Postpartum contraceptive practices among urban and peri-urban women in North India: a mixed-methods cohort study protocol

Abstract Background Postpartum family planning (PPFP) helps women space childbirths, increase exclusive breastfeeding and prevent unintended pregnancies, leading to reduction in maternal, infant and child morbidities and mortality. Unmet need of family planning is highest among women in the postpartum period due to lack of knowledge, cultural and religious barriers, access barriers and low antenatal care service utilization. However, in spite of low prevalence of postpartum family planning practices, birth-to-birth interval is reportedly high in Delhi, India. This study explores the postpartum contraception practices and the relationship between use of postpartum contraception and subsequent child linear growth. Methods This is a mixed method cohort study on PPFP and is nested within an ongoing “Women and Infants Integrated Interventions for Growth Study” (WINGS). Married women aged 18–30 years who have delivered a live baby are recruited for quantitative interviews at 6 weeks, 6, 12, and 24 months postpartum. In-depth interviews are conducted with a randomly selected sub-sample of women at each of the four time points, 35 husbands and 20 local service providers to understand their perspectives on PPFP practices. Discussion The findings from the study will provide useful insights into couples’ contraception preferences and choice of contraception, modern and traditional, initiation time and the effect of birth spacing and contraception use on subsequent linear growth of the child. This knowledge will be of significant public health relevance and will help in designing appropriate interventions for appropriate postpartum contraception use and delivery strategies. The study aims to work address the Sexual and Reproductive Health and Rights goal of promoting reproductive health, voluntary and safe sexual and reproductive choices for women. Trial registration Trial registration number: CTRI/2020/03/023954.

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The Relationship between Intimate Partner Violence and Family Planning among Girls and Young Women in the Philippines

Global Journal of Health Science ◽

10.5539/gjhs.v8n9p121 ◽

2016 ◽

Vol 8 (9) ◽

pp. 121 ◽

Cited By ~ 7

Author(s):

Laura Cordisco Tsai ◽

Claudia Cappa ◽

Nicole Petrowski

Keyword(s):

Intimate Partner Violence ◽

Family Planning ◽

Reproductive Health ◽

Young Women ◽

Partner Violence ◽

Unmet Need ◽

Intimate Partner ◽

The Philippines ◽

Contraception Use ◽

The Relationship

<p>This study explored the relationship between intimate partner violence (IPV) and family planning among adolescent girls and young women in formal unions in the Philippines. Analyzing a sample (n =1,566) from the 2013 Philippines Demographic and Health Survey, logistic regression models were separately run for current contraception use and unmet need for family planning on recent physical violence (yes/no), recent sexual violence (yes/no), and recent emotional (yes/no). Findings revealed that the odds of using contraception were significantly higher among girls and young women who reported recent physical IPV (OR=1.84; 95% CI=1.13, 2.99; p<0.05) and sexual IPV (OR=2.18; 95% CI=1.17, 4.06; p<0.05). No significant relationship between recent emotional IPV and contraception use was found. Having an unmet need for family planning showed no significant relationship to IPV. The study adds to a growing body of literature revealing a positive association between IPV and contraception use. Findings hold implications for the provision of family planning services for adolescents and young women in response to the recent passage of landmark legislation pertaining to reproductive health in the Philippines, the Responsible Parenthood and Reproductive Health Act. </p>

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Role of husband’s attitude towards the usage of contraceptives for unmet need of family planning among married women of reproductive age in Pakistan

BMC Women s Health ◽

10.1186/s12905-021-01314-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Muhammad Farhan Asif ◽

Zahid Pervaiz ◽

Jawad Rahim Afridi ◽

Ghulam Abid ◽

Zohra S. Lassi

Keyword(s):

Family Planning ◽

Unmet Need ◽

Wealth Quintile ◽

Married Women ◽

Reproductive Age ◽

Women Of Reproductive Age ◽

Family Planning Programs ◽

Contraception Use ◽

Wide Range

Abstract Background Family planning services deliver a wide range of benefits to the well-being of females and the community. It can curtail the risk of maternal and neonatal mortality through the reduction in abortions and pregnancies. The government of Pakistan has been struggling to convince people about the usefulness of family planning programs. However, different factors related to social norms, values, and culture are important to determine the success of these programs. One such factor is the patriarchal structure of Pakistani society where most of the household decisions are made by men. The objective of this research is to examine the role of the husband’s attitude towards the usage of contraceptives for the unmet need of family planning (UMNFP) among married women of reproductive age (MWRA) in Pakistan. Method The dataset of Pakistan Demographic and Health Survey 2017–18 is utilized to examine the role of the husband’s attitude towards the usage of contraceptives in UMNFP among MWRA in Pakistan. Results The UMNFP was considerably lower among MWRA between 40 years and above compared to women 15–19 years. The odds of UMNFP were higher among women and men who were educated up to the primary level compared to those with no education. Odds of UMNFP were higher among women from the poor wealth quintile compared to the poorest wealth quintile; similarly, it was significantly lower among women who were from the richer and the richest wealth quintile compared to the poorest wealth quintile. The odds of UMNFP were lower among women who were employed compared to those who were not employed. Lastly, the odds of UMNFP were higher among women whose husbands opposed to using contraceptives, who perceived that there was a religious prohibition for such use and when a decision on the contraception use was solely made by the husband. Conclusions Husband’s attitude towards the usage of contraceptives is an important predictor of UMNFP. Liaising with the community and religious leaders to persuade people particularly men about the usefulness of family planning programs and encouraging men to understand their women’s say in using contraceptives should be encouraged.

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Factors Affecting Unmet Need of Family Planning Among Married Tharu Women of Dang District, Nepal

International Journal of Reproductive Medicine ◽

10.1155/2018/9312687 ◽

2018 ◽

Vol 2018 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Chet Kant Bhusal ◽

Sigma Bhattarai

Keyword(s):

Family Planning ◽

Reproductive Health ◽

Strategic Behavior ◽

Universal Access ◽

Unmet Need ◽

Decisive Role ◽

Secondary Level ◽

Cross Sectional ◽

Factors Affecting ◽

Communication Program

Background. Increase in population plays a decisive role in providing universal access to reproductive health; however, there is very limited evidence about the reason of unmet need among marginalized and tribal communities such as Tharus. This study aimed to determine the factors affecting unmet need of family planning among married Tharu women of Dang, Nepal. Methods. Community-based cross-sectional household survey among 650 married Tharu women of age group 15-49 in October 2015 to April 2016 was conducted in Dang district, Nepal. Randomly 3 wards were selected from each Tulsipur municipality, Hekuli Village Development Committee, and Pawan Nagar VDC. Results. The mean age and parity were 30±7.31 and 2±0.69, respectively. Out of 650 women, 47% were using contraceptives. Westoff model was used for calculating total unmet need which is 49%, where unmet need for limiting and spacing was 27% and 22%, respectively. Hence after combining the current users and total unmet need, total demand for family planning was 96%. After adjustment, significant relation was observed between number of living sons ≥ 1 and unmet need of family planning (OR= 0.4; CI=0.2-0.8, p=0.01 ), similarly for women education; lower secondary level (OR=0.3; CI=0.1-0.6, p=0.01) and secondary (OR=0.1; CI=0.03-0.4, p=0.01); husband education, lower secondary level (OR=0.3; CI=0.1-0.6, p=0.01) and secondary (OR=0.4; CI= 0.2-0.9, p=0.04); and husband occupation, wage labor (OR=0.6; CI=0.4-0.99, p=0.05). In addition, having very good knowledge about method was also significantly associated (OR=0.49; CI= 0.2-0.97, p= 0.04). Conclusion. Unmet need of family planning was significantly higher among less than secondary educated women. It is also predisposed by spouse education, partner’s occupation, and number of living sons. This study concerns the need for all stake holders to focus on strategic behavior communication program regarding reproductive health.

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Prevalence of Postpartum Family Planning Service Coverage in Selected Referral Facilities of Nepal

Journal of Nepal Medical Association ◽

10.31729/jnma.4788 ◽

2020 ◽

Vol 58 (221) ◽

Author(s):

Kusum Thapa ◽

Rolina Dhital ◽

Sameena Rajbhandari ◽

Shikha Thapa ◽

Sabina Pokhrel ◽

...

Keyword(s):

Family Planning ◽

Intrauterine Device ◽

Cross Sectional Study ◽

Planning Method ◽

Family Planning Method ◽

Postpartum Contraception ◽

Cross Sectional ◽

Postpartum Family Planning ◽

Ethical Approval ◽

Service Coverage

Introduction: Nepal Society of Obstetricians and Gynecologists jointly with the Nepalese governmentand with the support from the International Federation of Obstetrics and Gynecology hasimplemented an initiative to institutionalize postpartum family planning services in selected majorreferral facilities of Nepal to address the gap of low uptake of postpartum family planning in Nepal.The aim of the study is to find the prevalence of the service coverage of postpartum contraception inthe selected facilities. Methods: A descriptive cross-sectional study was conducted in seven major referral facilities acrossNepal. Data were collected from the hospital records of all women who delivered in these facilitiesbetween October 2018 and March 2019. Ethical approval for this study was obtained from NepalHealth Research Council. Data analysis was done with SPSS version 23. Results: Among the 29,072 deliveries from all the facilities, postpartum family planning counselingcoverage was 27,301 (93.9%). The prevalence of uptake of Postpartum Intrauterine Device is 1581(5.4%) and female sterilization is 1830 (6.3%). In total 11387 mothers (52.2%) had the intention tochoose a postpartum family planning method. However, 36% of mothers neither used nor had theintention to choose a postpartum family planning method. Conclusions: The coverage of Postpartum Intrauterine Device counseling service coverage in Nepal ishigher in 2018 as compared to 2016-2017 and in other countries implementing Postpartum IntrauterineDevice initiatives. However, the prevalence of service coverage of immediate Postpartum FamilyPlanning methods, mainly Postpartum Intrauterine Device in 2018 is lower in Nepal as compared to2016-2017, and other countries implementing Postpartum Intrauterine Device initiative. More effortsare needed to encourage mothers delivering in the facilities to use the postpartum family planningmethod.

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Improving sexual and reproductive health knowledge and practice in Mozambican families with media campaign and volunteer family health champions

Family Medicine and Community Health ◽

10.1136/fmch-2018-000089 ◽

2019 ◽

Vol 7 (4) ◽

pp. e000089

Author(s):

Paulo Henrique Pires ◽

Ronald Siemens ◽

Martins Mupueleque

Keyword(s):

Family Planning ◽

Reproductive Health ◽

Sexual And Reproductive Health ◽

Health Knowledge ◽

Unmet Need ◽

Family Health ◽

Media Campaign ◽

Planning Practice ◽

Cross Sectional ◽

Before And After

ObjectiveTo increase knowledge, attitudes and practice of sexual and reproductive health and family planning and to reduce maternal and neonatal mortality rates in Mozambique.DesignAn implementation research project’s intermediate evaluation, applying two cross-sectional surveys. The surveys were planned for 316 subjects before and after interventions.SettingResearch performed in Natikiri district of Nampula province in northern Mozambique, targeting a suburban and rural populations in their homes.Participants452 people were surveyed (91 before, 361 after), all belonging to the Macua ethnic group.InterventionsA media campaign (2 weekly radio spots, bimonthly theatre performances) was performed for 8 months (2017 to 2018) and family health champions’ teachings (monthly home visits) performed for 3 months, on sexual and reproductive health and family planning. Outcome measures planned and measured were adolescent’s and adult’s knowledge, attitudes and practice about those. Data were analysed by gender, age group and frequencies, using a CI of 95% (p<0.5 statistically significant).ResultsRadio spots, community theatre and volunteer champions increased population’s knowledge about sexual and reproductive health and led to a more positive attitude toward family planning. Concerning attitude, results show differences between adults’ proportions before and after: (1) did you hear about sexual and reproductive health (p=0.0425); (2) knows project key messages (p<0.001); (3) knows prenatal visits importance (p=0.0301); (4) access to contraceptives was easy (p<0.001). Adolescents showed statistically significant differences before and after: (1) knows project key messages (p<0.001); (2) access to contraceptives was easy (p=0.0361). Family planning practice did not increase in both groups.ConclusionA health education intervention, using a media campaign and local volunteers, is useful to promote mother and child health. There is an unmet need for family planning and the use of modern contraception is below desired practice, needing further research about cultural barriers. Communication for behaviour change activities will pursue and impact will be assessed to document family planning practice improvement.

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Reasons for unmet need for family planning, with attention to the measurement of fertility preferences: protocol for a multi-site cohort study

Reproductive Health ◽

10.1186/s12978-016-0268-z ◽

2017 ◽

Vol 14 (1) ◽

Cited By ~ 19

Author(s):

Kazuyo Machiyama ◽

John B. Casterline ◽

Joyce N. Mumah ◽

Fauzia Akhter Huda ◽

Francis Obare ◽

...

Keyword(s):

Cohort Study ◽

Family Planning ◽

Unmet Need ◽

Fertility Preferences

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Factors affecting men’s support for the use of the contraceptive implant by their female intimate partners

Contraception and Reproductive Medicine ◽

10.1186/s40834-020-00140-7 ◽

2020 ◽

Vol 5 (1) ◽

Author(s):

Kim Jonas ◽

Moira Kalichman ◽

Seth Kalichman ◽

Chelsea Morroni ◽

Catherine Mathews

Keyword(s):

South Africa ◽

Family Planning ◽

Reproductive Health ◽

Health Clinic ◽

Intimate Partners ◽

Cross Sectional Survey ◽

Factors Affecting ◽

Contraception Use ◽

Contraceptive Implant ◽

Men’S Knowledge

Abstract Background Family planning services have been available at no cost in the public health settings of South Africa since 1994, and now include the long-acting reversible contraceptives (LARCs) namely, the contraceptive implant and intra-uterine device (IUD). However, the uptake of LARCs has been declining in the recent years and little is known about the cause of the decline. In many relationships, men may influence their female intimate partner’s contraceptive choices. Thus, men’s involvement in reproductive health decisions and family programming may improve their support for contraceptive use, including the LARC use by their female intimate partners. This study investigated factors affecting men’s support for the use of contraceptive implant by their female intimate partners. Methods A quantitative, cross-sectional survey was conducted among adult men attending a public, primary health clinic in Cape Town, South Africa. Using a structured questionnaire, we measured men’s knowledge, awareness and support of, and attitudes towards use of the contraceptive implant by their female intimate partners. Data were analyzed using SPSS version 25. Results The sample included 65 men with a mean age of 31.2 years. Most (76.6%) believed that both men and women should be responsible for family planning. Support for general contraception use by their female intimate partners was prevalent at 80.0%, but only 33.9% reported that they would like their partners to use the implant in the future, while 35.6% were unsure and 30.5% did not support their partner’s use of the implant. Factors significantly associated with men’s support of their partner’s future use of the contraceptive implant included men’s reports that their partner wished to have another child in future, knowledge that the implant is safe for use by women who have not had children, knowledge that the implant can effectively prevent pregnancy for 3 years, and a positive attitude towards the implant’s long-lasting effectiveness. Conclusion Improving men’s knowledge of, and attitudes toward the contraceptive implant might increase their support for their partner’s use of the implant, which in turn might promote uptake of the implant among women. The findings of our study suggest the importance of actively engaging men in reproductive health and family planning programs.

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Characteristics Associated with Emergency Contraception Use by Family Planning Patients: A Prospective Cohort Study

Perspectives on Sexual and Reproductive Health ◽

10.1363/3915807 ◽

2007 ◽

Vol 39 (3) ◽

pp. 158-166 ◽

Cited By ~ 13

Author(s):

Paul G. Whittaker ◽

Matthew Berger ◽

Kay A. Armstrong ◽

Toni L. Felice ◽

Janet Adams

Keyword(s):

Cohort Study ◽

Family Planning ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Emergency Contraception ◽

Contraception Use

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Promouvoir les services de vasectomie au Burundi

10.31899/sbsr2016.1002 ◽

2016 ◽

Keyword(s):

Family Planning ◽

Service Providers ◽

Unmet Need ◽

Cost Effective ◽

Evidence Based ◽

Healthy Relationships ◽

Unintended Pregnancies ◽

Engaging Men ◽

National Family ◽

National Family Planning

Vasectomy is a safe and highly effective family planning method for men and couples who do not want any more children, but in low resource settings, few men seek out or have access to this method. Increasing the voluntary use of vasectomy is a cost-effective strategy for countries to reduce unmet need for family planning, decrease unintended pregnancies, and meet national family planning goals. By engaging men directly in family planning, vasectomy also holds promise for promoting positive gender norms and healthy relationships. | This brief is part of a set of resources from FHI 360/Evidence Project providing policymakers, advocates, program managers, and service providers with evidence-based recommendations for improving vasectomy programming.

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Barriers and enablers to postpartum contraception among Aboriginal Australian women: factors influencing contraceptive decisions

Australian Journal of Primary Health ◽

10.1071/py17041 ◽

2018 ◽

Vol 24 (3) ◽

pp. 241 ◽

Cited By ~ 3

Author(s):

Sarah James ◽

Maree Toombs ◽

Wendy Brodribb

Keyword(s):

Family Planning ◽

Social Factors ◽

Health Professionals ◽

Postpartum Contraception ◽

Barriers And Enablers ◽

Aboriginal Women ◽

Factors Influencing ◽

Contraception Use ◽

Open Coding ◽

Improve Health

This qualitative research obtained insights into factors influencing postpartum contraception use among Aboriginal women in southern Queensland. Seventeen women participated in focus groups or interviews from July to October 2015 at an Aboriginal and Torres Strait Islander Community-Controlled Health Organisation. Data were analysed with open coding and thematic analysis. The results affirmed Aboriginal women want control over family planning. Participants indicated more could be done to improve health literacy and contraception uptake. A variety of family planning preferences were revealed, with an almost universal desire for increased access to postpartum contraception. Participants wanted information given antenatally and postnatally. Obtaining and using contraception were difficult for many. Social factors that hinder access such as shame, ideas surrounding women’s health, cultural disengagement, social isolation and using childbearing to control relationships were identified. The reproductive outcomes of Aboriginal women often do not reflect their preferences. A mandate exists to provide information about and access to postpartum contraception, empowering women with greater control over their reproductive practices. Health professionals can play a key role in dismantling barriers to autonomous family planning by offering information and resources both antenatally and postnatally.

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