Assessing the Knowledge, Attitudes and Perceptions on the Use of Intra-uterine Contraceptive Device Among Women in Ndola: A Case of Masala Clinic

Abstract Background Intra-Uterine Devices (IUDs) are highly effective long-acting reversible contraceptives, yet utilization remains extremely low in Zambia at 0.7% among married or sexually active women of reproductive age. This study assessed knowledge, attitudes, and perceptions regarding IUD use among women attending Masala Clinic in Ndola, Zambia. Methods A descriptive cross-sectional study was conducted among 270 women of reproductive age (15–49 years) attending Masala Clinic. Systematic random sampling was employed. Data were collected using a structured questionnaire assessing socio-demographics, knowledge, attitudes, and perceptions. Descriptive statistics, chi-square tests, and binary logistic regression were used for analysis. Results Only 37.8% of respondents had heard of IUDs, and 17.8% had adequate knowledge. Major misconceptions included beliefs that IUDs affect future fertility (80.7%) and protect against STIs (85.9%). Negative attitudes were held by 77.0%, and 78.5% held unfavorable perceptions. Willingness to use IUDs was low (25.2%), and current IUD utilization was only 3.6% among contraceptive users. Fear of side effects (36.6%), cultural/religious beliefs (19.7%), and lack of knowledge (18.3%) were the main barriers. Adequate knowledge (AOR = 3.42), positive attitudes (AOR = 4.18), favorable perceptions (AOR = 3.86), and secondary education (AOR = 2.84) were significant predictors of willingness to use IUDs. Conclusion Knowledge, attitudes, and perceptions regarding IUDs are predominantly poor among women at Masala Clinic, contributing to low uptake. Targeted health education, improved provider counseling, and community engagement are urgently needed.