Contraceptive Utilization and Unmet Need for Contraception Among Women Undergoing Treatment for Tuberculosis in Addis Ababa, Ethiopia; a Cross-sectional Study

Introduction: Pregnancy can pose a risk to women on tuberculosis (TB) treatment with a threat to the mother, fetus, and family at large. Contraceptive counseling and provision should be an integral part of TB clinics. Physiological and stress-related effects result when pregnancy occurs on TB illness and while treatment. Hence, this study aimed to assess contraceptive utilization, unmet need among women on TB treatment, and integration of family planning (FP) services with TB clinics in Addis Ababa, Ethiopia.Methods: A facility-based cross-sectional study was conducted using an interviewer-administered questionnaire. A total of 316 women aged 18-49 who were on TB treatment were recruited from one TB referral hospital and five randomly selected health centers in Addis Ababa with a response rate of 100%. The contraceptive utilization rate, unmet need, and integration of FP and TB services were determined. Logistic regression models were conducted to identify factors associated with contraceptive utilization.Result: Among women on TB treatment 49 (41.9%) were using contraceptives. Out of contraceptive users, 10 (34.5%) used contraceptive to limit and 18 (62.1%) used to space. In multiple logistic regression only parity had a significant association with contraceptive utilization. Women who had 1-3 children had 0.351 odds of having used contraception than those who had no children (AOR=0.351, 95% CI 0.152, 0.815, p=0.001). Among women who were married or sexually active, 12 (18.9%) had an unmetneed. Of the study participants, 144 (45.6% )have been informed about FP services at the TB clinics.Conclusion: The contraceptive utilization rate of women in the current study is slightly higher than the national prevalence yet it is still very low. Furthermore, the unmet need was lower than the national report for the general population However, more attention should be given to raise awareness of utilization in this group. Educating women about the risk of getting pregnant while visiting the health facility for TB medication will help improve their chances of better recovery, avoid medication side effects on the fetus, and improve their quality of life. TB guidelines can consider providing FP couselings when initiating treatment to provide women with the power of information to make deliberate decisions.