Increasing desire for permanent Family Planning methods in a high HIV-prevalence rural setting in Uganda

Background: High fertility and persistent unmet need still remain health challenges among women in Uganda. We explore fertility desires, trends in use of family planning (FP) and changing FP preferences among women in a rural resource limited setting.
Methods: Retrospective analysis of non-pregnant sexually active women aged 15-44 yrs enrolled in an open community cohort between 2002 and 2008.
Results: The desire for childbearing significantly increased from 36% to 42% (p<0.0001). However, this significant increase was observed among HIV-ve and not HIV+ve women. Women’s desire for a/another child declined with age and higher parity. Use of modern FP significantly increased from 35% to 42% (p<0.0001). Among women who did not desire a/another child, increased FP use was observed for short term methods (44% to 66% among HIV+ve and 39% to 46% among HIV-ve; p<0.0001) while long term method use significantly declined from 4% to 2% among both groups of women. However, over half of the women who wanted to limit childbearing stated willingness to adopt a permanent FP method, irrespective of parity and HIV status.
Conclusions: Greater attention needs to be paid to women’s intentions to limit childbearing and to provision of long-term and permanent FP in Uganda.