Table 1 Summary of barriers and facilitators for acceptability and uptake of long-acting reversible contraceptives (LARC) in Ethiopia across population groups
Product category | Population | Barriers | Facilitators |
|---|---|---|---|
Either method | Immediate postpartum/postabortion women | • Lack of awareness, misconceptions, and fear of side effects | • Postpartum/postabortion counselling on IUCD and implant benefits |
|  | • Cultural and religious prohibitions, partner disapproval, and family opposition | • Desire to space/limit children, partner support, and availability of LARC services at health facilities | |
Extended postpartum | • Preference for short-term contraceptives and social stigma | • Prior knowledge, community-based education, and increased awareness | |
Nonpostpartum women | • Lack of knowledge, misinformation, cultural restrictions, and fear of side effects | • Community education programs and desire for family planning and birth spacing | |
Healthcare providers | • Lack of training on IUCD and implant counselling and insertion; time constraints | • Training programs, up-to-date clinical guidelines, and increased confidence in LARC promotion | |
Adolescents | • Parental disapproval, myths about LARC effects on fertility, and social stigma | • Youth-friendly, confidential counselling services and school-based LARC education | |
IUCD/IUDs | Immediate postpartum/postabortion women | • Concerns about insertion discomfort, menstrual changes, and lack of trained providers. | • Immediate access to services, postabortion counselling, and motivation for long-term spacing |
Extended postpartum | • Fear of invasive procedures and limited trained providers in rural areas | • Community-based education and rural outreach | |
Nonpostpartum women | • Misconceptions about effects on reproductive health and discomfort during insertion | • Long-term protection, fewer clinic visits, and provider recommendations | |
Implants | Immediate postpartum/post-abortion women | • Myths about hormonal effects, health risks, and compatibility post-abortion | • Ease of use, low maintenance, and postabortion counselling on safety |
Extended postpartum | • Fear of hormonal side effects | • Facility-based availability and convenience for extended postpartum use | |
Nonpostpartum women | • Family and social opposition, along with misconceptions about health impacts | • Convenience and minimal maintenance requirements |