scholarly journals Multilevel factors influencing contraceptive use and childbearing among adolescent girls in Bara district of Nepal: a qualitative study using the socioecological model

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e046156
Author(s):  
Kazutaka Sekine ◽  
Nirajan Khadka ◽  
Rogie Royce Carandang ◽  
Ken Ing Cherng Ong ◽  
Anand Tamang ◽  
...  
Keyword(s):  
Family Planning ◽  
Adolescent Girls ◽  
Contraceptive Use ◽  
Healthcare Providers ◽  
Married Couples ◽  
Rural Municipality ◽  
Community Health Volunteers ◽  
Female Community ◽  
Female Community Health Volunteers ◽  
Depth Interviews

ObjectivesThis study aimed to identify the multilevel factors that influence contraceptive use and childbearing decisions in Nepal and examine relationships among these factors.DesignThe study drew on qualitative data collected through in-depth interviews (IDIs) and key informant interviews (KIIs) and triangulated results.SettingAn urban municipality and a rural municipality in Bara district, Nepal.ParticipantsWe recruited a total of 60 participants (e.g., 20 married adolescent girls aged 15–19, 20 husbands, 20 mothers-in-law) for IDIs and 10 (e.g., four healthcare providers, three health coordinators, three female community health volunteers) for KIIs.ResultsMarried adolescent girls faced a range of barriers that are inter-related across different levels. Patriarchal norms and power imbalances between spouses limited their decision-making power regarding contraception. Social pressures to give birth soon after marriage drove the fear of infertility, abandonment and the stigmatisation of childless married couples, which leads to lack of women’s autonomy in making decisions about family planning. Mothers-in-law and religion exerted considerable influence over couples’ decisions regarding contraception. Limited access to information about the benefits and methods of family planning contributed to fear of the side effects of contraceptives and low awareness about the risks involved in adolescent pregnancy.ConclusionsThe convergent results from triangulation confirm that the decision to postpone childbearing is not merely the personal choice of an individual or a couple, highlighting the importance of targeting families and communities. The study underscores the need to challenge restrictive sociocultural norms so that adolescent girls become empowered to exercise greater control over contraceptive use.

scholarly journals Exploring determinants of hydrocele surgery coverage related to Lymphatic Filariasis in Nepal: An implementation research study

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0244664
Author(s):  
Choden Lama Yonzon ◽  
Retna Siwi Padmawati ◽  
Raj Kumar Subedi ◽  
Sagun Paudel ◽  
Ashmita Ghimire ◽  
...  
Keyword(s):  
Lymphatic Filariasis ◽  
Information Dissemination ◽  
Clinical Manifestations ◽  
Group Discussions ◽  
Community Factors ◽  
Community Health Volunteers ◽  
Recommended Treatment ◽  
Female Community ◽  
Female Community Health Volunteers ◽  
Depth Interviews

Background Hydrocele is a chronic condition in males in which there is an excessive collection of straw-colored fluid, which leads to enlargement of the scrotum. It is a common manifestation of lymphatic filariasis (LF) affecting nearly 25 million men worldwide. Surgery is the recommended treatment for hydrocele and is available free of cost in all government hospitals in Nepal. This research explored patient, provider, and community factors related to accessing hydrocele surgery services by the patients. Methods This study employed a qualitative method. The research was conducted in two LF endemic districts, namely Kanchanpur and Dhading, which are reported to have the highest number of hydrocele cases during morbidity mapping conducted in 2016. In addition to five key informant interviews with the LF focal persons (one national and 4 district-level), nine in-depth interviews were conducted with hydrocele patients (5 of whom had undergone surgery and 4 who had not undergone surgery) and with 3 family members, and two focus group discussions with the female community health volunteers. Results Most of the respondents did not have knowledge of hydrocele as one of the clinical manifestations of LF nor that it is transmitted through a mosquito bite. Although perceived as treatable with surgery, most of the patients interviewed believed in as well as practiced home remedies. Meanwhile, fear of surgery, embarrassment, lack of money, along with no knowledge of the free hydrocele surgery acted as barriers for accessing the surgery. On the other hand, financial support, flexible guidelines enabling the hospital to conduct surgery, decentralization and scaling up of morbidity mapping along with free hydrocele surgery camps in any remaining endemic districts were identified as enablers for accessing surgery. Conclusion Hydrocele surgery coverage could be improved if the program further addresses community awareness. There is a need for more focus on information dissemination about hydrocele and hydrocele surgery.

scholarly journals Effect of an Educational Intervention on Knowledge and Perception Regarding Rational Medicine Use and Self-medication

2018 ◽  
Vol 16 (3) ◽  
pp. 313-320
Author(s):  
Nisha Jha ◽  
Pathiyil Ravi Shankar ◽  
Anurag Marasini
Keyword(s):  
Drug Use ◽  
Community Health ◽  
Healthcare Professionals ◽  
Medicine Use ◽  
Self Medication ◽  
Community Health Volunteers ◽  
Female Community ◽  
Pharmaceutical Promotion ◽  
Female Community Health Volunteers ◽  
The Mean

Background: Rational use of medicines is important for safe and cost-effective pharmacotherapy. However, nearly half of the medicines available in the market may be used irrationally. The present study assessed the perceptions and knowledge about rational medicine use and responsible self-medication among participants before and after an educational intervention at KIST Medical College, Lalitpur. Methods: An educational module was conducted among healthcare professionals, media personnel and female community health volunteers. The questionnaire was administered before and immediately after the module. The areas addressed were rational medicine use, ethical prescribing, rational drug use situation in Nepal, pharmaceutical promotion, rational self-medication, safe use of antibiotics, and drug use problems in Nepal. Results: Among healthcare professionals, the rational drug use situation in Nepal and the total score significantly increased post-intervention (p<0.05). Among media personnel the mean scores increased significantly in pharmaceutical promotion and drug use problems in Nepal areas but there was a significant decrease in safe use of antibiotics. The pre-intervention pharmaceutical promotion score was significantly higher among healthcare professionals compared to media personnel while the rational self-medication scores were highest among female community health volunteers, safe use of antibiotics scores were highest among the media personnel. Post-intervention the mean pharmaceutical promotion scores was highest among healthcare professionals, rational self-medication scores among female community health volunteers, safe use of antibiotics, drug use problems in Nepal and total scores were highest among the media personnel. Conclusions: There were differences in the mean pre-intervention scores among different subgroups. A single session may not be enough to bring about significant changes in knowledge and perception. The retention of knowledge could be measured in future studies. Keywords: Female community health volunteers; health care professionals; media; rational medicine use; self medication.

scholarly journals Choices and services related to contraception in the Gaza strip, Palestine: perceptions of service users and providers

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Bettina Böttcher ◽  
Mysoon Abu-El-Noor ◽  
Nasser Abu-El-Noor
Keyword(s):  
Family Planning ◽  
Contraceptive Method ◽  
Quantitative Data ◽  
Contraceptive Use ◽  
Gaza Strip ◽  
Healthcare Providers ◽  
Family Planning Services ◽  
Potential Barriers ◽  
Unintended Pregnancies ◽  
The Gaza Strip

Abstract Background Reliable contraception enables women and men to plan their family sizes and avoid unintended pregnancies, which can cause distress and anxiety, but also increase maternal mortality. This study explored potential barriers to contraceptive use for women in the Gaza Strip, Palestine from user and provider perspectives. Methods A convenient sample was used to recruit women, who were current contraception users, from three healthcare clinics that provide family planning care, two governmental and one non-governmental. A 16-item questionnaire was completed by 204 women, including socio-demographic data, contraceptive use and eight questions exploring user experience. Additionally, 51 women attended focus groups for a deeper insight into their contraceptive use experience and potential barriers. Furthermore, 14 healthcare providers were interviewed about their experience with service provision. Quantitative data are presented as means and frequencies and qualitative data were analysed item by item and are presented in themes jointly with the quantitative data. Results Women reported usage of only three main modern methods of contraception with 35.2% using intrauterine devices, 25.8% combined oral contraception and 16.4% condoms, while only 3.1% used the hormonal implant. Expectations from family planning services were low with most women attending the clinic having already decided their contraceptive method with decisions being made by husbands (41.2%) or women jointly with their partner (33.3%), only 13.7% took advice from service providers. Healthcare providers experienced high prevalence of beliefs that modern contraceptives cause infertility and cancer. Main barriers to effective family planning services were misconceptions of potential harm, poor availability and limited choice of contraceptive methods. Conclusion Women’s contraceptive choices in Gaza are limited by prevalent misconceptions and fears as well as recurring shortages, negatively impacting fertility control. Men are a major factor in choosing a contraceptive method, however, they have limited access to information and therefore, potentially more misconceptions. Therefore, male community members need to be included in the delivery of information on contraceptives to increase women’s choice. Furthermore, greater access to long-acting reversible contraceptives, such as the hormonal implant, and improved availability might be key factors in improving contraceptive uptake in Gaza and, thus, reducing unintended pregnancies.

scholarly journals Effect of an Educational Intervention on Knowledge and Perception Regarding Rational Medicine Use and Self-medication

2018 ◽  
Vol 16 (3) ◽  
pp. 313-320
Author(s):  
Nisha Jha ◽  
Shankar Pathiyil Ravi ◽  
Marasini Anurag
Keyword(s):  
Drug Use ◽  
Community Health ◽  
Healthcare Professionals ◽  
Medicine Use ◽  
Self Medication ◽  
Community Health Volunteers ◽  
Female Community ◽  
Pharmaceutical Promotion ◽  
Female Community Health Volunteers ◽  
The Mean

Background: Rational use of medicines is important for safe and cost-effective pharmacotherapy. However, nearly half of the medicines available in the market may be used irrationally. The present study assessed the perceptions and knowledge about rational medicine use and responsible self -medication among participants before and after an educational intervention at KIST Medical College, Lalitpur.Methods: An educational module was conducted among healthcare professionals, media personnel and female community health volunteers. The questionnaire was administered before and immediately after the module. The areas addressed were rational medicine use, ethical prescribing, rational drug use situation in Nepal, pharmaceutical promotion, rational self-medication, safe use of antibiotics, and drug use problems in Nepal.Results:  Among healthcare professionals, the rational drug use situation in Nepal and the total score significantly increased post-intervention (p<0.05). Among media personnel the mean scores increased significantly in pharmaceutical promotion and drug use problems in Nepal areas but there was a significant decrease in safe use of antibiotics. The pre-intervention pharmaceutical promotion score was significantly higher among healthcare professionals compared to media personnel while the rational self-medication scores were highest among female community health volunteers, safe use of antibiotics scores were highest among the media personnel. Post-intervention the mean pharmaceutical promotion scores was highest among healthcare professionals, rational self-medication scores among female community health volunteers, safe use of antibiotics, drug use problems in Nepal and total scores were highest among the media personnel. Conclusions: There were differences in the mean pre-intervention scores among different subgroups. A single session may not be enough to bring about significant changes in knowledge and perception. The retention of knowledge could be measured in future studies. 

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