Experiences With the Levonorgestrel Intrauterine System Among Clients, Providers, and Key Opinion Leaders: A Mixed-Methods Study in Nigeria

Figures & Tables

TABLE 1.

Data Sources

Data Source	Frequency	Participants
Routine MSION service data	Collected by providers at time of service on ongoing basis	All MSION family planning clients
Supplementary LNG IUS client data	Collected by providers at time of service as part of LNG IUS program	Sample of LNG IUS clients (N=388)
MSION client exit interview data^a	Collected by MSION annually	Sample of MSION LARC clients (N=692)
In-depth interviews	Conducted in 2017	LNG IUS clients (N=33) LNG IUS providers (N=32) Key opinion leaders (N=17)

Abbreviations: LARC, long-acting reversible contraception; LNG IUS, levonorgestrel intrauterine system; MSION, Marie Stopes International Organisation Nigeria.
↵a Used for comparison purposes, not part of LNG IUS study protocol.

TABLE 2.

Voluntary LARC Provision in Facilities Participating in LNG IUS Introduction Program, Nigeria, September 2016–December 2017

Abbreviations: IUDs, intrauterine devices; LARC, long-acting reversible contraception; LNG IUS, levonorgestrel intrauterine system.
↵a Public-sector figures on provision of other LARCs were not available so the 24 LNG IUS provided through public-sector facilities are not presented in this table.

TABLE 3.

Reasons for Choosing the LNG IUS (N=326)^a

Reason^a	No. (%)
Reduced menstrual bleeding	197 (61.4)
It lasts for a long time	167 (52.0)
Effective	157 (48.9)
Nobody will know	134 (41.7)
It is convenient/don't need to do anything	100 (31.3)
Won't affect future fertility	98 (30.7)
Few side effects	86 (26.9)
Recommended by friend or family	63 (19.7)
Don't want more children	59 (18.5)
Want to delay pregnancy for at least 2 years	54 (17.0)
Can use while breastfeeding	51 (16.0)
Affordable here	39 (12.3)
Other	11 (3.3)
Not sure	3 (0.9)

Abbreviation: LNG IUS, levonorgestrel intrauterine system.
↵a Source: Supplementary LNG IUS client data collected at time of service. 326 women gave at least 1 response to this question; the women could provide multiple responses and responses were offered spontaneously.

TABLE 4.

First Source of Information About the LNG IUS (N=347)^a

First Source of Information	No. (%)
From clinic staff today	189 (54.4)
Friend/family member	97 (28.0)
From clinic staff on another day	49 (14.1)
Community health worker/volunteer	40 (11.5)
Referred by other health provider	38 (11.0)
Poster/flyer	15 (4.3)
Other	7 (2.0)

Abbreviation: LNG IUS, levonorgestrel intrauterine system.
↵a Source: Supplementary LNG IUS client data collected at time of service. 347 women gave at least 1 response to this question; the women could provide multiple responses and responses were offered spontaneously.

TABLE 5.

Sociodemographic Characteristics and Family Planning Use of LNG IUS Clients (N=33)^a

Sociodemographic Characteristics	Women
Age, years, mean	33.8
Marital status, No.
Married	27
Not married	2
Number of children, mean	3.2
Education, No.
None/some or completed primary	9
Some or completed secondary	12
Post-secondary	8
Currently using the LNG IUS, No.	30
Recently removed the LNG IUS, No.	3
Previously used family planning, No.	24
Family planning methods ever used, No.b
Condoms	5
Pills	5
Injectables	14
Implants	8
Copper IUD	8
Other	2
Desire for future children, No.
Yes	17
No	9
Maybe	3

Abbreviations: IUD, intrauterine device; LNG IUS, levonorgestrel intrauterine system.
↵a Source: In-depth interviews with LNG IUS clients. Sociodemographic data and data on desire for future children are missing for 4 women.
b Not mutually exclusive.