study

Background: The copper intrauterine device (IUD) is a safe, long-acting, and effective method of contraception that is under-utilized in many countries, including Ethiopia. The several studies presented to address the problem, nearly all are quantitative in nature. These have primarily generated a list of associated factors and reasons that did not seem to help health systems to design effective strategies to address the problem. This study looked at the problem with a different approach with the aim to explore the issue in detail and help to develop locally appropriate strategies to increase this effective and safest contraceptive in Ethiopia. To this end, qualitative methods focused entirely on understanding why women are not using IUD from maternal health service programs was conducted. Objective: To explore the reasons for not utilization of IUD among short term modern contraceptive user women in Hossana town, southern Ethiopia . Method: A Phenomenological qualitative study was conducted in Hossana town public health facilities, Southern Ethiopia from 1-30 November 2019. A total of eighteen in-depth interviews were held with short term contraceptive user mothers, key informants, and health centers heads. Semi-structured interviewer guide and tape recorder were used to collect data. The collected data were expanded, labeled and ordered chronologically. Data were organized after subsequent detailed reading and analysis. Thematic analysis was used to analyze the collected data. Observations and review of relevant documents were also conducted. Result: In this study, the main reason for not utilization of IUD was lack of knowledge about the benefits of IUD, insufficient counseling about IUD from Health professionals and insufficient giving the informed choice for mothers, and the absence trained health professional at the time of appointment. Moreover, provider-client relationships were poor with mothers reporting fear of mistreatment and lack of cooperation from the service providers. Conclusion: The main reasons for not utilization of IUD was poor counseling of mothers, unsupportive provider-client relationships, and poor counseling by service providers. Efforts to rise IUD users need to focus on improving counseling of mothers and strengthening the health systems. Keywords: Intrauterine Device, Modern contraceptive users, Qualitative study