Factors affecting compliances to oral contraceptive pill use among women of child bearing age 15-49 years in Dar es Salaam 1993

To identify factors influencing adherence to oral contraceptive regimens, a cross-sectional descriptive study was conducted in 15 health units offering family planning services in Dar es Salaam city. Between August and November 1993, 752 oral contraceptive users attending selected health units providing family planning services were randomly selected to participate in the study. Consenting women were interviewed by using structured questionnaire. Data analysis was done by using SPSS/PC+. Frequency tables and cross tabulation were initially done to explore primary association between variables. Stratified analyses were done to assess potential confounding. To adjust for multiple confounders, multivariate analyses were performed using multiple logistic regressions. Model was fitted to identify determinants of non-compliance to oral contraceptive use. Statistical association was assessed by using the Chi-square test. Associations were considered significant if p-value was found to be less than 0.05. Five hundred eight four (77.7%) respondents were compliant, while one hundred sixty eight (22.3%) were non-compliant. Compliance was associated with high level of proper knowledge on how to take the pills and correct knowledge on what to do when one pill is missed. Non-compliance was found to be more common among women who were younger, uneducated, having more than three children, not preferring oral contraceptives, and those reporting to have experienced pill related side effects. Respondents were also found to have low knowledge of other methods of contraception besides condom, injectables and IUCD. Knowledge about side effects of pills and what to do when two or more pills are missed was generally lacking. Majority of respondents were using pills to space their next birth and only one third reported to have experienced pill related side effects. These findings indicated the need for continued information to clients on how to take pills and what to do when they miss one or more pills. More information about other family planning methods is required to increase their awareness in this population. The family planning unit within the Ministry of Health should be able to incorporate this information in their ongoing community based Information, Education and Communication activities