Method-specific beliefs associated with the choice of future contraception among women in refugee settlements in Uganda

Introduction: Factors underlying reproductive decisions, including contraceptive method choice, are poorly understood, especially in humanitarian settings where sexual and reproductive health (SRH) needs may be highest due to heightened risk of sexual violence and disruptions of health services. The study examined the association between method-specific beliefs and future method choice among women in refugee settlements in Uganda. Methods: Data were from a baseline of a one-year prospective study involving a cohort of 2,498 women aged 15-45 years living in Kiryadongo and Kyangwali refugee settlements. Analysis used cross-tabulation with chi-square test and conditional logistic regression analysis to examine associations between method-specific beliefs and intention to use injectables, implants, or pills among contraceptive non-users. Result: = 1,486), 32% intended to use a method within the next 12 months or later. Injectable was the most preferred future method (39%), followed by implants (25%) and pills (17%). Concerns about interference with menstruation, unpleasant side effects, and safety for long-term use were common across all three methods (range 58% - 90%). The likelihood that a woman intended to use injectable, implant, or pill in future was positively associated with perceived ease to access (AOR = 1.95; 95% CI: 1.03-3.66), ease of use (AOR = 4.17; 95% CI: 2.22-7.86), safety for long use (AOR = 4.51; 95% CI: 1.61-12.64), and satisfaction with past use (AOR = 2.87; 95% CI: 1.51-5.46). Conclusion: Intention to use contraception in future among non-users in refugee settlements is low, coupled with widespread negative beliefs about available methods. There is need to improve counseling to counter negative beliefs and to expand access to a range of modern contraceptive methods.