A systematic review and meta-analysis of immediate postpartal intrauterine contraceptive device use in Ethiopia.

Background: Immediate postpartum intrauterine device (IPPIUCD) use remains too low in Ethiopia and there are high levels of unmet need for IPPIUCD. This systematic review and meta-analysis investigates individual studies conducted in Ethiopia on IPPIUCD use and influencing factors.

Method: Extensive database searching was done using Google Scholar, PubMed, Scopes, Cochrane library, Web of Science, and Science Direct search engines. Data were extracted and analyzed using Cochrane review manager version 5.4.1. A random-effects model with a 95% confidence interval (CI) was used to estimate the pooled magnitude of IPPIUCD use. Forest plot was used to estimate the pooled IPPIUCD use and inverse variance was used to identify the presence of heterogeneity. Publication bias was assessed by using funnel plots and Egger's statistical tests.

Result: This study showed that the pooled use of IPPIUCD in Ethiopia was 8.37% (95% CI: 4.32, 16.21). Those who had heard about IPPIUCD were 4.2 times (OR = 4.2, 95% CI: 1.51, 11.68) more likely, had birth interval >3 years were 3.90 times (OR = 3.90, 95% CI: 1.68, 9.05) more likely, had good knowledge were 4.44 times (OR = 4.44, 95% CI: 2.26, 8.76) more likely and counseled clients were 3.99 times (OR = 3.99, 95% CI: 1.28, 12.37) more likely to use IPPIUCD; and the odds of using IPPIUCD was 45% (OR = 0.55, 95% CI: 0.40, 0.77) less likely among aged 15-24 years old to use IPPIUCD.

Conclusion: IPPIUCD use in Ethiopia was low. Age category, ever heard about IPPIUCD, level of knowledge, birth interval and being counseled about IPPIUCD were statistically significant factors influencing IPPIUCD use.