scholarly journals Individual and facility-level factors associated with women’s receipt of immediate postpartum family planning counseling in Ethiopia: results from national surveys of women and health facilities

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alexandria K. Mickler ◽  
Celia Karp ◽  
Saifuddin Ahmed ◽  
Mahari Yihdego ◽  
Assefa Seme ◽  
...  
Keyword(s):  
Family Planning ◽  
Performance Monitoring ◽  
Multilevel Models ◽  
Contraceptive Use ◽  
Delivery Care ◽  
Lower Odds ◽  
Health Officer ◽  
Postpartum Family Planning ◽  
Facility Type ◽  
Facility Level

Abstract Background Immediate postpartum family planning (IPPFP) helps prevent unintended and closely spaced pregnancies. Despite Ethiopia’s rising facility-based delivery rate and supportive IPPFP policies, the prevalence of postpartum contraceptive use remains low, with little known about disparities in access to IPPFP counseling. We sought to understand if women’s receipt of IPPFP counseling varied by individual and facility characteristics. Methods We used weighted linked household and facility data from the national Performance Monitoring for Action Ethiopia (PMA-Ethiopia) study. Altogether, 936 women 5–9 weeks postpartum who delivered at a government facility were matched to the nearest facility offering labor and delivery care, corresponding to the facility type in which each woman reported delivering (n = 224 facilities). We explored women’s receipt of IPPFP counseling and individual and facility-level characteristics utilizing descriptive statistics. The relationship between women’s receipt of IPPFP counseling and individual and facility factors were assessed through multivariate, multilevel models. Results Approximately one-quarter of postpartum women received IPPFP counseling (27%) and most women delivered government health centers (59%). Nearly all facilities provided IPPFP services (94%); most had short- and long-acting methods available (71 and 87%, respectively) and no recent stockouts (60%). Multivariate analyses revealed significant disparities in IPPFP counseling with lower odds of counseling among primiparous women, those who delivered vaginally, and women who did not receive delivery care from a doctor or health officer (all p < 0.05). Having never used contraception was marginally associated with lower odds of receiving IPPFP counseling (p < 0.10). IPPFP counseling did not differ by age, residence, method availability, or facility type, after adjusting for other individual and facility factors. Conclusion Despite relatively widespread availability of IPPFP services in Ethiopia, receipt of IPPFP counseling remains low. Our results highlight important gaps in IPPFP care, particularly among first-time mothers, women who have never used contraception, women who delivered vaginally, and those who did not receive delivery care from a doctor or health officer. As facility births continue to rise in Ethiopia, health systems and providers must ensure that equitable, high-quality IPPFP services are offered to all women.

scholarly journals Factors Associated with Postpartum Family Planning in a Cohort of Kelantanese Women with Previous Caesarean Delivery in Malaysia

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Hafizah I ◽  
Tengku Alina TI ◽  
Suhaily MH ◽  
Zaharah S
Keyword(s):  
Social Support ◽  
Family Planning ◽  
Health Education ◽  
Caesarean Delivery ◽  
Contraceptive Use ◽  
Knowledge Score ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Postpartum Family Planning

 Introduction: This community-based, cross-sectional study aimed to identify the factors associated with postpartum family planning use among a cohort of women with recent caesarean delivery in a state with the lowest contraceptive use in Malaysia. Materials and Methods: A total of 281 women aged between 18-49 years old who had caesarean delivery in government tertiary centres in Kelantan from January until April 2017 were enrolled in this study. The study was conducted from January until April 2018. Women were selected through stratified random sampling with probability proportional to size. Data were collected through a validated structured questionnaire. The main outcome was binary (postpartum family planning use or non-use). The factors included socio-demographic details, reproductive history, previous contraceptive use, contraceptive health education received, knowledge, and social support. Simple and multiple logistic regression were conducted to identify significant determinants of postpartum family planning use. Results: The factors associated with postpartum family planning use included a secondary and below education level of women (AOR= 2.37, 95% CI (1.05, 5.34)), previous contraceptive use (AOR= 9.82, 95% CI (4.81, 20.06)), individual health education (AOR= 4.19, 95% CI (1.23, 14.30)), higher knowledge score (AOR= 1.12, 95% CI (1.03, 1.23)), and higher social support score (AOR= 1.09, 95% CI (1.03, 1.16)). Conclusions: here remains a need to enhance personalised contraceptive counselling in the primary care setting as well as to promote longer acting reversible contraceptive methods.

scholarly journals Women’s Autonomy Decision Making Power on Postpartum Modern Contraceptive Use and Associated Factors in North West Ethiopia

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Samrawit Yonas Tadesse ◽  
Amanu Aragaw Emiru ◽  
Tadese Ejigu Tafere ◽  
Melash Belachew Asresie
Keyword(s):  
Decision Making ◽  
Family Planning ◽  
Contraceptive Use ◽  
Modern Contraceptive ◽  
Immunization Service ◽  
Women’S Autonomy ◽  
Women's Autonomy ◽  
Autonomous Decision ◽  
Postpartum Family Planning ◽  
Modern Contraceptive Use

Background. Most postpartum women (95%) do not want pregnancy within 24 months after birth, however, 70% of them do not use modern contraceptives. In Ethiopia postpartum modern contraceptive use is low. Evidences show that women’s autonomy within the household is the most important thing in modern contraceptive use. Yet, there is dearth of information in Ethiopian context. Therefore, this study was aimed to assess women’s autonomy on modern contraceptive use and its associated factors among women who attended their children immunization service. Methods. Facility-based cross-sectional study was carried out from May 5 to Jone15, 2017 in sekota town and its surroundings among 415 women who attended immunization service for their children. Participants were selected by using a systematic sampling technique. The data were collected through face-to-face interviews using pre-tested structured questionnaires. The data were entered into epi.info version7 and analyzed using SPSS version 23. Both descriptive and logistic regression analyses were performed. A P-value less than or equal to 0.05 at 95% confidence interval was set to test statistical significance. Result. The proportion of women’s decision making power on postpartum modern contraceptive use was 77.3%. Being counseled on postpartum family planning (2.29, 95% CI: 1.27, 5.71), discussed on postpartum family planning with their husbands (AOR = 14.62, 95% CI: 6.52, 32.75), and had the index child within one year after previous birth (AOR = 7.98, 95% CI: 2.52, 30.65) were found positively associated with women’s autonomous decision making power on postpartum modern contraceptive use. In addition, those women who knew that pregnancy could happen during the postpartum period (AOR = 6.53, 95% CI: 3.2, 14.12) were more autonomous in decision to use postpartum contraception. Conclusion. The proportion of women’s autonomous decision making power on postpartum modern contraceptive use was low. Those women who were counseled on postpartum family planning, discussed with partners, and those who knew that pregnancy could happen during the postpartum period had higher odds of autonomous decision making power. Therefore, strengthening counseling, educating on postpartum family planning, and encouraging women to discuss postpartum family planning with their husbands may improve women’s power.

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

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Suresh Mehata ◽  
Yuba Raj Paudel ◽  
Ranju Mehta ◽  
Maureen Dariang ◽  
Pradeep Poudel ◽  
...  
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Neonatal Morbidity ◽  
Risk Groups ◽  
Demographic And Health Surveys ◽  
Postpartum Family Planning ◽  
Level Data ◽  
Modern Family ◽  
Planning Methods

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.

scholarly journals The Maximum CPR Model: a demographic tool for family planning policy

2019 ◽  
Vol 3 ◽  
pp. 1736
Author(s):  
Kristin Bietsch ◽  
Emily Sonneveldt
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Policy Makers ◽  
Number Of Children ◽  
Planning Policy ◽  
Family Planning Programs ◽  
Postpartum Family Planning ◽  
Ideal Number ◽  
Contraceptive Prevalence ◽  
Mathematical Construction

The Maximum CPR Model (MCM) allows demographers, policy makers, and family planning advocates to determine a country’s highest potential contraceptive prevalence rate (CPR), based on an ideal number of children, demographic life events, and population structure. Understanding the highest potential level of CPR achievable under current circumstances in a population leads to realistic expectations and appropriate policy implementation. Countries with a large gap between current CPR and maximum CPR can focus on removing blocks to contraceptive use, while countries where the maximum potential CPR is near the actual CPR may need to shift their focus to demand generation or postpartum family planning programs. With a focus on equality of access to family planning, MCM produces CPR for all women, regardless of marital status. This paper details the mathematical construction of the MCM. A version of the model is available online for easy use by non-technical audiences in English and French.

scholarly journals The Maximum CPR Model: a demographic tool for family planning policy

2020 ◽  
Vol 3 ◽  
pp. 1736
Author(s):  
Kristin Bietsch ◽  
Emily Sonneveldt
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Policy Makers ◽  
Number Of Children ◽  
Planning Policy ◽  
Family Planning Programs ◽  
Postpartum Family Planning ◽  
Ideal Number ◽  
Contraceptive Prevalence ◽  
Mathematical Construction

The Maximum CPR Model (MCM) allows demographers, policy makers, and family planning advocates to determine a country’s highest potential contraceptive prevalence rate (CPR), based on an ideal number of children, demographic life events, and population structure. Understanding the highest potential level of CPR achievable under current circumstances in a population leads to realistic expectations and appropriate policy implementation. Countries with a large gap between current CPR and maximum CPR can focus on removing blocks to contraceptive use, while countries where the maximum potential CPR is near the actual CPR may need to shift their focus to demand generation or postpartum family planning programs. With a focus on equality of access to family planning, MCM produces CPR for all women, regardless of marital status. This paper details the mathematical construction of the MCM. A version of the model is available online for easy use by non-technical audiences in English and French.

Determinants of Family Planning and Child Immunization Services Integration in Urban Areas of Nigeria: A Longitudinal Analysis

2020 ◽  
Author(s):  
Kate Sheahan ◽  
Ilene Speizer ◽  
Jennifer Orgill-Meyer ◽  
Sian Curtis ◽  
Morris Weinberger ◽  
...  
Keyword(s):  
Family Planning ◽  
Urban Areas ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Modern Contraceptive ◽  
Child Immunization ◽  
Period 2 ◽  
Immunization Services ◽  
Facility Level ◽  
The Impact

Abstract Background: Unmet need for contraception is high in the postpartum period. Research has identified the role that integration of family planning into child immunization services can have in addressing this need. However, evidence about the effects of family planning and immunization integration has been inconsistent and more evidence is required to determine whether and how to invest in integration. This study applies continuous facility-level family planning and child immunization integration index scores to: (1) determine whether facility-level integration changes over time, (2) assess the impact of the Nigerian Urban Reproductive Health Initiative (NURHI) - a program that aimed to increase modern contraceptive use - on integration, and (3) identify determinants of integration across facilities in urban areas of Nigeria. Methods: Longitudinal data from health facilities in six urban areas of Nigeria are available from 400 facilities at baseline and 385 facilities at endline. Difference-in-differences models are used to assess the impact of NURHI on Provider Integration and Facility Integration Index scores, and to identify facility-level determinants of integration. The two outcome measures, Provider and Facility Integration Index scores, measure attributes that support integrated service delivery. The independent variables are (1) time period (2) whether the facility received the NURHI intervention, and (3) facility-level characteristics. Results: Our results show that the Provider Integration Index scores increased significantly only among non-intervention facilities while Facility Integration Index scores did not increase significantly in either group. We find that NURHI did not have a significant effect on integration index scores. Results also pinpoint facility characteristics that influence integration, including public ownership and the proportion of providers who have received family planning training. Conclusion: Programs aiming to increase integration of family planning and immunization services should monitor and provide targeted support for the implementation of a well-defined integration strategy that considers the influence of facility characteristics and concurrent initiatives.

scholarly journals Correlates of Contraceptive Use and Health Facility Choice among Young Women in Malawi

2016 ◽  
Vol 669 (1) ◽  
pp. 93-124 ◽  
Author(s):  
Jean Digitale ◽  
Stephanie Psaki ◽  
Erica Soler-Hampejsek ◽  
Barbara S. Mensch
Keyword(s):  
Family Planning ◽  
Health Facility ◽  
Young Women ◽  
Service Provision ◽  
Contraceptive Use ◽  
Early Years ◽  
Family Planning Services ◽  
Facility Type ◽  
Almost All

We explore whether differential access to family-planning services and the quality of those services explain variability in uptake of contraception among young women in Malawi. We accomplish this by linking the Malawi Schooling and Adolescent Study, a longitudinal survey of young people, with the Malawi Service Provision Assessment collected in 2013–14. We also identify factors that determine choice of facility among those who use contraception. We find that the presence and characteristics of nearby facilities with contraception available did not appear to affect use. Rather, characteristics such as facility type and whether contraception was provided free of charge determined where women deciding to use contraception obtained their contraception. We argue that in a context where almost all respondents resided within 10 kilometers of a health facility, improving access to and quality of family-planning services may not markedly increase contraceptive use among young women without broader shifts in norms regarding childbearing in the early years of marriage.

scholarly journals Long-acting reversible contraception utilization and associated factors among women in extended postpartum period in southern Ethiopia

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Yibeltal Mesfin ◽  
Abraham Wallelign
Keyword(s):  
Family Planning ◽  
Sexual Intercourse ◽  
Postpartum Period ◽  
Associated Factors ◽  
Contraceptive Use ◽  
Postpartum Family Planning ◽  
Contraception Use ◽  
Family Planning Counseling ◽  
Long Acting ◽  
Long Acting Reversible Contraceptive

Abstract Background Postpartum long-acting reversible contraceptive is important to prevent unintended and closed spaced pregnancy following the first 12 months of childbirth. Few data were available on postpartum long-acting reversible contraceptive use in Ethiopia. So, this study aimed to assess the long-acting reversible contraception use and associated factors among women who gave birth in the last 12 months. Methods A community-based cross-sectional study was conducted from October 1st to November 2019. Systematic random sampling was applied to recruit a total of 416 study participants. Data were collected using a structured questionnaire. Data were entered using Epidata 4.6 and exported to SPSS version 25 for analysis. P-value < 0.05 with 95% confidence interval (CI) used to declare statistical significance. Result In this study, long acting contraceptive utilization among women in the extended postpartum period was 22.6%. Maternal age ≤ 24 years (AOR = 3.7, 95% CI: 1.5, 8.9), being married (AOR =3.5 95% CI: (1.17–10.28)), menses resumption (AOR = 4.9 95% CI: (2.92, 8.20)), sexual intercourse resumption (AOR = 7.1 95% CI: (4.03, 12.56)) and received postpartum family planning counseling (AOR = 3.2 95% (1.95, 5.28)) were the factors associated with Long-acting reversible contraception use. Conclusion This finding showed postpartum women’s long-acting reversible contraceptive use during the extended postpartum period was low. The factors significantly associated with extended postpartum modern contraceptive use were women’s age, being married, menses resumption, sexual intercourse resumption, and got postnatal family planning counseling. Strengthening Antenatal and postnatal counseling of postpartum family planning would improve long-acting reversible contraception use.

scholarly journals Uptakes and associated factors of postpartum family planning in southern Ethiopia: A cross-sectional study

2021 ◽  
Vol 8 (3) ◽  
pp. 388-396
Author(s):  
Dubale Dulla Koboto ◽  
Sintayehu Assefa
Keyword(s):  
Family Planning ◽  
Associated Factors ◽  
Contraceptive Use ◽  
Post Partum ◽  
Cross Sectional Study ◽  
Southern Ethiopia ◽  
First Year ◽  
Sectional Study ◽  
Cross Sectional ◽  
Postpartum Family Planning

Post-partum family planning aims to prevent unintended pregnancy within the first year postpartum. Closely spaced pregnancy within the first year of post-partum (PP) is associated with higher risk of preterm birth, low birth weight or small for gestational age. However, the perceived uptakes of postpartum contraceptives is very low. The intention of this study was determine uptakes and associated factors of postpartum family planning in southern Ethiopia. The study was conducted in Hawassa city administration which is the capital of SNNPR. Community based cross-sectional study was employed women who gave birth in the last 12 months before survey. Data was collected using structured questionnaire proceeding informed verbal consent. Logistic regression model was used to identify associations between variables and findings were presented by tables and figures. The prevalence of current post-partum contraceptive use was 85.1%. After adjusting for covariates; the odds of using postpartum contraceptive were 1.31 times, 12.13 times, 5.17 times, 10.77 time and 4.69 times higher among women with, knowledge about advantages and side effects of contraceptives, partner support for contraceptive use, previously contraceptive use and not returned period respectively with (P &#60;0. 05).uptakesofpostpartum contraceptives in Hawassa city administration was promising. Detailed counseling about postpartum contraceptive use, could assist equipping women with knowledge of family planning methods; empowering them to be decisive in the health and positivity of male partners are very crucial to promote postpartum use of contraceptives.

Sign in / Sign up

Export Citation Format

Share Document