Factors Associated With Willingness to Undergo Bilateral Tubal Ligation Among Women Attending Antenatal and Family Clinics of UNIOSUN Teaching Hospital, Osogbo, Nigeria.

BACKGROUND

Bilateral tubal ligation (BTL) is a surgical and permanent form of contraception offered to women who have completed their family size or for the limitation of family size due to medical conditions. The practice of BTL is, however, limited in Nigeria and other sub-Saharan African countries, due to religious and sociocultural factors, as well as misunderstanding and fear of the procedure. Therefore, this study aims to compare the willingness to undergo BTL among women attending antenatal and family planning clinics in Osogbo.

METHODS

This study was a descriptive comparative study carried out over a six-week period among women attending the antenatal and family planning clinics from December 2022 to January 2023. A minimum sample size of 123 was determined for each group. Data was obtained using a semi-structured self-administered questionnaire. Data analysis was done with IBM SPSS Statistics for Windows, version 22 (IBM Corp., Armonk, New York, United States). Chi-square test was used to determine potential statistically significant differences between the two groups. Binary logistic regression was used to predict willingness to undergo BTL. A p-value < 0.05 was considered statistically significant.

RESULTS

A total of 120 questionnaires and 100 questionnaires were properly filled out and returned from the antenatal and family planning clinics, respectively. Overall, willingness to uptake BTL was higher among women attending the family planning clinic than among those attending the antenatal clinic. Logistic regression showed that age ≥36 years (adjusted OR (AOR) = 2.30, 95%CI: 1.28-4.12, p = 0.005), having ≥2 children (AOR = 2.92-4.76, p < 0.01), desiring more than five children with a partner (AOR = 3.92, p = 0.005), and an interval of more than five years since last delivery (AOR = 3.17, p = 0.003) significantly predicted willingness for BTL. Partner support was the strongest predictor (AOR = 4.25, 95% CI: 2.38-7.59, p < 0.001).

CONCLUSION

Willingness to undergo BTL is higher among older, high-parity women and strongly influenced by partner approval. Interventions to improve BTL acceptance should prioritize couple-focused counselling, engage men in reproductive health decisions, and integrate BTL education into antenatal services.