PMID- 31046715 OWN - NLM STAT- MEDLINE DCOM- 20191224 LR - 20200225 IS - 1471-2393 (Electronic) IS - 1471-2393 (Linking) VI - 19 IP - 1 DP - 2019 May 2 TI - Factors affecting the behavior outcomes on post-partum intrauterine contraceptive device uptake and continuation in Nepal: a qualitative study. PG - 148 LID - 10.1186/s12884-019-2310-y [doi] LID - 148 AB - BACKGROUND: The use of post-partum family planning (PPFP) methods such as post-partum intrauterine device (PPIUD) in general remains low despite its benefits for the women. The reasons or factors affecting the uptake and continuation of such PPFP methods in developing countries such as Nepal remains unclear. This qualitative research aims to explore the factors affecting PPIUD uptake and continuation related behaviors among post-partum mothers within 6 weeks of childbirth in Nepal. METHODS: This qualitative study was conducted through 43 in-depth interviews among post-partum mothers who delivered in 3 selected hospitals in Nepal. Data were analyzed through content analysis using the theory of planned behavior (TPB) as the theoretical framework. RESULTS: The themes and categories were structured around the three major components of the TPB on attitude, subjective norms, and behavioral control. Majority of the women in this study, irrespective of their behavioral outcome expressed a positive attitude towards PPIUD use. However, the women who expressed an unfavorable attitude towards PPIUD influenced their behavior to not choose or discontinue PPIUD. Subjective norms such as the family, peer, and societal influences against PPIUD negatively affected the women's intention and behavior related to PPIUD. Whereas, the positive influence of the health providers positively affected their behavior. Regarding the behavior control, women who had their own control over decisions tended to use PPIUD. However, external factors such as their husband's preference or medical conditions also played a prominent role in preventing many to use PPIUD despite their positive intentions. CONCLUSION: As suggested in TPB, this study shows that multiple factors that are interlinked affected the behaviors related to uptake and continuation of PPIUD. The attitude helped in s;haping intention but did not always lead to the behavioral outcome of PPIUD uptake and continuation. Subjective norms had a strong influence on both intention and behavior. Behavior control belief also had an important role in the outcome with respect to PPIUD uptake and continuation. Thus, a more layered, multidimensional and interlinked intervention is necessary to bring positive behavior changes related to PPIUD. FAU - Thapa, Kusum AU - Thapa K AUID- ORCID: 0000-0003-3051-0426 AD - Nepal Society of Obstetricians and Gynaecologists, Paropakar Maternity and Women's Hospital, Thapathali, Kathmandu, GPO: 23700, Nepal. kusumthapa2006@gmail.com. FAU - Dhital, Rolina AU - Dhital R AD - Nepal Society of Obstetricians and Gynaecologists, Paropakar Maternity and Women's Hospital, Thapathali, Kathmandu, GPO: 23700, Nepal. FAU - Rajbhandari, Sameena AU - Rajbhandari S AD - Nepal Society of Obstetricians and Gynaecologists, Paropakar Maternity and Women's Hospital, Thapathali, Kathmandu, GPO: 23700, Nepal. FAU - Acharya, Shreedhar AU - Acharya S AD - Nepal Society of Obstetricians and Gynaecologists, Paropakar Maternity and Women's Hospital, Thapathali, Kathmandu, GPO: 23700, Nepal. AD - Department of Obstetrics and Gynecology, Lumbini Zonal Hospital, Butwal, Nepal. FAU - Mishra, Sangeeta AU - Mishra S AD - Nepal Society of Obstetricians and Gynaecologists, Paropakar Maternity and Women's Hospital, Thapathali, Kathmandu, GPO: 23700, Nepal. AD - Department of Obstetrics and Gynecology, Koshi Zonal Hospital, Biratnagar, Nepal. FAU - Pokhrel, Sunil Mani AU - Pokhrel SM AD - Nepal Society of Obstetricians and Gynaecologists, Paropakar Maternity and Women's Hospital, Thapathali, Kathmandu, GPO: 23700, Nepal. AD - Department of Obstetrics and Gynecology, Bharatpur Hospital, Bharatpur, Nepal. FAU - Pande, Saroja AU - Pande S AD - Nepal Society of Obstetricians and Gynaecologists, Paropakar Maternity and Women's Hospital, Thapathali, Kathmandu, GPO: 23700, Nepal. FAU - Tunnacliffe, Emily-Ann AU - Tunnacliffe EA AD - International Federation of Obstetrics and Gynaecology, London, UK. FAU - Makins, Anita AU - Makins A AD - International Federation of Obstetrics and Gynaecology, London, UK. LA - eng PT - Journal Article DEP - 20190502 PL - England TA - BMC Pregnancy Childbirth JT - BMC pregnancy and childbirth JID - 100967799 SB - IM MH - Adult MH - Contraception Behavior/*psychology MH - Family Planning Services MH - Female MH - Humans MH - Intention MH - Intrauterine Devices/*statistics & numerical data MH - Mothers/*psychology MH - Nepal MH - Patient Acceptance of Health Care/*psychology MH - Postpartum Period/*psychology MH - Pregnancy MH - Qualitative Research MH - Young Adult PMC - PMC6498647 OTO - NOTNLM OT - Continuation OT - Nepal OT - PPIUD OT - Post-partum mothers OT - Theory of planned behavior OT - Uptake COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: Ethical approval was obtained from Nepal Health Research Council. The written informed consent were collected from all the participants. CONSENT FOR PUBLICATION: Not applicable. COMPETING INTERESTS: The authors declare that they have no competing interest. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. EDAT- 2019/05/03 06:00 MHDA- 2019/12/25 06:00 PMCR- 2019/05/02 CRDT- 2019/05/04 06:00 PHST- 2019/01/21 00:00 [received] PHST- 2019/04/23 00:00 [accepted] PHST- 2019/05/04 06:00 [entrez] PHST- 2019/05/03 06:00 [pubmed] PHST- 2019/12/25 06:00 [medline] PHST- 2019/05/02 00:00 [pmc-release] AID - 10.1186/s12884-019-2310-y [pii] AID - 2310 [pii] AID - 10.1186/s12884-019-2310-y [doi] PST - epublish SO - BMC Pregnancy Childbirth. 2019 May 2;19(1):148. doi: 10.1186/s12884-019-2310-y.