Unmet Need for Family Planning in Nepal during the First Two Years Postpartum

Contraceptive use during the postpartum period is critical for maternal and child health. However, little is known about the use of family planning and the determinants in Nepal during this period. This study explored pregnancy spacing, unmet need, family planning use, and fertility behaviour among postpartum women in Nepal using child level data from the Nepal Demographic and Health Surveys 2011. More than one-quarter of women who gave birth in the last five years became pregnant within 24 months of giving birth and 52% had an unmet need for family planning within 24 months postpartum. Significantly higher rates of unmet need were found among rural and hill residents, the poorest quintile, and Muslims. Despite wanting to space or limit pregnancies, nonuse of modern family planning methods by women and returned fertility increased the risk of unintended pregnancy. High unmet need for family planning in Nepal, especially in high risk groups, indicates the need for more equitable and higher quality postpartum family planning services, including availability of range of methods and counselling which will help to further reduce maternal, perinatal, and neonatal morbidity and mortality in Nepal.

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Inequalities in the Use of Family Planning in Rural Nepal

BioMed Research International ◽

10.1155/2014/636439 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 8

Author(s):

Suresh Mehata ◽

Yuba Raj Paudel ◽

Bhogendra Raj Dotel ◽

Dipendra Raman Singh ◽

Pradeep Poudel ◽

...

Keyword(s):

Family Planning ◽

Rural Areas ◽

Household Survey ◽

Risk Groups ◽

Reproductive Age ◽

Younger Women ◽

Modern Family ◽

Planning Methods ◽

Rural Nepal ◽

Modern Family Planning

This paper explores inequalities in the use of modern family planning methods among married women of reproductive age (MWRA) in rural Nepal. Data from the 2012 Nepal Household Survey (HHS) were utilized, which employed a stratified, three-stage cluster design to obtain a representative sample of 9,016 households from rural Nepal. Within the sampled households, one woman of reproductive age was randomly selected to answer the survey questions related to reproductive health. Only four out of every ten rural MWRA were using a modern family planning method. Short-acting and permanent methods were most commonly used, and long-acting reversible contraceptives were the least likely to be used. Muslims were less likely to use family planning compared to other caste/ethnic groups. Usage was also lower among younger women (likely to be trying to delay or space births) than older women (likely to be trying to limit their family size). Less educated women were more likely to use permanent methods and less likely to use short-term methods. To increase the CPR, which has currently stalled, and continue to reduce the TFR, Nepal needs more focused efforts to increase family planning uptake in rural areas. The significant inequalities suggest that at-risk groups need additional targeting by demand and supply side interventions.

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Side Effect Concerns and their Impact on Women’s Uptake of Modern Family Planning Methods in Rural Ghana: A Mixed Methods Study

10.21203/rs.2.14117/v2 ◽

2019 ◽

Author(s):

Leah A. Schrumpf ◽

Maya J. Stephens ◽

Nathaniel E. Nsarko ◽

Eric Akosah ◽

Joy Noel Baumgartner ◽

...

Keyword(s):

Family Planning ◽

Side Effects ◽

Contraceptive Use ◽

Mixed Methods Study ◽

Modern Family ◽

Planning Methods ◽

Depth Interviews ◽

Modern Family Planning ◽

Family Planning Methods

Abstract Background: Despite availability of modern family planning methods and a desire for smaller families, many women decide to forgo modern methods due to anticipated side effects. The goal of this study was to examine the use of modern family planning in one district in rural Ghana, and to understand the role that side effects play in women’s decisions to start or continue use. Methods: This exploratory mixed-methods study included 281 surveys and 33 in-depth interviews of women 18-49 years old from the Amansie West District of Ghana. The survey assessed contraceptive use and potential predictors of use. In-depth interviews examined the context around uptake and continuation of contraceptive use, with a particular focus on the role of perceived and experienced side effects. Results: The prevalence of unmet need for modern family planning among sexually active women who wanted to avoid pregnancy (n=135) was 68.9%. No factors were found to be significantly different in comparing those with a met need and unmet for modern family planning. Qualitative interviews revealed significant concerns about side effects stemming from previous method experiences and/or rumors regarding short-term impacts and perceived long-term consequences of family planning use. Conclusion: As programs have improved women’s ability to access modern family planning, it is paramount to address patient-level barriers to uptake, in particular information about side effects and misconceptions about long-term use. Unintended pregnancies can be reduced through comprehensive counseling about contraceptive options including accurate information about side effects, and the development of new contraceptive technologies that meet women’s needs in low-income countries.

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Persisting Regional Disparities in Modern Contraceptive Use and Unmet Need for Contraception among Nigerian Women

BioMed Research International ◽

10.1155/2019/9103928 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9

Author(s):

Chao Wang ◽

Huimin Cao

Keyword(s):

Family Planning ◽

Contraceptive Use ◽

Unmet Need ◽

Universal Coverage ◽

Regional Disparities ◽

Demographic And Health Surveys ◽

Modern Contraceptive ◽

Cross Sectional ◽

Modern Contraceptives ◽

Unmet Need For Contraception

Background. Evidence suggests that equitable provision of contraceptive services can help women achieve their reproductive goals and has significant impact on reducing the rates abortion and unintended pregnancy at large. However, regional disparities continue to persist on top of low family planning prevalence which is a critical public health challenge for fast growing populations like Nigeria. Objectives. The present study aimed to explore the prevalence of (1) nonuse of modern contraceptives, (2) unmet need for contraception, and (3) regional disparities in these two. Methods. The present study used cross-sectional data obtained from the Nigeria Demographic and Health Surveys conducted in 2003, 2008, and 2013. Participants were women of reproductive of age (15-49 years) regardless of marital status. Regional disparities of nonuse of modern contraceptives and unmet need were analysed by descriptive and multivariate regression methods. Results. In the pooled sample of 79,656 participants during 2003, 2008, and 2013, 88.6% reported not using any modern methods, and 13.5% reported having unmet need for contraception. The prevalence rates of nonuse were, respectively, 91.8%, 90.6%, and 88.6% and those of unmet need were 14.2%, 16.6%, and 13.5% in the years 2003, 2008, and 2013. Significant differences were observed in the odds of reporting nonuse and unmet need for contraception across the geopolitical zones. Conclusions. The rates of nonuse of contraception are remarkably high among women in Nigeria with significant disparities across the six geopolitical zones. Efforts should be made to address the regional disparities in order to achieve the goals of universal coverage of family planning services in the country.

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Improving Utilisation and awareness of Family Planning services in Adults of Reproductive age through Community Sensitization in Police Wing Village, Jinja District.

10.51168/sjhrafrica.v2i6.43 ◽

2021 ◽

Author(s):

◽

Rodgers Isiko

Keyword(s):

Family Planning ◽

Contraceptive Use ◽

Unmet Need ◽

Reproductive Age ◽

Sub Saharan Africa ◽

Project Implementation ◽

Number Of Children ◽

Planning Methods ◽

Sub Saharan ◽

Family Planning Methods

Background Family planning refers to a conscious effort by a couple to space the number of children they have through the use of contraceptive methods. According to WHO, an estimated 225 million women in developing countries, 24.2% of women of reproductive age have an unmet need for contraception. However, contraceptive use in sub-Saharan Africa is low at only 21%. The total fertility rate remains high for many countries in the region (4.6 in Kenya and Rwanda, 5.4 in Tanzania, 6.2 in Uganda, and 6.4 for Burundi). Methodology This was a community-based project implementation on increasing awareness and utilization of family planning methods in Police Wing village, Jinja district. Consent was gotten from the VHT, LC1, and DHO before mobilizing people to gather at the VHT’s home and her neighbour’s compound where we carried out the different educational sessions. Different team members got different roles to play as regards the health education session. One week later, we evaluated the progress of our project implementation through the administration of questionnaires to the same people we health educated. The questionnaire assessed the level of utilization, awareness, myths, misconception, and demography of the participants. Results 28% had heard about at least three family planning methods and 24.1% had at one time used family planning while 75.9% of the participants admitted not to have used it. The post-session assessment showed an increase from 28% to 93% in knowledge regarding the available methods of FP and an increase in the utilization of FP from 28% to 42%. Conclusion and recommendations Addressing the myths and misconceptions about FP by exposing them as a fallacy would help increase the uptake as evidenced by the will of the community to take up the different methods. Organize frequent health talks about FP in the community.

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Postpartum family planning in Rwanda: a cost effectiveness analysis

Gates Open Research ◽

10.12688/gatesopenres.12934.1 ◽

2019 ◽

Vol 3 ◽

pp. 887

Author(s):

Pamela Williams ◽

Katie Morales ◽

Vikram Sridharan ◽

Alekya Tummala ◽

Elliot Marseille

Keyword(s):

Cost Effectiveness ◽

Family Planning ◽

Unmet Need ◽

Cost Effectiveness Analysis ◽

Reproductive Age ◽

World Health ◽

Effectiveness Analysis ◽

Postpartum Family Planning ◽

Planning Methods ◽

Family Planning Methods

Background: Globally, there is a large unmet need for family planning in the postpartum period: 90% of women in this group want family planning for birth spacing or to avoid unintended pregnancies and stop child bearing once desired family size has been reached. Women spend on average about 30 years, or three-quarters of their reproductive lives, attempting to avoid pregnancy. In total 76% of Rwandan women want family planning postpartum, yet a 26% unmet need remains. Methods: This cost effectiveness analysis compared the two most frequently-used family planning methods in Rwanda, longer-acting reversible contraception (LARC), injections and subdermal implants, and shorter-acting reversible contraceptives (non-LARC), pills and condoms. Women who do not use contraception postpartum were also represented. A time horizon of 24 months was used to reflect the World Health Organization suggested two-year spacing from birth until the next pregnancy, and the analysis was conducted from a health systems perspective. Results: For women of reproductive age (12-49 years) in Rwanda, including LARC postpartum family planning methods in the options, saves $18.73 per pregnancy averted, compared to family planning options that offer non-LARC methods exclusively. Conclusion: $2.8 million US$ per year can be saved if LARC is included as a contraceptive choice across all health centers in Rwanda; this cost savings provides the opportunity for these funds to be allocated to other high value interventions. Potential inclusion of these methods at Rwanda’s faith-based health facilities warrants further attention.

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Making family planning accessible in resource-poor settings

Philosophical Transactions of the Royal Society B Biological Sciences ◽

10.1098/rstb.2009.0172 ◽

2009 ◽

Vol 364 (1532) ◽

pp. 3093-3099 ◽

Cited By ~ 34

Author(s):

Ndola Prata

Keyword(s):

Family Planning ◽

Contraceptive Use ◽

Unmet Need ◽

Easy Access ◽

Access To Health Services ◽

Low Resource Settings ◽

Low Resource ◽

Resource Poor ◽

Planning Methods ◽

Family Planning Methods

It is imperative to make family planning more accessible in low resource settings. The poorest couples have the highest fertility, the lowest contraceptive use and the highest unmet need for contraception. It is also in the low resource settings where maternal and child mortality is the highest. Family planning can contribute to improvements in maternal and child health, especially in low resource settings where overall access to health services is limited. Four critical steps should be taken to increase access to family planning in resource-poor settings: (i) increase knowledge about the safety of family planning methods; (ii) ensure contraception is genuinely affordable to the poorest families; (iii) ensure supply of contraceptives by making family planning a permanent line item in healthcare system's budgets and (iv) take immediate action to remove barriers hindering access to family planning methods. In Africa, there are more women with an unmet need for family planning than women currently using modern methods. Making family planning accessible in low resource settings will help decrease the existing inequities in achieving desired fertility at individual and country level. In addition, it could help slow population growth within a human rights framework. The United Nations Population Division projections for the year 2050 vary between a high of 10.6 and a low of 7.4 billion. Given that most of the growth is expected to come from today's resource-poor settings, easy access to family planning could make a difference of billions in the world in 2050.

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Unmet Need for Family Planning among Urban and Rural Married Women in Yangon Region, Myanmar—a Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16193742 ◽

2019 ◽

Vol 16 (19) ◽

pp. 3742 ◽

Cited By ~ 1

Author(s):

Myint Myint Wai ◽

Espen Bjertness ◽

Hein Stigum ◽

Thein Thein Htay ◽

Tippawan Liabsuetrakul ◽

...

Keyword(s):

Family Planning ◽

Rural Women ◽

Contraceptive Use ◽

Unmet Need ◽

Married Women ◽

Considerable Proportion ◽

Demographic And Health Surveys ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Unintended Pregnancies

Despite increasing contraceptive use and prevalence, many women who want to avoid or delay pregnancy are not using contraceptives. This results in unintended pregnancies, which increases the risk of unsafe abortions. This study aimed to explore the extent of the unmet need for family planning (FP) among urban and rural married women in Myanmar and their demand for and satisfaction with FP. A cross-sectional survey using adapted Demographic and Health surveys questions was conducted in south and north Yangon from September 2016 to November 2016. A total of 1100 currently married women of 18–49 years participated. The contraceptive prevalence was 67.2% in total, 63% urban, and 70% rural. About 19.4% (95% CI: 16.7%–22.4%) of the studied women had an unmet need for FP, significantly higher in urban than rural women (22.6% versus 16.6%). Rural women also showed significant lesser odds (adjusted OR: 0.63; 95% CI: 0.461–0.849) of unmet need than the urban counterparts. About 86% of the women had demand for contraception and 77% of them satisfied their demand. The study population revealed a fairly good contraceptive coverage; however, a considerable proportion of women had an unmet need for FP, especially the urban women. The demand for contraception is increasing, and contraceptive services need to expand coverage to marginalized groups in order to reduce the risk of unsafe abortions.

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Study of determinants of contraceptive practices and impact assessment of counselling on acceptance of contraception in tribal area of Rajasthan, India

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20192828 ◽

2019 ◽

Vol 6 (7) ◽

pp. 2933

Author(s):

Medha Mathur ◽

Piyush Parmar ◽

Navgeet Mathur

Keyword(s):

Family Planning ◽

Contraceptive Use ◽

Health Workers ◽

Unmet Need ◽

Post Intervention ◽

Community Based ◽

Barrier Methods ◽

The Family ◽

Planning Methods ◽

Permanent Method

Background: Unmet need of family planning affects the society by uncontrolled population explosion. Tribal population being socioeconomic deprived group requires special attention for contraceptive needs. This study was planned to study the determinants of contraceptive practices and impact of intervention in the form of counselling over the family planning acceptance behaviour.Methods: This community based longitudinal study was conducted for duration of six months in selected areas of Udaipur district, by two stage sampling method. Baseline data was collected followed by counselling of non-users of contraception and later on collection of post intervention data for comparison.Results: Out of total 422 study subjects, 193 (45.7%) were contraceptive users and 229 (54.3%) were non-users. All the participants had knowledge about permanent method (100%) of sterilization followed by barrier methods (62%). Non-users of contraception were counselled and their practices improved significantly (p<0.001) afterwards.Conclusions: The knowledge of family planning methods is present inadequately among tribal and non-tribal eligible couples and actual practice of contraceptive use is lacking which requires efforts of health workers thorough counselling to change their attitude towards adoption of family planning practices.

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Levels and trends in family planning method use among urban adolescents and young women in Guinea: analysis of Demographic and Health Surveys from 1999 to 2018

10.21203/rs.3.rs-50093/v1 ◽

2020 ◽

Author(s):

Sidikiba Sidibe ◽

Alexandre Delamou ◽

Bienvenu Salim Camara ◽

Nafissatou Camara ◽

Hawa Manet ◽

...

Keyword(s):

Family Planning ◽

Ethnic Groups ◽

Young Women ◽

Health Surveys ◽

Urban Adolescents ◽

Contraceptive Use ◽

Unmet Need ◽

Health Concern ◽

Demographic And Health Surveys ◽

Modern Contraceptive

Abstract Background Despite improvements, adolescent fertility remains high in Africa. In Guinea, high fertility among adolescents and young women in urban areas remains a public health concern. This study aims to describe levels and trends in, and factors associated with using modern family planning (FP) methods among urban adolescents and young women in Guinea.Methods We used four Guinea Demographic and Health Surveys (DHS) conducted in 1999, 2005, 2012, and 2018. Among urban adolescents and young women (15–24 years), we examined trends over time in four key indicators: 1. Contraceptive use (% using any using any FP method among all and among those in need for FP), 2. Unmet need for FP (% not using any FP method among all and among those in need for FP) and 3.Modern contraceptive use (% of using modern FP methods and among those in need of FP), and 4. % using modern FP method (demand satisfied). We multivariable logistic regression to examine association between socio-demographic factors and modern FP use (indicator 2) on the most recent DHS dataset (2018).Results We found a statistically significant changes over the time period exmained in modern contracetive use (8.4% in 1999 to 12.8% in 2018, p < 0.01), demand satisfied (29.0% in 1999, 54.1% in 2018, p < 0.001), and halving of unmet need for FP (from 15.8% in 1999 to 8.6% in 2018, p < 0.001). The most important changes in these two indicators occurred between 1999 and 2005.. Compared to those 15–19 years, young women (20–24) more likely to use modern FP methods. Those living in Faranah and Kankan more likely to use modern FP method than those in Conakry. Middle and richer wealth quintile households were more likely to use modern FP compared to poorer. Married women compared to nevever married and those from the Peulh and Malinke ethnic groups compared to Soussou were less likely to use modern FP methods.Conclusion Despite some progress, efforts are still needed to improve FP method use among urban adolescent and you women. Future policies and intervention programs should emphasize on improving adolescents’ reproductive health knowledge and increasing awareness of FP method use. The focus should also be on adolescents aged 15–19 years, disparities of urban administrative regions, ethnic groups, and wealth index, especially the poor quintiles.

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Assessment of the awareness and usages of family planning methods in the Lebanese community

BMJ Sexual & Reproductive Health ◽

10.1136/bmjsrh-2018-200067 ◽

2019 ◽

Vol 45 (4) ◽

pp. 269-274

Author(s):

Ghada El Khoury ◽

Pascale Salameh

Keyword(s):

Family Planning ◽

Contraceptive Use ◽

National Level ◽

Unmet Need ◽

Reproductive Age ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Contraception Use ◽

Planning Methods ◽

National Prevalence

BackgroundWorldwide, one in three women has unmet family planning (FP) needs because of difficulties in accessing or using contraceptives. In Lebanon, information from the scientific literature on the national prevalence of contraceptive use appears scarce.ObjectiveIn view of this, we measured the current Lebanese national prevalence of FP methods’ uptake among women and men of reproductive age, and we assessed barriers for potential unmet need.MethodsWe conducted a cross-sectional survey on a nationally representative sample of 825 married women (aged 15–49 years) and men of reproductive age (aged 18+ years). We used the validated Demographic & Health Survey (DHS) data collection tool and analysed data with SPSS Version 22.0 with p values <0.05 considered statistically significant.ResultsWe found that the current prevalence of contraceptive use is 55.6%, the unmet need is 11.4%, the total demand for FP is 67% and the percentage of satisfied demand for FP is 83%. Despite favourable knowledge of and access to FP methods as well as positive attitudes towards FP; there is a clear stagnation in the rate of contraception use over the past four decades. The identified major factors hindering the use of FP methods in Lebanon appear to be religion, age and lower educational levels.ConclusionWe suggest the implementation of effective interventions at the national level to promote and encourage the uptake of modern FP methods among couples. The latter will further promote maternal and child health, as well as empower women to fulfil their equal function in society.

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