Factors Associated with the Use of Modern Contraceptive Methods by Women in Marital Union in the City of Lubumbashi, Democratic Republic of the Congo: Cross- Sectional Study

Research Article

Austin J Womens Health. 2017; 4(1): 1022.

Factors Associated with the Use of Modern Contraceptive Methods by Women in Marital Union in the City of Lubumbashi, Democratic Republic of the Congo: Cross- Sectional Study

Matungulu MC, Ntambue MA*, Ilunga KS, Musau NA, Ilunga MT and Malonga KF

Ecole de Sante Publique, Universite de Lubumbashi, Lubumbashi, Democratic Republic of the Congo

*Corresponding author: Ntambue MA, Hôpital Sendwe, Lubumbashi, Democratic Republic of the Congo

Received: November 11, 2016; Accepted: February 22, 2017; Published: February 24, 2017


Introduction: This study aimed to determine the prevalence of modern contraception and to identify factors that are associated with the use of modern contraceptive methods in the city of Lubumbashi.

Methods: We conducted a cross-sectional study from April to June 2015, with women in marital union in the city of Lubumbashi, where a sample was drawn. The sampling strata helped us to select households where women were interviewed; Data were collected by interview guided by a questionnaire; tests of Pearson chi-square, at the 5% risk threshold and the prevalence ratio and confidence interval 95% allowed us to determine the association. The Excel and the State software v13.1 helped us to analyze.

Results: In total 1096 women responded to our questions. The modern contraceptive prevalence was 28.4%. The use of modern methods predictors were age of women = 30 years, the level of university study, the Catholic religious denominations, Protestant, Muslim and Kimbanguistes, formal occupations such as public company, public service and private company, owning a radio and possession 4-5 living children, the high level of knowledge of the methods, the positive attitude, the current discussion with spouses and spousal support.

Conclusion: The modern contraceptive prevalence was low. Some socio demographic, cultural and obstetric characteristics could be promoted in order to boost the use of modern methods in the city of Lubumbashi.

Keywords: Family Planning; Contraception; Contraceptive Methods; Contraceptive Prevalence


CI: Confidence interval; DHS: Demographic and Health Survey; DRC: Democratic Republic of Congo; IUD: Intra uterine dispositive; LAM: Lactational Amenorrhea Method; OR: Odd ratio; Ora: Adjusted odd ratio; PR: Prevalence ratio; TV: Television


Family planning is one of the essential components of primary health care and reproductive health, to improve maternal, newborn and child, by reducing morbidity and mortality in this category and the transmission of HIV/AIDS [1]. Contraception could prevent around 104,000 maternal deaths each year, either 29% of reduction [2]. It can also reduce child mortality by almost 10%, if it is available to all who need it [3].

Democratic Republic of Congo (DRC), as many countries in Sub-Saharan Africa [2,4], is characterized by a low use of modern contraceptive methods, although it is among the countries with very high rates of maternal and infant mortality. The maternal mortality ratio is estimated at 549 per 100 000 live births; so a woman of 29 is at risk of dying of maternal causes during childbearing age [5].

Recents results [6] on infant mortality are reporting 97 deaths per 1,000 live births and an under-five mortality rate of 158 per 1000 live births. The total fertility rate stands at 6.6 children per woman for the rural and urban areas and 5.4 children in urban areas [7]. This shows the lack of fertility control as it assumes that Henry quoted in the report of the DHS-DRC 2007 [5].

Since 1970, the DRC is characterized by growth rates among the highest in the world at more than 3% [5]. And it established that the rapid growth of the population (> 2%) and high fertility are a threat to the wellbeing of individuals and the poorest societies in developing countries [8]. In DRC, seven out of ten households are poor [9]. The modern contraceptive prevalence was 5.4% in 2010 [6]. The results of the Demographic and Health Survey 2013 show a prevalence of 8% for the whole country, and 15% in urban areas against 5% in rural areas [7]. It shows a very small progress. Therefore, the national government has committed to increase modern contraceptive prevalence to 19% across the country on a deadline from 2014 to 2020 [10]. The same document reveals that the coverage for family planning activities is low in the country.

Lubumbashi located in the southeast of the province of Haut Katanga (formerly Katanga), is the capital of this province. Its area of 747 km² of which 140 km² urbanized, its estimated population by end of 2006 to 1.5 million inhabitants of which about 1.4 million live in the urbanized part (a density of 10 000 inhabitants / km2) make it the second city DRC, after Kinshasa the capital [11]. No information source can learn about the determinants of the use of modern contraceptive methods in Lubumbashi. The objective of this study was to determine the modern contraceptive prevalence and identify factors that are associated with the use of contraceptive methods in the city of Lubumbashi.

Materials and Methods

We conducted a cross-sectional study in analytical designs, from April to June 2015. It covered all women of childbearing age (15 to 49) in a conjugal relationship of the city of Lubumbashi, where a sample was drawn through the following formula: n = z²pq / d2.

The sampling strata allowed us to select households, within which, women aged 15 to 49 were interviewed. The Health Zones (the local health system) were considered strata, whose numbers amounted to six (Tshamilemba, Kamalondo, Katuba, Mumbunda, Kenya and Kisanga). The selection of this health zone was done by simple random. In each stratum, an allocation proportional to the size of the area of Health (under layers) was performed. With simple random, avenues and street have been selected and the first household to investigate should be located in a parcel in the middle of the avenue, and the way forward on the avenue was determined by the pointed part of pen after that it was torn down. In the event that a parcel was inhabited by more than one household, one was pulled by simple random.

With a pre-tested and validated questionnaire, we collected data through interviews. A team of investigators was recruited and trained before descending into households to administer the questionnaire consisted of the following: Characteristics of Households and Housing, identity of the woman and spouse, fertility, information on contraceptive methods, knowledge of methods, use of contraceptive methods.

Data analysis

The descriptive part was to describe the socio demographic characteristics of our respondents, obstetric history, knowledge of methods, use and non-use of contraception; this description generated percentages, mean and standard deviation. The analytical part, for its part, consisted of the search for associations between the use of modern contraceptive methods and predictors of the use of these modern methods: this is the univariate analysis. To do this, the test chi-square of Pearson, the risk level of 5% was used [12]. The association was determined by the prevalence ratio test and confidence interval of 95% [13].

Dependent variable

We considered as part of this study, the use of modern contraceptive methods as the dependent variable is dichotomous: use (yes = 1) and not using (No = 0). For modern contraceptive method, we considered the following methods: male condoms, pills, injectable (depo provera), implants, IUD, tubal ligation, spermicidal because they were the only ones cited by women.

Independent variables

We have retained predictors of the use of contraception following factors: age, marital status, level of education, religion, occupation of women, possession of radio, possession of Television (TV), number of living children, attitude of women face methods, level of knowledge of contraceptive methods (low: knowledge of one modern methods, average: knowledge of two methods and high: knowledge of three modern methods or more), discussion with the spouse, support spouse. We used the Excel software to encode data and the Stata Version 11 to perform analyzes.

Results and Discussion

A total of 1096 married women have answered our questions, a response rate was 97, 8%. An analyze data has revealed the mean of age for women was 31.7 ± 7 years; the less old was 14 years and the oldest was 49 years old. However, 0.3% of women did not know their age. More than ¾ of women were in a monogamous union. We found that over half (58.8%) had secondary level of study; by contrast, 0.3% of women had never attended school. The results showed that 32.7% of respondents had such denomination wake churches. More than half (62.0%) of women did not have an income-earning activity; they cared only for their households. We noticed that 76.6% of women had a radio, and 75.7% had a viewfinder TV in their households (Table 1).