scholarly journals Postpartum contraceptive use and unmet need for family planning in five low-income countries

2015 ◽  
Vol 12 (S2) ◽  
Author(s):  
Omrana Pasha ◽  
Shivaprasad S Goudar ◽  
Archana Patel ◽  
Ana Garces ◽  
Fabian Esamai ◽  
...  
Keyword(s):  
Family Planning ◽  
Low Income ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Low Income Countries

scholarly journals Postpartum Family Planning Use and Its Determinants among Women of the Reproductive Age Group in Low-Income Countries of Sub-Saharan Africa: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Tesfalem Tilahun Yemane ◽  
Getahun Gebre Bogale ◽  
Gudina Egata ◽  
Tilahun Kassa Tefera
Keyword(s):  
Systematic Review ◽  
Family Planning ◽  
Low Income ◽  
Contraceptive Use ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
Modern Contraceptive ◽  
Pooled Prevalence ◽  
Sub Saharan

Background. Postpartum family planning is the initiation and use of family planning services within the first 12 months following childbirth. Postpartum contraceptives reduce maternal and infant mortality by preventing unplanned and unwanted pregnancies and by spacing pregnancies at least two years after the previous birth. Thus, it is usually designed as an integral part of reproductive and maternal and child health programs. Therefore, the aim of this systematic review and meta-analysis is to estimate the pooled prevalence of postpartum modern contraceptive use and identify its determinants in low-income countries of sub-Saharan Africa. Methods. A systematic review and meta-analysis of published and unpublished studies were used. PubMed, HINARI, ScienceDirect, Cochrane Library, Wiley Library, ETH Library, and Google Scholar were used to search all articles. STATA 14 software was used for data analysis. Funnel plots and Egger’s test were used to examine the risk of publication bias. Heterogeneity was checked by using Cochran’s Q test and I 2 test. A random effect model was computed to estimate the pooled prevalence. Results. A total of 33 articles were included. The pooled prevalence of postpartum contraceptive use in low-income countries of sub-Saharan Africa was 37.41%, 95% CI: (31.35, 43.48%). Secondary and above level of education (AOR 2.09, 95% CI: (1.52, 2.86)), discussion with husband (AOR 3.68, 95% CI: (1.96, 6.89)), resumption of menses (AOR: 3.98, 95% CI: (2.62, 6.03)), ANC follow-up (AOR; 5.10, 95% CI: (3.57, 7.29)), knowledge of modern family planning (AOR: 5.65, 95% CI: 3.58, 8.93)), and family planning counseling during ANC (AOR =5.92, 95% CI: (2.54, 13.79)) were found to be determinants of postpartum contraceptive utilization. Conclusion. In this systematic review and meta-analysis, the prevalence of postpartum modern contraceptive use was found to be low compared to the existing global recommendations. Therefore, empowering maternal education, delivering adequate counseling, and strengthening existing integrated maternal and child health services are highly recommended to increase postpartum contraceptive use. This trial is registered with CRD42020160612.

scholarly journals A qualitative exploration of contraceptive use and discontinuation among women with an unmet need for modern contraception in Kenya

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Susan Ontiri ◽  
Lilian Mutea ◽  
Violet Naanyu ◽  
Mark Kabue ◽  
Regien Biesma ◽  
...  
Keyword(s):  
Family Planning ◽  
Side Effects ◽  
Peer Influence ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Modern Contraceptive ◽  
Modern Contraception ◽  
Modern Contraceptives ◽  
Family Planning Programs ◽  
Contraceptive Discontinuation

Abstract Background Addressing the unmet need for modern contraception underpins the goal of all family planning and contraception programs. Contraceptive discontinuation among those in need of a method hinders the attainment of the fertility desires of women, which may result in unintended pregnancies. This paper presents experiences of contraceptive use, reasons for discontinuation, and future intentions to use modern contraceptives. Methods Qualitative data were collected in two rural counties in Kenya in 2019 from women with unmet need for contraception who were former modern contraceptive users. Additional data was collected from male partners of some of the women interviewed. In-depth interviews and focus group discussions explored previous experience with contraceptive use, reasons for discontinuation, and future intentionality to use. Following data collection, digitally recorded data were transcribed verbatim, translated, and coded using thematic analysis through an inductive approach. Results Use of modern contraception to prevent pregnancy and plan for family size was a strong motivator for uptake of contraceptives. The contraceptive methods used were mainly sourced from public health facilities though adolescents got them from the private sector. Reasons for discontinued use included side effects, method failure, peer influence, gender-based violence due to covert use of contraceptives, and failure within the health system. Five reasons were provided for those not willing to use in the future: fear of side effects, cost of contraceptive services, family conflicts over the use of modern contraceptives, reduced need, and a shift to traditional methods. Conclusion This study expands the literature by examining reasons for contraceptive discontinuation and future intentionality to use among women in need of contraception. The results underscore the need for family planning interventions that incorporate quality of care in service provision to address contraceptive discontinuation. Engaging men and other social influencers in family planning programs and services will help garner support for contraception, rather than focusing exclusively on women. The results of this study can inform implementation of family planning programs in Kenya and beyond to ensure they address the concerns of former modern contraception users.

DESIRE FOR MORE CHILDREN, CONTRACEPTIVE USE AND UNMET NEED FOR FAMILY PLANNING IN A REMOTE AREA OF BALI, INDONESIA

2010 ◽  
Vol 42 (4) ◽  
pp. 549-562 ◽  
Author(s):  
MELLISSA WITHERS ◽  
MEGUMI KANO ◽  
GDE NGURAH INDRAGUNA PINATIH
Keyword(s):  
Family Planning ◽  
Health Services ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Multivariate Logistic Regression Analysis ◽  
Reproductive Age ◽  
Access To Health Services ◽  
The Past ◽  
Access To Health ◽  
Living Children

SummaryExploring fertility preferences in relation to contraceptive use can increase the understanding of future reproductive behaviour and unmet family planning needs. This knowledge can help assist women in meeting their reproductive goals. The influences on the desire for more children and current contraceptive use were examined among 1528 married women of reproductive age in an isolated community in Bali, Indonesia, using multivariate logistic regression analysis. Women who were younger, had fewer living children, had given birth in the past year and had regular access to health services were more likely to desire children. Being older, having fewer living children, not having regular access to health services, having given birth in the past year and having the desire for more children were associated with a lower likelihood of using contraception. Women with regular access to health care are more likely to desire more children, probably because they are confident in their ability to have successful birth outcomes. However, specialized clinics or family planning outreach workers may be required to reduce barriers to service utilization among some groups. The findings of this study identify key target populations for family planning, including older women and postpartum women – groups that may not perceive themselves to be at risk for unintended pregnancy. Meeting unmet need for family planning among these groups could help women meet their fertility goals, as well as reduce maternal morbidity and mortality.

scholarly journals Predictors of modern contraceptive use among women and men in Uganda: a population-level analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034675 ◽  
Author(s):  
Amrita Namasivayam ◽  
Sarah Lovell ◽  
Sarah Namutamba ◽  
Philip J Schluter
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Secondary Data ◽  
Population Level ◽  
Modern Contraceptive ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Logistic Regression Models ◽  
Modern Contraceptive Use

Objective(s)Despite substantial and rapid improvements in contraceptive uptake in Uganda, many women continue to have unmet need for contraception. As factors affecting contraceptive use are dynamic and complex, this study seeks to identify current predictors and provide effect size estimates of contraceptive use among women and men in Uganda.Study designA nationally representative cross-sectional population survey, using secondary data from Uganda’s 2016 Demographic and Health Survey. Stratified by sex, weighted bivariable and multivariable logistic regression models were derived from a suite of potential predictor variables. Predictive abilities were assessed via 10-fold cross-validated area under the receiver operating characteristic curves (AUCs).SettingUganda.ParticipantsAll women aged 15–49 years who were permanent residents of the selected households or stayed in the household the night before the survey were eligible to participate. In one-third of the sampled households, all men aged 15–54 years who met the same residence criteria were also eligible.Primary outcome measuresModern contraceptive use.ResultsOverall, 4914 (26.6%) women and 1897 (35.6%) men reported using a modern contraceptive method. For women and men, both demographic and proximate variables were significantly associated with contraceptive use, although notable differences in effect sizes existed between sexes—especially for age, level of education and parity. Predictively, the multivariable model was acceptable for women with AUC=0.714 (95% CI 0.704 to 0.720) but less so for men with AUC=0.654 (95% CI 0.636 to 0.666).Conclusion(s)Contemporary significant predictors of contraceptive use among women and men were reported, thereby enabling key Ugandan subpopulations who would benefit from more targeted family planning initiatives to be identified. However, the acceptable AUC for women and modest AUC for men suggest that other important unmeasured predictors may exist. Nonetheless, these evidence-based findings remain important for informing future programmatic and policy directions for family planning in Uganda.

Post-abortion fertility desires, contraceptive uptake and unmet need for family planning: voices of post-abortion care clients in Tanzania

2020 ◽  
pp. 1-16
Author(s):  
Colin Baynes ◽  
Erick Yegon ◽  
Grace Lusiola ◽  
Japhet Achola ◽  
Rehema Kahando
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Pregnancy Intentions ◽  
Middle Income ◽  
Fertility Desires ◽  
Abortion Care ◽  
Post Abortion Care ◽  
Post Abortion ◽  
Contraceptive Uptake

Abstract Post-abortion care (PAC) integrates elements of care that are vital for women’s survival after abortion complications with intervention components that aid women in controlling their fertility, and provides an optimal window of opportunity to help women meet their family planning goals. Yet, incorporating quality family planning services remains a shortcoming of PAC services, particularly in low- and middle-income countries. This paper presents evidence from a mixed method study conducted in Tanzania that aimed at explaining factors that contribute to this challenge. Analysis of data obtained through client exit interviews quantified the level of unmet need for contraception among PAC clients and isolated the factors associated with post-abortion contraceptive uptake. Qualitative data analysis of interviews with a subset of these women explored the multi-level context in which post-abortion pregnancy intentions and contraceptive behaviours are formed. Approximately 30% of women interviewed (N=412) could recall receiving counselling on post-abortion family planning. Nearly two-thirds reported a desire to either space or limit childbearing. Of those who desired to space or limited childbearing, approximately 20% received a contraceptive method before discharge from PAC. The factors significantly associated with post-abortion contraceptive acceptance were completion of primary school, prior use of contraception, receipt of PAC at lower level facilities and recall of post-abortion family planning counselling. Qualitative analysis revealed different layers of contextual influences that shaped women’s fertility desires and contraceptive decision-making during PAC: individual (PAC client), spousal/partner-related, health service-related and societal. While results lend support to the concept that there are opportunities for services to address unmet need for post-abortion family planning, they also attest to the synergistic influences of individual, spousal, organizational and societal factors that influence whether they can be realized during PAC. Several strategies to do so emerged saliently from this analysis. These emphasize customized counselling to enable client–provider communication about fertility preferences, structural intervention aimed at empowering women to assert those objectives in family and health care settings, availability of information and services on post-abortion fertility and contraceptive eligibility in PAC settings and interventions to facilitate constructive spousal communication on family planning and contraceptive use, after abortion and in general.

scholarly journals “The Financial Is the Main Issue, It’s Not Even the Child”: Exploring the Role of Finances in Men’s Concepts of Fatherhood and Fertility Intention

2018 ◽  
Vol 12 (4) ◽  
pp. 1074-1083 ◽  
Author(s):  
Megan Hamm ◽  
Elizabeth Miller ◽  
Lovie Jackson Foster ◽  
Mario Browne ◽  
Sonya Borrero
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Health Services ◽  
Low Income ◽  
Financial Stability ◽  
Sexual And Reproductive Health ◽  
Contraceptive Use ◽  
Fertility Intention ◽  
Reproductive Health Services ◽  
Family Planning Services

Despite demonstrable need, men’s utilization of sexual and reproductive health services remains low. This low utilization may particularly affect low-income men, given the disproportionate prevalence of unintended pregnancy in low-income populations. Bolstering men’s utilization of sexual and reproductive health services requires understanding the services that are most relevant to them. Semistructured interviews about fatherhood, fertility intention, and contraceptive use were conducted with 58 low-income Black and White men in Pittsburgh, Pennsylvania. The interviews were analyzed using content analysis to determine common themes that were most relevant to the men interviewed. The primacy of financial stability emerged as a dominant theme in men’s perceptions of fatherhood readiness, successful fathering, and fertility intentions. However, men had children despite feeling financially unprepared, and their contraceptive use was not always congruent with their stated fertility intentions. Some men described financial services as a feature of family planning services that they would find useful. Because of the salience of financial stability in preparation for fatherhood, integrating financial counseling and job skills training into the context of sexual and reproductive health services could be a useful structural intervention to increase men’s use of family planning services and to provide them with the support they say they need as fathers.

scholarly journals Implementation of Adolescent and Youth Friendly Health Services in a Rural Region of Tigray, Ethiopia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
F Cigliano ◽  
H Gebremichael ◽  
K Teklay ◽  
B Ayele ◽  
D Negash ◽  
...  
Keyword(s):  
Family Planning ◽  
Young People ◽  
Health Services ◽  
Sex Education ◽  
Low Income ◽  
Public Health Problem ◽  
Health Centers ◽  
Low Income Countries ◽  
Sexual Life ◽  
Youth Friendly

Abstract Background The Eastern Zone of the Tigray (Ethiopia) is inhabited by 900,000 people, 34% of whom are adolescents and young people between 10-24 years of age, who are easily influenced by the social and family context and are exposed to significant health risks associated with the earliness of their approach to sexual life. Nonetheless, even if a complete health service is available, the quality is often undermined by the lack of the so-called Youth-Friendly Corners (high confidentiality spaces reserved for young people), promoted internationally by WHO. The aim of the study is to evaluate the effectiveness of the program established in this zone by the Medical Collaboration Committee regarding the creation of friendly health services for adolescent and youth people (AYFHS), especially built for sex education, family planning, abortion, and sexual transmitted infection (STI) prevention. Methods The program “#Youths at the centre!” was implemented in 20 rural health centers in the North-East Tigray on April 2018. Data from these AYFHS were collected monthly in aggregated indicators, separated for gender and age class. Use of AYFHS during 2018 and 2019 was assessed using percentage and 95% confidence interval and the period of implementation of the project and centers' characteristics were analyzed to investigate differences in AYFHS utilization. Results A monthly mean of 6.04% (6.01% - 6.08%) of adolescents and young people utilized an AYHFS for any of its service; 0.03% accessed for counseling, diagnosis, and treatment of STI, 1.31% for family planning, 1.09% for delivery, and 0.05% for legal abortion. Lower level of utilization was observed in more remote health centers, despite a general increase across the study period. Conclusions This project shows the importance of providing friendly facilities dedicated to adolescents and youth in low-income countries, in order to increment the utilization of health services from this population, especially in rural contexts. Key messages In rural areas of Africa the risks associated with poor health information of young people and the earliness of the beginning of sexual life remain a Public Health problem. In low income countries the presence of high confidentially spaces for young people in the Health Services could increase their utilization, especially for sex education and family planning.

scholarly journals Men’s Attitude Towards Contraception and Sexuality, Women’s Empowerment, and Demand Satisfied for Family Planning in India

2021 ◽  
Vol 6 ◽  
Author(s):  
Iván Mejía-Guevara ◽  
Beniamino Cislaghi ◽  
Gary L. Darmstadt
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Household Survey ◽  
Women's Empowerment ◽  
Protective Role ◽  
Reproductive Age ◽  
Women’S Empowerment ◽  
Standard Deviation Increase ◽  
The Right

Whilst the prevalence of unmet need and contraceptive use remained unchanged for 10 years (between 2005–2015) in India, gender restrictive norms and power imbalances also have persisted, preventing married women from meeting their family planning desires. Data for this study are from the 2015–6 National Family Household Survey, which contains information on fertility preferences and family planning for women in reproductive age. As a proxy for men’s attitudinal norms, we aggregated men’s perceptions regarding contraception (contraception is women’s business, women who use contraception may become promiscuous) and control over their wife (if his wife refuses to have sex, men have the right to deny financial support, have sex with another woman, or beat wife) at district level. Using a three-level random intercepts model, we assessed individual and contextual-level associations of men’s attitudinal norms and met need for contraception among sexually active women (aged 15–49) with any demand for family planning, while adjusting for women’s empowerment indicators [education, job status, and adult marriage] and individual demographic factors. Our results indicate that men’s attitudinal norms are negatively associated with women’s contraceptive use; for instance, a 1 standard deviation increase in the proportion of men who believe that contraception is women’s business was associated with a 12% reduced likelihood of contraceptive use (OR = 0.88, 95% CI 0.82–0.95). Similar associations remained or were stronger after considering only modern methods, or when excluding female sterilization. Furthermore, our contextual effects analysis revealed that women’s higher education or wealth did not improve contraceptive uptake in communities with strong attitudinal norms, but working women or women married as children were more likely to use contraception in those communities. Our results suggest that men’s attitudinal norms may be dominating over women’s empowerment regarding family planning choices among reproductive age women. However, employment appeared to play a strong protective role associated with women’s contraceptive use. It is important for programs seeking to transform gender equality and empower women in making contraceptive choices to consider women’s employment opportunities and to also address male attitudinal norms in the context of the ecosystem in which men and women coexist and interact.

A study on prevalence of contraception and estimate unmet need of family planning among married women in the rural Shamirpet, Ranga Reddy District, T.S, India.

2017 ◽  
Vol 6 (10) ◽  
pp. 5513
Author(s):  
Vijayasree L.
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Contraceptive Use ◽  
Family Planning Program ◽  
Unmet Need ◽  
Married Women ◽  
Mortality And Morbidity ◽  
The Family ◽  
Contraceptive Prevalence ◽  
Population Stabilization

The study on contraceptive use and unmet need for family planning is the key to understanding the change in fertility and improving reproductive health. Family planning program aims to not only achieve population stabilization but also to promote reproductive health and reduce maternal, infant & child mortality and morbidity. In this study an attempt has been made to assess the family planning practices adopted in the rural Shamirpet. Probability proportion sampling was done and 402 women were selected from 13 villages. Prevalence of contraception was found to be 61.7%. Permanent methods were preferred over temporary methods. Total unmet need for family planning was 11.7%. The contraceptive prevalence rate found in the present study is higher than the district figures and is on par with the state statistics. Unmet needs also are low compared to state figures.

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