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Prevalence and factors associated with the use of long-acting reversible and permanent contraceptive methods among women who desire no more children in Bangladesh

Contraception and Reproductive Medicine volume 10, Article number: 32 (2025) Cite this article

Abstract

Background

Long-acting reversible and permanent contraceptive methods (LARC/PM) with high efficacy and continuity of use are highly effective pregnancy prevention methods. However, most sexually active women do not use it and end up with unintended pregnancies and unsafe abortions in Bangladesh. This study aims to assess the prevalence of LARC/PM use and its determinants among sexually active women who desire no more children in Bangladesh.

Methods

The study used Bangladesh Demographic and Health Survey (BDHS) 2017-18 data, which employed a two-stage cluster sampling design. This study extracted 6422 married women of reproductive age who desired no more children. Descriptive statistics were used to present the characteristics of the women. Chi-square and binary logistic regression were also used to identify the factors associated with LARC/PM use.

Results

A total of 20.2% of women use LARC/PM who desire no more children. Women aged 25–34 (aOR = 1.52, 95% CI: 1.10–2.09) and 35 years and above (aOR = 1.99, 95% CI: 1.41–2.81), women from Rangpur (aOR = 2.27, 95% CI = 1.57–3.28), Rajshahi (aOR = 2.15, 95% CI = 1.49–3.11), Khulna (aOR = 2.17, 95% CI = 1.48–3.17), Sylhet (aOR = 1.66, 95% CI = 1.07–2.58) and Dhaka (aOR = 1.97, 95% CI = 1.37–2.83) divisions, who were non-Muslims (aOR = 1.72, 95% CI = 1.40–2.11), having a desired number of children (2+) (aOR = 1.27, 95% CI = 1.08–1.49), whose contraceptive decision solely made by husband (aOR = 3.61, 95% CI = 2.73–1.77) or jointly (aOR = 1.59, 95% CI = 1.32–1.92) were more likely to use LARC/PM. On the other hand, women with primary education (aOR = 0.78, 95% CI = 0.65–0.92), secondary education (aOR = 0.59, 95% CI = 0.47–0.72) and higher education (aOR = 0.64, 95% CI = 0.43–0.95) belonging to richest wealth index (aOR = 0.73, 95% CI = 0.55–0.97), having at least two living children (aOR = 0.62, 95% CI = 0.44–0.85), partner with secondary education (aOR = 0.79 95% CI = 0.65–0.97) and women who were visited by family planning (FP) visitors (aOR = 0.34, 95% CI = 0.29–0.40) were less likely to use LARC/PM.

Conclusion

The LARC/PM use rate among women in Bangladesh is low. It must be increased to meet the targets of the Sustainable Development Goals (SDGs). To increase LARC/PM use in Bangladesh, attention should be given to factors like women’s age, education, partner’s education, religion, wealth index, division, number of living children, and desired number of children.

Introduction

Family planning (FP), one of the ten outstanding public health achievements of the 20th century, allows individuals to determine their family size and the timing and spacing of the children, resulting in better socio-economic and health outcomes for a population [1, 2]. Effective family planning methods play a crucial role in public health by helping individuals control fertility and plan families, which can reduce maternal and child mortality rates. It includes primarily, among other things, contraception, a method of birth control, which refers to the deliberate prevention of pregnancy during sexual activity by using devices, agents, medications, sexual behavior, or surgery [3]. There are short-term modern contraceptive methods (pills, injectables, condoms) and long-term methods, including intrauterine devices (IUDs), implants, tubal ligation, and vasectomy [4]. Among them, IUDs and implants are considered long-acting reversible methods. At the same time, tubal ligation and vasectomy are the permanent methods, which are, in short, called Long-acting reversible and permanent contraceptive methods (LARC/PM) [5]. Effective contraception can play a vital role in reducing maternal and child mortality by preventing unwanted pregnancies [6]. Furthermore, increasing access to effective contraceptive methods is essential for achieving different targets of Sustainable Development Goal 3 (SDGs) like reducing maternal mortality, reducing neonatal and under-5 mortality, and caring for sexual and reproductive health, including family planning, which all would contribute to achieving universal health coverage by 2030 [6].

Although the proportion of women satisfied with their FP needs has increased worldwide, significant change has yet to be found with the unmet needs. Increased contraceptive prevalence rate (CPR), among many factors, is essential in reducing fertility [4, 6]. However, along with increased CPR, the effectiveness and user adherence to the FP methods are crucial [7]. High failure rates of short-term methods contribute to unintended pregnancies. LARC/PM has a high use-effectiveness, low discontinuation and failure rate, and has the potential to reduce unintended pregnancies and abortions [8, 9]. Therefore, the LARC/PM could help reduce the FP unmet needs in delaying, spacing and limiting births [10]. However, the use rate of LARC/PM is low in developing countries [11, 12].

In Bangladesh, CPR has increased from 8.0% in 1975 to 64.0% in 2022, yet unmet needs persist, especially in certain regions [13, 14]. Rajshahi and Rangpur divisions have the highest CPR (61.0% each), while Sylhet and Chattogram divisions have the lowest CPR (49.0% and 44.0%, respectively) with high unmet needs [15]. The total fertility rate (TFR) was 2.3 in 2022, which has remained unchanged since 2011 [14]. Despite efforts, CPR in Bangladesh has only slightly increased recently, and reliance on short-term methods remains high. High failure rates of short-term methods contribute to unintended pregnancies and abortions [10, 16, 17]. Thus, almost 0.7 more children are being born than the desired fertility rate, which means the fertility rate could be lower than the present one if there were no unplanned or unwanted pregnancies [5]. The targets of the 4th Health, Population, and Nutrition Sector Program’s (4th HPNSP) of CPR (75.0%) and TFR (2.0) were not achieved by 2023 [6].

Given the high effectiveness and reliability of LARC/PM, it is essential to promote these methods to women who want birth spacing and those who desire no more children. Using LARC/PM allows women to make an informed decision about whether to limit or space childbearing. However, the use of LARC/PM is only 8.0%, which is incomprehensible compared to other contraceptive methods. Considering the benefits of LARC/PM, Bangladesh targeted to increase the usage of LARC/PM from 8.0 to 20.0% as in the 4th HPNSP 2017–2022; however, it failed to achieve [6, 13, 14]. Different interventions were taken to increase the usage of LARC/PM, including enhancing the knowledge and skills of service providers through training, financial assistance, home visits by family welfare assistants (FWAs), courtyard meetings, distribution of behavior change communication (BCC) materials (billboards, posters, and leaflets), etc [5]. Increased usage of LARC/PM would help the country a lot to address the issues of high teenage pregnancy, low use of modern contraception methods, increased unmet need, divisional variations in CPR, a large number of unplanned pregnancies, and stalled fertility. Low uptake of LARC/PM is particularly problematic in Bangladesh because of high teenage pregnancies and unmet needs for family planning. To enhance the use of LARC/PM, it is essential to examine the determinants of LARC/PM use. This study aimed to investigate the factors associated with LARC/PM use among Bangladeshi women who wish to limit further childbearing, which would ultimately lower the TFR and achieve the related targets of SDG 3.

Data and methods

The Bangladesh Demographic and Health Survey (BDHS) 2017-18 dataset was used for this study [13]. It collected reliable and internationally comparable data for making policies and programs based on evidence and tracking advancements toward national and international development goals. BDHS 2017-18 employed a two-stage cluster sampling design for collecting data. The first stage involved selecting enumeration areas (EA) using a probability proportional process. A total of 675 EAs were selected with this process. In the second stage, once the enumeration areas were chosen, a household listing was performed within these designated areas. Then, a systematic sample of 30 households was selected from each primary sampling unit (PSU). According to the IR (birth record) file, 20,127 women aged between15-49 were interviewed to gather information on contraceptive use (Fig. 1). BDHS 2017-18 obtained ethical approval from the Ethical Review Committee (ERC) and the Bangladesh Medical Research Council (BMRC), Dhaka, Bangladesh.

Fig. 1
figure 1

The flow-chart illustrating the final sample selection for the current study

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The study excluded sexually inactive women, women who wanted more children, infecund women, and those who were not using any methods or using traditional methods. Among 20,127 women, 5101 women who were sexually inactive in the last four weeks and 6758 women who wanted more children were excluded from the study. Furthermore, 850 infecund women were also excluded. Additionally, 996 women were not using any method, and women using traditional methods (periodic abstinence, withdrawal, and other traditional methods) were also excluded from the study. As these filters are not mutually exclusive, the final analysis included only sexually active 6422 women who desire no more children and use modern contraception. Potential sampling weight adjustments for BDHS 2017-18 data were applied to ensure representativeness.

Outcome variable

The primary outcome variable of the study was the current method of contraception use among sexually active women who desire no more children. This study included only the women who were using modern contraceptives. Modern contraceptive use was categorized into two categories: 0 = not using LARC/PM, and 1 = LARC/PM users. Here, women who were using pills, injections, emergency contraception, and other modern methods and whose husbands were using condoms were classified as not using LARC/PM. On the other hand, when women or their husbands were sterilized or women using IUDs, implants/nor-plant were classified as LARC/PM users.

Independent variables

After a literature review, this study included several independent variables and analyzed the variables presented in the BDHS-2017-2018. Some demographic, socio-economic, and family planning variables were selected. The demographic variables included the respondent’s age, the number of living children, and the desired number of children. The socio-economic variables included- place of residence, religion, education status, wealth index, region, partner’s education, child marriage, sex of the household head, and decision maker for using contraception. The family planning variables included access to media and visits by FP workers. Some independent variables were re-categorized to produce a more meaningful interpretation. The categories of independent variables are given in Table 1:

Table 1 Categories of the independent variables
Full size table

Statistical analysis

Descriptive analyses were used to show the frequency and percentage distribution of the explanatory variables to summarize the findings. A bivariate analysis, which includes cross-tabulation with chi-square, was also conducted. Finally, the binary logistic regression included independent variables with a p-value less than 0.05, as the outcome variables included binary factors. Since our dependent variable is dichotomous, we used a binary logistic regression model instead of other regression models for multivariable analysis. The results were presented in the adjusted odd ratio (aOR) with a 95% confidence interval. All the analyses were done using SPSS version 20.

Results

Among the sexually active women who desire no more children, only 20.2% of them use LARC/PM, whereas 79.8% of women use other modern methods, indicating that the prevalence of using different methods was higher among sexually active women even if they do not want any more children (Fig. 2).

Fig. 2
figure 2

Prevalence of LARC/PM use among sexually active women who want no more children

**Only modern method of contraception was included in the analysis

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Table 2 shows that the highest number of women (46.5%) belong to the 25–34 age category, and the second highest number of women (44.4%) were from the 35 and above age group, whereas only 9.1% of women are in the 15–24 age group. Among the respondents, 71.1% of women lived in rural areas, and only 28.9% lived in urban areas. Most respondents are Muslim (88.5%), and 11.5% follow other religions. Regarding educational status, 37.1% of women had secondary education, and 36.5% of women had primary education, whereas the percentage of no education (18.4%) and higher education (8.0%) were relatively low. Among the respondents, 21.4% belong to the poorest wealth quintile, and the percentage of poorer (20.8%) and middle (20.0%) wealth quintiles were closely similar. The highest number of women was from the Dhaka division (25.0%), and the lowest number of respondents was from the Barishal (5.2%) and Sylhet (5.1%) divisions.

Table 2 Distribution of modern contraceptive users of sexually active women who desire no more children (n = 6422)
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Regarding partner’s education, 27.3% had no education, whereas 34.8% and only 12.4% had primary and higher education, respectively. Among the respondents, 54.2% had access to media, and 79.6% had married before the age of 18. The percentage of different categories for 0–1 living children, two living children, and more than two living children were 4.8%, 43.4%, and 51.9%, respectively. The husband predominantly made the contraceptive decision in the past, and this scenario has changed a lot now. An overwhelming 76.4% of contraceptive decisions were made jointly by the respondent and her partner (Table 2).

Most of the respondents (71.3%) reported that they were not visited by FP visitors (Table 2). The maximum number of respondents (79.3%) desired to have two children. Among the respondents, 56.5% were currently working, and 21.4% have had an abortion. Only 34.1% of the respondents had good knowledge of ovulatory cycles, and 19.9% were breastfeeding.

Table 3 shows that almost all the explanatory variables had a significant association with the use of LARC/PM (p < 0.05) except access to media, sex of household head, knowledge of the ovulatory cycle, and having ever had an abortion. Among the women aged 35 and above, 26.3% reported using LARC/PM. The preference (9.7%) was lower among women aged 15–24. On the other hand, rural women had a higher prevalence (21.2%) of using LARC/PM.

Table 3 Use of LARC/PM by demographic, socio-economic, and family planning factors
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Among the Muslim women, 19.7% reported using LARC/PM, and 24.2% of non-Muslim women had a preference for using LARC/PM. Women from the Dhaka division (29.4%) preferred to use LARC/PM. Meanwhile, women living in Barishal (13.4%) had a lower prevalence. Among the respondents with no education, 31.7% preferred to use LARC/PM, whereas only 12.8% of women with higher education reported using LARC/PM. Of women working, 21.0% preferred to use LARC/PM. Women in the poorest wealth quintile (24.7%), having more than two living children (26.1%), got married before the age of 18 (21.2%), and women whose desired number of children was more than 2 (28.7%) had a higher preference to use LARC/PM.

Respondents who reported their husbands’ having no education (27.1%) preferred to use LARC/PM. Almost 14.0% of the women who were currently breastfeeding had a preference to use LARC/PM as their contraceptive method. Contraceptive decisions made by husbands (36.8%) and had not been visited by FP visitors (24.3%) had a higher preference to use the LARC/PM (Table 3).

Binary logistic regression was performed to assess the impact of several factors on the likelihood that respondents prefer to use LARC/PM. The model contained fourteen independent variables. As shown in Table 3, nine of the independent variables made a unique statistically significant contribution to the model (age, religion, educational status, wealth index, division, partner’s education, number of living children, desired number of children, visited by FP workers, decision makers for using contraception).

Results on factors associated with LARC/PM use are presented in Table 4. Women aged 25–34 were 1.5 times (aOR = 1.51, 95% CI: 1.10–2.09), and women aged 35 and above were 1.9 times (aOR = 1.99, 95% CI: 1.41–2.81) higher preference to use LARC/PM than women belonging to 15–24 age group. The odds of using LARC/PM were higher among rural women compared to urban, but the result was not statistically significant. Compared with women who had no education, those with primary (aOR = 0.78, 95% CI: 0.65–0.92), secondary (aOR = 0.59, 95% CI: 0.47–0.72), and higher education (aOR = 0.64, 95% CI: 0.43–0.95) were less likely to use LARC/PM. The odds of using LARC/PM among non-Muslim women (aOR = 1.72, 95% CI: 1.40–2.11) were 1.7 times higher compared with Muslim women.

Table 4 Factors associated with the use of LARC/PM among women who desire no more children
Full size table

Partners with secondary education (aOR = 0.79, 95% CI: 0.65–0.97) were less likely to use LARC/PM than those without education. The odds of using LARC/PM among women with two living children (aOR = 0.62, 95% CI: 0.44–0.85) were 38.0% less likely than those with zero or one child. Results showed that decisions made by only the husband (aOR = 3.61, 95% CI: 2.73–4.77) and joint decisions (aOR = 1.59, 95% CI: 1.32–1.92) had 3.6 and 1.5 times higher odds of using LARC/PM respectively than a decision made by only women.

Women from the richest wealth index (aOR = 0.73, 95% CI: 0.55–0.97) were 27.0% less likely to use LARC/PM than the poorest. Women who were visited by FP workers (aOR = 0.34, 95% CI: 0.29–0.40) had a 66.0% lower likelihood of using LARC/PM than those who were not visited by FP workers. Compared with women living in Barisal, those living in Dhaka (aOR = 1.97, 95% CI: 1.37–2.83), Khulna (aOR = 2.17, 95% CI: 1.48–3.17), Rajshahi (aOR = 2.15, 95% CI: 1.49–3.11), Rangpur (aOR = 2.27, 95% CI: 1.57–3.28) and Sylhet (aOR = 1.66, 95% CI: 1.07–2.58) were more likely to use LARC/PM (Table 4).

Discussion

This study aimed to find the prevalence and factors associated with the use of LARC/PM among sexually active women who want no more children. The study found that around 20.0% of sexually active women who wished to have no more children were using LARC/PM, which is similar to the prevalence of Senegal (20.9%) [7]. It implies that a considerable portion of women could not fulfill their desire for no more children. They may be going through an unwanted pregnancy, menstrual regulation (MR), childbearing, or other adverse effects or health consequences. Similar to other studies, in the face of high teenage pregnancy, high rate of MR, and high maternal mortality rate, effective and enhanced use of LARC/PM can reduce the adverse effects of reproductive health complications in the country [18, 19]. The prevalence of using LARC/PM was higher in Indonesia (28.0%) [20], India (43.0%), and Nepal (27.0%) [21] than in our findings. This variation in the prevalence of LARC/PM may be attributed to variations in the country-specific programs and interventions regarding contraceptive usage. Access to FP services in those countries remains uneven by province, region, and division due to policy issues, beliefs, and practices of societies [22, 23]. However, the countries’ governments are committed to increasing FP services to improve maternal and child health, reduce poverty, and promote economic growth [24]. Except for religion, India and Nepal have socio-economic and cultural settings similar to Bangladesh’s. Society’s traditions, religion, and other cultural factors may also be accountable for these differences.

This study revealed that women aged 24–34 and 35 and above age group had a higher preference to use LARC/PM than women in the young age group. Women aged 15–24 in Sub-Saharan Africa were less likely to use LARC/PM than women in the higher age group [25]. Studies from Ethiopia [26] and Nigeria [27] showed similar findings regarding the age of women and the use of LARC/PM. Women belonging to the young age group may have less knowledge and access to contraceptive methods [28]. In contrast, higher age group women know more about FP methods [29]. Also, they may have reached their desired number of children, which motivates them to use LARC/PM to avoid unwanted pregnancies [30].

The findings of the study also showed that uneducated women were more likely to use LARC/PM. The findings are similar to those of Indonesia [20], Kenya [31], and Ethiopia [32]. Women whose husbands had no or low levels of education had a higher preference to use LARC/PM than husbands with secondary or higher education [33]. A possible explanation could be that less educated or uneducated women are more likely to marry at a young age and have their desired number of children earlier than the higher-educated women. So, they use LARC/PM more than educated women to prevent unintended pregnancies when they have the desired number of children already. Alternative findings have also found that higher-educated women were more likely to use LARC/PM [7, 31, 34]. Women with higher education may have better access to FP methods-related knowledge and information, which helps them choose a better and more realistic birth/contraceptive plan in the context of their lives. On the other hand, educated women have better access to decision-making regarding contraception, which makes it possible that higher-educated women have a higher likelihood to use LARC/PM [35, 36]. So, the context is that the uneducated poor women who got early marriage and already had the desired number of children and were intervened/visited by FP visitors/workers were prone/more likely to use LARC/PM. The second group of educated women, those who got married late and wanted a birth, did not use LARC/PM. At the same time, educated women who were in service and had birth/contraceptive plans or achieved the desired number of births were already the users of LARC/PM [37]. One possible explanation for these findings is that poor and uneducated men and women were given financial incentives from the government to use LARC/PM. An amount of BDT 2300.00 ($1 = BDT 119.00) as financial incentives or compensations to the permanent service recipient, BDT 873.00 for an intrauterine device (IUD), and BDT 690.00 for implant receivers are provided by the government. The government also provides necessary medicines for the clients at the facilities [5].

Place of residence has a significant influence on the use of LARC/PM. It implies that division-specific cultural practices, marriage, and childbearing norms, practices, or programmatic implications have differences and must be studied. Other studies have shown a significant association between place of residence and use of LARC/PM [7, 38, 39]. Women from the richest wealth quintile were less preferred/likely to use LARC/PM than the women from the poorest wealth quintile [40, 41]. Studies from Nigeria [27] and India [21] revealed consistent findings that women with poor wealth index are more likely to use LARC/PM. The reason might be that the richest women might be in service or have defined planning for childbearing, so they go for LARC/PM for their planned childbearing. The higher prevalence of the use of LARC/PM among poor women in India may be resulted from charge-free services. Findings from Nepal [41], Iran [42], and Ethiopia [26] revealed that women from the rich wealth index also have a higher likelihood of using LARC/PM. This study showed that women with zero or one child are more likely to use LARC/PM compared to women with two children. This is because a woman with no or one child wants to delay or space their pregnancies [43], and as early marriage is high, FP providers counsel for LARC/PM to delay early pregnancy [44]. In comparison, other studies showed that women with high parity have a higher prevalence of using LARC/PM to limit their pregnancies [45, 46]. The focus should be given to the women in the highest wealth quintile to increase their use of LARC/PM and to the women in the lowest quintile to maintain the existing level of use at least.

Studies conducted in Nepal [41] and Ethiopia [26] revealed similar results that non-Muslim women have a higher preference to use LARC/PM than Muslim women. This may be due to disagreements between religious practices and contraceptive avoidance [47]. Results show that contraceptive decisions made by the husband or jointly have a higher association with the use of LARC/PM, which is similar to other studies in which husband approval significantly affects contraceptive usage [26, 48]. The possible reason for this finding could be that Bangladesh is a traditional patriarchal society where women are expected to follow their husbands’ decisions in every situation.

Strengths and limitations

The strength of this study is that it used nationally representative data from BDHS-2017-18 to determine the prevalence and determinants of LARC/PM among women. On the other hand, the study’s limitation is that it used a cross-sectional design, which prevents drawing a causal relationship between the outcome and explanatory variables and self-reported data that may introduce bias.

Conclusion

The study found low utilization of LARC/PM and/by a varied proportion of women who desire no more children in Bangladesh. Individual factors like higher education, older/higher age, women whose husbands had secondary education, number of living children, the desired number of children, jointly contraceptive decision-making, and community factors like household wealth, women who were visited by FP visitors, place of residence, religion were the significant predictors of LARC/PM use. Our policymakers and concerned stakeholders should pay attention to the vital predictors during the implementation of the policies, strategies, and interventions to enhance LARC/PM use among women who desire no more children. Policy revisits and adjustments may needed to target age, wealth, and education gaps, especially for underserved groups of the country. More in-depth research, especially longitudinal research, is required to understand the causative relationship of the phenomena better. The study findings would be relevant for similar socio-economic and low-resource settings beyond the study’s immediate context.

Data availability

Bangladesh Health and Demographic Survey (BDHS) data is open and available online.

References

  1. MH&FW. Bangladesh FP2030 Country Commetment. In. Dhaka: Medical Education and Family Welfare Division. Ministry of Health and Family Welfare Division (MH&FW); 2022. pp. 1–8.

  2. UN. Family Planning and the 2030 Agenda for Sustainable Development: Data Booklet. (ST/ESA/SER.A/429). In. NY: United Nations, Department of Economic and Social Affairs, Population Division; 2019.

  3. Hossain MB, Khan MHR, Ababneh F, Shaw JEH. Identifying factors influencing contraceptive use in Bangladesh: evidence from BDHS 2014 data. BMC Public Health. 2018;18(1):192.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Islam SM. Determinants of contraceptive method choice in Bangladesh: Male perspectives. South East Asia J Public Health. 2014;3(1):50–6.

    Article  Google Scholar 

  5. Dana GPT, Sutopa TS, Afroz S. Disparities in readiness of health facilities to provide long-acting reversible contraceptives (LARCs) and permanent methods (PMs) in Bangladesh. Heliyon. 2023;9(4):e15349.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Nations U, Affairs DE, Social, Division P. Family planning and the 2030 agenda for sustainable development. Dep Econ Soc Aff Popul Div [Internet] 2019.

  7. Bolarinwa OA, Afaya A, Ajayi KV, Ojo A, Alawode OA. Prevalence and factors associated with the use of long-acting reversible and permanent contraceptive methods among women who desire no more children in high fertility countries in sub-saharan Africa. BMC Public Health. 2022;22(1):2141.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Rahman M, Haider MM, Curtis SL, Lance PM. The Mayer Hashi Large-Scale Program to Increase Use of Long-Acting Reversible Contraceptives and Permanent Methods in Bangladesh: Explaining the Disappointing Results. An Outcome and Process Evaluation. Global health Sci Pract. 2016;4(Suppl 2):S122–139.

    Article  Google Scholar 

  9. Burns AAL, Maxwell R. J.;: Where Women Have No Doctor: A Health Guide for Women. 8th ed. Hesperian Health Guides; 2020.

  10. Huda FA, Robertson Y, Chowdhuri S, Sarker BK, Reichenbach L, Somrongthong R. Contraceptive practices among married women of reproductive age in Bangladesh: a review of the evidence. Reproductive Health. 2017;14(1):69.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Harzif AK, Mariana A, Malik DM, Silvia M, Lovita BT. Factors associated with the utilization of long-acting reversible contraceptives among family planning clients at the Pameungpeuk Rural Hospital, Indonesia. F1000Research 2018, 7:1891.

  12. Negash WD, Belachew TB, Asmamaw DB. Long acting reversible contraceptive utilization and its associated factors among modern contraceptive users in high fertility sub-Saharan Africa countries: a multi-level analysis of recent demographic and health surveys. Archives public health = Archives belges de sante publique. 2022;80(1):224.

    Article  Google Scholar 

  13. National Institute of, Population R, Training N, Ministry of H, Family W. Icf: Bangladesh Demographic and Health Survey 2017-18. In. Dhaka. Bangladesh: NIPORT/ICF; 2020.

    Google Scholar 

  14. ICF NIoPRaTNa: Bangladesh Demographic and Health Survey 2022. In. Dhaka, Bangladesh, and Rockville, Maryland, USA. 2022: 1-600.

  15. Amin S, Basu AM, Stephenson R. Spatial variation in contraceptive use in Bangladesh: looking beyond the borders. Demography. 2002;39(2):251–67.

    Article  PubMed  Google Scholar 

  16. Policy Brief. Potential interventions to improve the use of long-acting reversible contraceptives and permanent methods in Bangladesh.

  17. Barkataki S, Huda F, Nahar Q, Rahman M. Postpartum Family Planning in Bangladesh: A Situation Analysis and Way Forward. In. Dhaka, Bangladesh and Chapel Hill, NC, USA; 2019.

  18. Initiative I, Mutemwa R. Fertility intentions and contraceptive practices among clinic-users living with HIV in Kenya: a mixed methods study. 2017.

  19. Baynes C, Kahwa J, Lusiola G, Mwanga F, Bantambya J, Ngosso L, Hiza M. What contraception do women use after experiencing complications from abortion? An analysis of cohort records of 18,688 postabortion care clients in Tanzania. BMC Womens Health. 2019;19:1–12.

    Article  Google Scholar 

  20. Gayatri M. The use of long-acting and permanent contraceptive methods (LAPMs) among women who have completed childbearing in Indonesia: does informed choice matter? Eur J Contracept reproductive health care: official J Eur Soc Contracept. 2022;27(1):28–33.

    Article  Google Scholar 

  21. Ugaz JI, Chatterji M, Gribble JN, Banke K. Is Household Wealth Associated With Use of Long-Acting Reversible and Permanent Methods of Contraception? A Multi-Country Analysis. Global health Sci Pract. 2016;4(1):43–54.

    Article  Google Scholar 

  22. Maharani A, Sujarwoto S, Ekoriano M. Health insurance and contraceptive use, Indonesian Family Planning Census 2021. Bull World Health Organ. 2023;101(8):513–21.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Matsushita T, Hasegawa T, Noma H, Ota E, Chou VB, Okada Y. Interventions to increase access to long-acting reversible contraceptives: Cochrane Database Syst Rev. 2021;2021(11):CD014987. https://doiorg.publicaciones.saludcastillayleon.es/10.1002/14651858.CD014987. eCollection 2021.

  24. Das M, Anand A, Hossain B, Ansari S. Inequalities in short-acting reversible, long-acting reversible and permanent contraception use among currently married women in India. BMC Public Health. 2022;22(1):1264.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Bolarinwa OA, Nwagbara UI, Okyere J, Ahinkorah BO, Seidu AA, Ameyaw EK, Igharo V. Prevalence and predictors of long-acting reversible contraceptive use among sexually active women in 26 sub-Saharan African countries. Int health. 2022;14(5):492–500.

    Article  PubMed  Google Scholar 

  26. Gashaye KT, Tsegaye AT, Abebe SM, Woldetsadik MA, Ayele TA, Gashaw ZM. Determinants of long acting reversible contraception utilization in Northwest Ethiopia: An institution-based case control study. PLoS ONE. 2020;15(10):e0240816.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Ejembi CL, Dahiru T, Aliyu AA. Contextual factors influencing modern contraceptive use in Nigeria. In: DHS Working Papers No 120. Rockville, Maryland, USA: ICF International; 2015.

  28. Craig AD, Dehlendorf C, Borrero S, Harper CC, Rocca CH. Exploring young adults’ contraceptive knowledge and attitudes: disparities by race/ethnicity and age. Women’s health issues: official publication Jacobs Inst Women’s Health. 2014;24(3):e281–289.

    Article  Google Scholar 

  29. Tilahun T, Coene G, Luchters S, Kassahun W, Leye E, Temmerman M, Degomme O. Family planning knowledge, attitude and practice among married couples in Jimma Zone, Ethiopia. PLoS ONE. 2013;8(4):e61335.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Bulto GA, Zewdie TA, Beyen TK. Demand for long acting and permanent contraceptive methods and associated factors among married women of reproductive age group in Debre Markos Town, North West Ethiopia. BMC Womens Health. 2014;14(1):46.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Ontiri S, Ndirangu G, Kabue M, Biesma R, Stekelenburg J, Ouma C. Long-Acting Reversible Contraception Uptake and Associated Factors among Women of Reproductive Age in Rural Kenya. Int J Environ Res Public Health 2019, 16(9).

  32. Amo-Adjei J, Mutua M, Mukiira C, Mutombo N, Athero S, Ezeh A, Izugbara C. Fertility intentions and the adoption of long-acting and permanent contraception (LAPM) among women: evidence from Western Kenya. BMC Womens Health. 2019;19(1):26.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Kateregga W, Oluka J: 31., Kateregga W, Oluka J. (2022). Factors contributing to Low Uptake of Long Acting Reversible contraceptives among Women aged 18–45 years in Maanyi Health Centre III, Mityana District. A Cross-section Study. Journal of Health Research Africa 2022, 3(6):16–16.

  34. Alemayehu M, Kalayu A, Desta A, Gebremichael H, Hagos T, Yebyo H. Rural women are more likely to use long acting contraceptive in Tigray region, Northern Ethiopia: a comparative community-based cross sectional study. BMC Womens Health. 2015;15(1):71.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Zenebe CB, Adefris M, Yenit MK, Gelaw YA. Factors associated with utilization of long-acting and permanent contraceptive methods among women who have decided not to have more children in Gondar city. BMC Womens Health. 2017;17(1):75.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Bolarinwa OA, Ajayi KV, Okeke SR, Hailegebreal S, Odimegwu C. Spatial distribution and multilevel analysis of factors associated with long-acting reversible contraceptive use among sexually active women of reproductive age in Nigeria. Archives Public Health. 2023;81(1):99.

    Article  Google Scholar 

  37. Pazol K, Zapata LB, Tregear SJ, Mautone-Smith N, Gavin LE. Impact of Contraceptive Education on Contraceptive Knowledge and Decision Making: A Systematic Review. Am J Prev Med. 2015;49(2 Suppl 1):S46–56.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Bolarinwa OA, Olagunju OS. Knowledge and factors influencing long-acting reversible contraceptives use among women of reproductive age in Nigeria. Gates open Res. 2019;3:7.

    Article  PubMed  Google Scholar 

  39. Ujah OI, Kirby RS. Long-Acting Reversible Contraceptive Use by Rural-Urban Residence among Women in Nigeria, 2016–2018. Int J Environ Res Public Health 2022, 19(20).

  40. Sharif AB, Hasan MT, Naziat MH, Zerin T, Kundu S. Permanent, long-acting and short-acting reversible contraceptive methods use among women in Bangladesh: an analysis of Bangladesh Demographic and Health Survey 2017–2018 data. BMJ open. 2023;13(7):e073469.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Bhandari R, Pokhrel KN, Gabrielle N, Amatya A. Long acting reversible contraception use and associated factors among married women of reproductive age in Nepal. PLoS ONE. 2019;14(3):e0214590.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Azmoude E, Behnam H, Barati-Far S, Aradmehr M. Factors Affecting the Use of Long-Acting and Permanent Contraceptive Methods Among Married Women of Reproductive Age in East of Iran. Women’s Health Bull. 2017;4(3):1–8.

    Article  Google Scholar 

  43. MacQuarrie KLD, Nahar Q, Khan R, Sultana M. Why so young? The social context of early childbearing and contraception among young women in Khulna, Bangladesh. DHS Further Analysis Reports No 99. Maryland, USA: ICF International;: Rockville; 2016.

    Google Scholar 

  44. Samandari G, Sarker BK, Grant C, Huq NL, Talukder A, Mahfuz SN, Brent L, Nitu SNA, Aziz H, Gullo S. Understanding individual, family and community perspectives on delaying early birth among adolescent girls: findings from a formative evaluation in rural Bangladesh. BMC Womens Health. 2020;20(1):169.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Anguzu R, Sempeera H, Sekandi JN. High parity predicts use of long-acting reversible contraceptives in the extended postpartum period among women in rural Uganda. Contracept reproductive Med. 2018;3:6.

    Article  Google Scholar 

  46. Orwa J, Gatimu SM, Ngugi A, Agwanda A, Temmerman M. Factors associated with use of long-acting reversible and permanent contraceptives among married women in rural Kenya: A community-based cross-sectional study in Kisii and Kilifi counties. PLoS ONE. 2022;17(10):e0275575.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Palamuleni ME, Adebowale AS. Women empowerment and the current use of long acting and permanent contraceptive: Evidence from 2010 Malawi Demographic and Health Survey. Malawi Med journal: J Med Association Malawi. 2014;26(3):63–70.

    CAS  Google Scholar 

  48. Mutombo N, Bakibinga P. The effect of joint contraceptive decisions on the use of Injectables, Long-Acting and Permanent Methods (ILAPMs) among married female (15–49) contraceptive users in Zambia: a cross-sectional study. Reproductive Health. 2014;11(1):51.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

The authors are thankful to the Demographic and Health Survey program under the National Institute of Population Research & Training (NIPORT), in collaboration with USAID and other partners, for making this dataset available for this study.

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Authors and Affiliations

  1. Department of Population Sciences, University of Dhaka, Dhaka, 1000, Bangladesh

    Swapna Akter, Md. Mehedi Hasan Khan, Abu Hasanat Mohammad Kishowar Hossain & Md. Aminul Haque

  2. Department of Statistics, Jagannath University, Dhaka, 1100, Bangladesh

    M. Sheikh Giash Uddin

Authors
  1. Swapna Akter
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  2. Md. Mehedi Hasan Khan
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  3. Abu Hasanat Mohammad Kishowar Hossain
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Contributions

SA, the main author, contributed to the study’s conceptualization, data analysis, data interpretation, and manuscript writing; MHK, AHMKH, and MSGU critically reviewed the manuscript; and MAH contributed to the study design, methodology, and analysis and supervised the research. All authors approved the final version of the manuscript.

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Correspondence to Md. Aminul Haque.

Ethics declarations

Ethical approval and consent to participate

The study used BDHS- 2017–2018 open data only. BDHS received ethical approval from the Ethical Review Committee (ERC) and Bangladesh Medical Research Council (BMRC), Dhaka, Bangladesh.

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We have taken consent for publication from all authors.

Ethical guidelines

We complied with all the ethical guidelines.

Competing interests

The authors declare no competing interests.

Could you please clarify whether the dataset used in the study is a public database?

The dataset is public and available online.

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Akter, S., Khan, M.M.H., Hossain, A.H.M.K. et al. Prevalence and factors associated with the use of long-acting reversible and permanent contraceptive methods among women who desire no more children in Bangladesh. Contracept Reprod Med 10, 32 (2025). https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s40834-024-00331-6

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Keywords

Contraception and Reproductive Medicine

ISSN: 2055-7426

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