Original Research

Knowledge, beliefs and practices of nurses with long-acting reversible contraception, Cape Town

Tracey-Leigh Abrahams, Michael K. Pather, Steve Swartz
African Journal of Primary Health Care & Family Medicine | Vol 15, No 1 | a3571 | DOI: https://doi.org/10.4102/phcfm.v15i1.3571 | © 2023 Tracey-Leigh Abrahams, Michael K. Pather, Steve Swartz | This work is licensed under CC Attribution 4.0
Submitted: 23 March 2022 | Published: 24 May 2023

About the author(s)

Tracey-Leigh Abrahams, Department of Family and Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Michael K. Pather, Department of Family and Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Steve Swartz, Department of Family and Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

Abstract

Background: Implanon and copper intrauterine contraceptive device (IUCD) are long-acting reversible contraceptives (LARC) available in public primary health care (PHC) South Africa. These methods are the most effective forms of contraception.

Aim: To evaluate the knowledge, beliefs and practices on provision of LARC.

Setting: Primary health care facilities within the Khayelitsha Eastern Substructure, Cape Town.

Methods: A descriptive survey of all permanent nurses who provided contraception. Data were collected from 72/90 (80% response rate) via a validated questionnaire and evaluated using Statistical Package for Social Sciences (SPSS).

Results: Knowledge of eligibility for LARC was tested. The mean knowledge scores for Implanon were 8.56/11 (s.d. 1.42) for the trained and 7.16/11 (s.d. 2.83) for the untrained (p = 0.007). The mean knowledge scores for IUCD were 10.42/12 (s.d. 1.80) for the trained and 8.03/12 (s.d. 3.70) for the untrained (p = 0.019). Participants believed that inaccessibility to training courses (29%), no skilled person available (24%) and staff shortages (35%) were barriers. Less than 50% of women were routinely counselled for LARC. Forty-one percent of nurses were trained and performed IUCD insertion, and 64% were trained and performed Implanon insertion, while 61% and 45% required further training. Confidence was low, with 32% trained and confident in IUCD and 56% trained and confident in Implanon insertion.

Conclusion: Lack of training, poor confidence and deficient counselling skills were barriers to effective LARC provision. The identified system-specific barriers must be addressed to improve uptake.

Contribution: The first study to evaluate knowledge, beliefs and practices on LARC in providers in the Western Cape.


Keywords

long-acting reversible contraception; primary health care; intrauterine contraceptive device; Implanon; intrauterine contraceptive device.

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