Maternal and child health and family planning service utilization in Guatemala: implications for service integration

2005 ◽  
Vol 61 (2) ◽  
pp. 279-291 ◽  
Author(s):  
Eric E. Seiber ◽  
David R. Hotchkiss ◽  
Jeffrey J. Rous ◽  
Andrés A. Berruti
Keyword(s):  
Family Planning ◽  
Child Health ◽  
Service Utilization ◽  
Maternal And Child Health ◽  
Family Planning Service ◽  
Service Integration ◽  
Planning Service ◽  
And Child Health

scholarly journals Impact of COVID-19 Pandemic on Utilization of Facility-Based Essential Maternal and Child Health Services in North Shewa Zone, Ethiopia

2022 ◽  
Author(s):  
Chalachew Bekele ◽  
Delayehu Bekele ◽  
Bezawit Hunegnaw ◽  
Kimiko Van Wickle ◽  
Fanos Ashenafi ◽  
...  
Keyword(s):  
Health Care ◽  
Family Planning ◽  
Child Health ◽  
Service Utilization ◽  
Health Care Providers ◽  
Maternal And Child Health ◽  
Child Health Services ◽  
Care Providers ◽  
New Family ◽  
And Child Health

Introduction: Ethiopia registered its first case of COVID-19 on March 13, 2020. We aimed to assess maternal, newborn, and child health care (MNCH) utilization during the first six months of the COVID-19 pandemic, as well as potential barriers and enablers of service utilization from health care providers and clients. Methods: Mixed study design was conducted as part of the Birhan Health and Demographic Surveillance System in Ethiopia. The trend of service utilization during the first six months of COVID-19 was compared to corresponding time and data points of the preceding year. Result: Service utilization of new family planning visits (43.2 to 28.5/month, p = 0.014) and sick under five child visits (225.0 to 139.8/month, P = 007) declined during the initial six months of the pandemic compared to the same period in the preceding year. Antenatal and postnatal care visits, facility delivery rates, and child routine immunization visits also decreased although this did not reach statistical significance. Interviews with health care providers and clients highlighted several barriers to service utilization during COVID-19, including fear of disease transmission, economic hardship, and transport service disruptions and restrictions. Enablers of service utilization included communities' decreased fear of COVID-19, and awareness-raising activities. Conclusion: Provision of essential MNCH services is crucial to ascertain favorable maternal and child health outcomes. In low- and middle-income country settings like Ethiopia, health systems might be fragile to withstand the caseloads and priority setting due to the pandemic. Our study presents early findings on the utilization of MNCH services that were maintained except sick child and new family planning visits. Government leaders, policy makers, and clinicians who wish to improve the resilience of their health system will need to continuously monitor service utilization and clients' evolving concerns during the pandemic to prevent increases in maternal and child morbidity and mortality.

scholarly journals Men’s involvement in family planning service utilization among married men in Kondala district, western Ethiopia: a community-based comparative cross-sectional study

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Lemessa Assefa ◽  
Zemenu Shasho ◽  
Habtamu Kebebe Kasaye ◽  
Edao Tesa ◽  
Ebisa Turi ◽  
...  
Keyword(s):  
Family Planning ◽  
Service Utilization ◽  
Family Planning Service ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Planning Service ◽  
Community Based ◽  
Cross Sectional ◽  
Western Ethiopia ◽  
Men’S Involvement

Abstract Background Men involvement is one of the important factors in family planning (FP) service utilization. Their limitation in the family planning program causes a decrease in service utilization as well as the discontinuation of the method which eventually leads to failure of the program. Family planning uptake is low but there is no enough study conducted on the parameters of husband involvement in Ethiopia. Hence, this study focused to assess men’s involvement in family planning service utilization in Kondala district, western Ethiopia. Methods Community based comparative cross-sectional study design was employed in urban and rural kebeles of kondala district using quantitative and qualitative data collection tools. The multi-stage sampling method was employed to select 370 participants from each of the four urban and eight rural kebeles. Logistic regression analysis was used to identify variables that affect husbands’ involvement in FP service utilization. Statistical significance was declared at p-value of < 0.05 with 95% confidence interval (CI) and strength of association was reported by odds ratio (OR). Results The study showed that 203(55.6%) men from urban and 178(48.8%) from rural were involved in FP service utilization. The median age of the respondents was 36+ 8.5 years (IQR: 27.5–44.5) in urban and 35 years (IQR: 25–45) in rural parts. Respondents who had four and above current children (AOR = 3.25, 95%CI = 1.51–7.02) in urban and (AOR = 4.20, 95%CI = 1.80–9.79) in rural were positively associated with men’s involvement in FP service utilization. In the urban setting, being government employee (AOR = 2.58, 95%CI = 1.25–5.33), wishing less than two children (AOR = 3.08, 95%CI = 1.80–5.24) and having a better attitude towards FP methods (AOR = 1.86, 95%CI = 1.16–2.99) were positively associated with FP service utilization. While good educational background (AOR = 2.13, 95%CI = 1.02–4.44), short distance from home to health facility (AOR = 2.29, 95%CI = 1.24–4.19) and having better knowledge (AOR = 4.49, 95%CI = 2.72–7.38) were positively associated with men involvement in FP service utilization in the rural area. Conclusion Low involvement of men in family planning service utilization was reported in both settings. Factors associated with husbands’ involvement were varied between the two setups, except for the current number of children. Future FP program should incorporate infrastructure associated with the health facility, knowledge, and attitudinal factors.

Child Saving and Child Spacing in Africa: The Evolution of a Concept

1973 ◽  
Vol 3 (4) ◽  
pp. 765-768
Author(s):  
Robert D. Wright
Keyword(s):  
Family Planning ◽  
Child Health ◽  
Maternal And Child Health ◽  
Child Death ◽  
Child Health Services ◽  
Tropical Africa ◽  
Low Visibility ◽  
Child Spacing ◽  
High Level ◽  
And Child Health

In tropical Africa the primordial presence of enormous young child death rates precludes a successful frontal attack on birth rates through specialized programs. Experience in Nigeria indicates that gradual, quiet pressure can influence the power structure to tolerate and eventually espouse child spacing as an integral part of a program of services for child saving. The approach involves four phases: a low visibility start; obtaining high level acceptance; establishment of a federal training center to train cadres for state training programs; and deployment of trained primary care auxiliaries as a local maternal and child health-family planning service. In tropical Africa governmental attitudes toward family planning range from positive policy, to neutrality, to strong opposition. At present most Anglophone countries are favorable. Most Francophone countries are opposed. The general trend is toward a more favorable attitude toward family planning when it is a part of maternal and child health services.

scholarly journals What mechanisms drive uptake of family planning when integrated with childhood immunisation in Ethiopia? A realist evaluation

2021 ◽  
Author(s):  
Shari Krishnaratne ◽  
Jessie K. Hamon ◽  
Jenna Hoyt ◽  
Tracey Chantler ◽  
Justine Landegger ◽  
...  
Keyword(s):  
Family Planning ◽  
Child Health ◽  
Maternal And Child Health ◽  
Realist Evaluation ◽  
Religious Leaders ◽  
Community Members ◽  
Theoretical Frameworks ◽  
Programme Theory ◽  
Integrated Delivery ◽  
And Child Health

Abstract Background: Maternal and child health are key priorities among the Sustainable Development Goals, which include a particular focus on reducing morbidity and mortality among women of reproductive age, newborns, and children under the age of five. Two components of maternal and child health are family planning (FP) and immunisation. Providing these services through an integrated delivery system could increase the uptake of vaccines and modern contraceptive methods (MCMs) particularly during the post-partum period. Methods: A realist evaluation was conducted in two woredas in Ethiopia to determine the key mechanisms and their triggers that drive successful implementation and service uptake of an intervention of integrated delivery of immunisations and FP. The methodological approach included the development of an initial programme theory and the selection of relevant, published implementation related theoretical frameworks to aid organisation and cumulation of findings. Data from 23 semi-structured interviews were then analysed to determine key empirical mechanisms and drivers and to test the initial programme theory. These mechanisms were mapped against published theoretical frameworks and a revised programme theory comprised of context-mechanism-outcome configurations was developed. A critique of theoretical frameworks for abstracting empirical mechanisms was also conducted. Results: Key contextual factors identified were: the use of trained Health Extension Workers (HEWs) to deliver FP services; a strong belief in values that challenged FP among religious leaders and community members; and a lack of support for FP from male partners based on religious values. Within these contexts, empirical mechanisms of acceptability, access, and adoption of innovations that drove decision making and intervention outcomes among health workers, religious leaders, and community members were identified to describe intervention implementation. Conclusions: Linking context and intervention components to the mechanisms they triggered helped explain the intervention outcomes, and more broadly how and for whom the intervention worked. Linking empirical mechanisms to constructs of implementation related theoretical frameworks provided a level of abstraction through which findings could be cumulated across time, space, and conditions by theorising middle-range mechanisms.

scholarly journals What mechanisms drive uptake of family planning when integrated with childhood immunisation in Ethiopia? A realist evaluation

2020 ◽  
Author(s):  
Shari Krishnaratne ◽  
Jessie K. Hamon ◽  
Jenna Hoyt ◽  
Tracey Chantler ◽  
Justine Landegger ◽  
...  
Keyword(s):  
Family Planning ◽  
Child Health ◽  
Maternal And Child Health ◽  
Realist Evaluation ◽  
Religious Leaders ◽  
Community Members ◽  
Theoretical Frameworks ◽  
Programme Theory ◽  
Integrated Delivery ◽  
And Child Health

Abstract Background:Maternal and child health are key priorities among the Sustainable Development Goals, which include a particular focus on reducing morbidity and mortality among women of reproductive age, newborns, and children under the age of five. Two components of maternal and child health are family planning (FP) and immunisation. Providing these services through an integrated delivery system could increase the uptake of vaccines and modern contraceptive methods (MCMs) particularly during the post-partum period. Methods:A realist evaluation was conducted in two woredas in Ethiopia to determine the key mechanisms and their triggers that drive successful implementation and service uptake of an intervention of integrated delivery of immunisations and FP. The methodological approach included the development of an initial programme theory and the selection of relevant, published implementation related theoretical frameworks to aid organisation and cumulation of findings. Data from 23 semi-structured interviews were then analysed to determine key empirical mechanisms and drivers and to test the initial programme theory. These mechanisms were mapped against published theoretical frameworks and a revised programme theory comprised of context-mechanism-outcome configurations was developed. A critique of theoretical frameworks for abstracting empirical mechanisms was also conducted. Results:Key contextual factors identified were: the use of trained Health Extension Workers (HEWs) to deliver FP services; a strong belief in values that challenged FP among religious leaders and community members; and a lack of support for FP from male partners based on religious values. Within these contexts, empirical mechanisms of acceptability, access, and adoption of innovations that drove decision making and intervention outcomes among health workers, religious leaders, and community members were identified to describe intervention implementation.Conclusions:Linking context and intervention components to the mechanisms they triggered helped explain the intervention outcomes, and more broadly how and for whom the intervention worked. Linking empirical mechanisms to constructs of implementation related theoretical frameworks provided a level of abstraction through which findings could be cumulated across time, space, and conditions by theorising middle-range mechanisms.

scholarly journals Knowledge and Practice of Contraceptive Among Lactating Mothers Attending at Radda Maternal and Child Health and Family Planning Centre at Mirpur, Dhaka

2019 ◽  
Vol 17 (2) ◽  
pp. 40-46
Author(s):  
Mohammad Taslim Uddin ◽  
Shaibal Barua
Keyword(s):  
Family Planning ◽  
Child Health ◽  
Breast Feeding ◽  
Maternal And Child Health ◽  
Post Partum ◽  
Contraceptive Methods ◽  
Lactating Mothers ◽  
Child Spacing ◽  
Knowledge And Practice ◽  
And Child Health

Background: As a natural child-spacing method breast feeding is very effective during the early post partum period. In Bangladesh it is believed that conception occurs very rarely during post partum and lactation period. Mothers nurse their children for long period, believing this is an easy, practical and natural method to delay or prevent a subsequent pregnancy. Since child-spacing effect of breast feeding gradually diminishes over time depending on personal and social circumstances breast feeding women during lactation need contraceptive methods which must be effective and safe and must not affect lactation. Methods: A descriptive type of cross sectional study was carried out, from July 2012 to December 2012, among 110 lactating mothers at RADDA Maternal and Child Health (MCH) and Family planning Centre, Mirpur, Dhaka with the objective of assessing their knowledge and practice on contraceptive methods. Results: Out of 110 respondents, 92 respondents having 1-2 children (83.64%) 79.35% were practicing contraception and 20.5% were not practicing any method and rest of 18 respondents having >2 children (16.36%), 77.78% were practicing contraception and 22.22% were not practicing contraception. Of the 91 respondents having children 1-2, 75.4% had average and above average knowledge and the rest 8.1% had below average knowledge on contraceptive methods. Of the 19 respondents having >2 children, 16.3% had average and above average knowledge and the rest (0.2%) had below average knowledge on contraceptive methods. The difference between the two groups in respect of practice and knowledge of contraception were found statistically insignificant. Conclusion: The study shows significant relation between the knowledge and practice of contraceptive with number of the children. There is significant difference between the knowledge among primary and secondary educated mothers and the practice of contraception varied with their education levels. All the respondents had knowledge about contraceptive methods but 20.9% were not practicing any methods due to various reasons. Chatt Maa Shi Hosp Med Coll J; Vol.17 (2); Jul 2018; Page 40-46

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