scholarly journals Facility-level characteristics associated with family planning and child immunization services integration in urban areas of Nigeria: a longitudinal analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kate L. Sheahan ◽  
Ilene S. Speizer ◽  
Jennifer Orgill-Meyer ◽  
Siân Curtis ◽  
Morris Weinberger ◽  
...  
Keyword(s):  
Family Planning ◽  
Urban Areas ◽  
Unmet Need ◽  
Principal Component ◽  
Public Facility ◽  
Postpartum Contraception ◽  
Child Immunization ◽  
Period 2 ◽  
Immunization Services ◽  
Facility Level

Abstract Background Unmet need for postpartum contraception is high. Integration of family planning with routine child immunization services may help to satisfy unmet need. However, evidence about the determinants and effects of integration has been inconsistent, and more evidence is required to ascertain whether and how to invest in integration. In this study, facility-level family planning and immunization integration index scores are used to: (1) determine whether integration changes over time and (2) identify whether facility-level characteristics, including exposure to the Nigerian Urban Reproductive Health Initiative (NURHI), are associated with integration across facilities in six urban areas of Nigeria. Methods This study utilizes health facility data collected at baseline (n = 400) and endline (n = 385) for the NURHI impact evaluation. Difference-in-differences models estimate the associations between facility-level characteristics, including exposure to NURHI, and Provider and Facility Integration Index scores. The two outcome measures, Provider and Facility Integration Index scores, reflect attributes that support integrated service delivery. These indexes, which range from 0 (low) to 10 (high), were constructed using principal component analysis. Scores were calculated for each facility. Independent variables are (1) time period, (2) whether the facility received the NURHI intervention, and (3) additional facility-level characteristics. Results Within intervention facilities, mean Provider Integration Index scores were 6.46 at baseline and 6.79 at endline; mean Facility Integration Index scores were 7.16 (baseline) and 7.36 (endline). Within non-intervention facilities, mean Provider Integration Index scores were 5.01 at baseline and 6.25 at endline; mean Facility Integration Index scores were 5.83 (baseline) and 6.12 (endline). Provider Integration Index scores increased significantly (p = 0.00) among non-intervention facilities. Facility Integration Index scores did not increase significantly in either group. Results identify facility-level characteristics associated with higher levels of integration, including smaller family planning client load, family planning training among providers, and public facility ownership. Exposure to NURHI was not associated with integration index scores. 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 Facility-Level Characteristics Associated with Family Planning and Child Immunization Services Integration in Urban Areas of Nigeria: A Longitudinal Analysis

2021 ◽  
Author(s):  
Kate Sheahan ◽  
Ilene Speizer ◽  
Jennifer Orgill-Meyer ◽  
Sian Curtis ◽  
Morris Weinberger ◽  
...  
Keyword(s):  
Family Planning ◽  
Urban Areas ◽  
Unmet Need ◽  
Principal Component ◽  
Public Facility ◽  
Postpartum Contraception ◽  
Child Immunization ◽  
Immunization Services ◽  
Facility Level ◽  
The Impact

Abstract Background: Unmet need for postpartum contraception is high. Integration of family planning with routine child immunization services may help to satisfy unmet need. However, evidence about the effects of 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 integration changes over time, (2) assess the impact of the Nigerian Urban Reproductive Health Initiative (NURHI) on integration, and (3) identify facility-level characteristics associated with 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 (2011) and 385 facilities at endline (2014). Difference-in-differences models estimate the impact of NURHI on Provider and Facility Integration Index scores and determine associations between facility-level characteristics and integration. The two outcome measures, Provider and Facility Integration Index scores, reflect attributes that support integrated service delivery. These indexes, which range from 0 (low) to 10 (high), were constructed using principal component analysis. Scores were calculated for each facility. Independent variables are (1) time period, (2) whether the facility received the NURHI intervention, and (3) facility-level characteristics. Results: Within intervention facilities, mean Provider Integration Index scores were 6.46 at baseline and 6.79 at endline; mean Facility Integration Index scores were 7.16 (baseline) and 7.36 (endline). Within non-intervention facilities, mean Provider Integration Index scores were 5.01 at baseline and 6.25 at endline; mean Facility Integration Index scores were 5.83 (baseline) and 6.12 (endline). Provider Integration Index scores increased significantly (p = 0.00) among non-intervention facilities. Facility Integration Index scores did not increase significantly in either group. NURHI did not have a significant effect on integration index scores. Results identify facility-level characteristics associated with integration: location, family planning client load, years of provider experience, provider training, and public facility ownership. 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.

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 Development of Integration Indexes to Determine the Extent of Family Planning and Child Immunization Services Integration in Health Facilities in Urban Areas of Nigeria

2020 ◽  
Author(s):  
Kate Sheahan ◽  
Jennifer Orgill-Meyer ◽  
Ilene Speizer ◽  
Sian Curtis ◽  
John Paul ◽  
...  
Keyword(s):  
Family Planning ◽  
Service Delivery ◽  
Urban Areas ◽  
Health Facilities ◽  
Index Score ◽  
Child Immunization ◽  
Integrated Service Delivery ◽  
Immunization Services ◽  
The Impact ◽  
Integrated Service

Abstract Background: Integrating family planning into child immunization services may address unmet need for contraception by offering family planning information and services to postpartum women during routine child immunization visits. However, policies and programs promoting integration are often based on insubstantial or conflicting evidence about its effects on service delivery and health outcomes. Since most studies measure integration as binary (a facility is integrated or not) rather than a multidimensional and varying continuum, it is difficult to understand the determinants and effects of integration. This study creates Facility and Provider Integration Indexes, which measure capacity to support integrated family planning and child immunization services, and applies them to analyze the extent of integration across 400 health facilities. Methods: This study utilizes cross-sectional health facility (N= 400; 49% hospitals, 51% primary healthcare centers) and healthcare provider (N= 1,479) survey data that were collected in six urban areas of Nigeria for the impact evaluation of the Nigerian Urban Reproductive Health Initiative. Principal Components Analysis was used to develop Provider and Facility Integration Indexes that estimate the extent of integration in these health facilities. The Provider Integration Index measures provider skills and practices that support integrated service delivery while the Facility Integration Index measures facility norms that support integrated service delivery. Index scores range from zero (low) to ten (high). Results: Mean Provider Integration Index score is 5.42 (SD 3.10), and mean Facility Integration Index score is 6.22 (SD 2.72). Twenty-three percent of facilities were classified as having low Provider Integration scores, 32% as medium, and 45% as high. Fourteen percent of facilities were classified as having low Facility Integration scores, 38% as medium, and 48% as high. Conclusion: Many facilities in our sample have achieved high levels of integration, while many others have not. Results suggest that measuring integration as a binary variable does not (a) reflect the true variation in integration within and across health facilities, (b) enable nuanced measurement of the determinants or effects of integration, or (c) provide tailored, actionable information about how best to improve integration. Overall, results reinforce the importance of utilizing more nuanced measures of facility-level integration.

scholarly journals Development of Integration Indexes to Determine the Extent of Family Planning and Child Immunization Services Integration in Health Facilities in Urban Areas of Nigeria

2020 ◽  
Author(s):  
Kate L. Sheahan ◽  
Jennifer Orgill-Meyer ◽  
Ilene Speizer ◽  
Sian Curtis ◽  
John Paul ◽  
...  
Keyword(s):  
Family Planning ◽  
Service Delivery ◽  
Urban Areas ◽  
Health Facilities ◽  
Index Score ◽  
Child Immunization ◽  
Integrated Service Delivery ◽  
Immunization Services ◽  
The Impact ◽  
Integrated Service

Abstract Background: Integrating family planning into child immunization services may address unmet need for contraception by offering family planning information and services to postpartum women during routine child immunization visits. However, policies and programs promoting integration are often based on insubstantial or conflicting evidence about its effects on service delivery and health outcomes. While integration models vary, many studies measure integration as binary (a facility is integrated or not) rather than a multidimensional and varying continuum. It is thus challenging to ascertain the determinants and effects of integrated service delivery. This study creates Facility and Provider Integration Indexes, which measure capacity to support integrated family planning and child immunization services and applies them to analyze the extent of integration across 400 health facilities. Methods: This study utilizes cross-sectional health facility (N= 400; 58% hospitals, 42% primary healthcare centers) and healthcare provider (N= 1,479) survey data that were collected in six urban areas of Nigeria for the impact evaluation of the Nigerian Urban Reproductive Health Initiative. Principal Components Analysis was used to develop Provider and Facility Integration Indexes that estimate the extent of integration in these health facilities. The Provider Integration Index measures provider skills and practices that support integrated service delivery while the Facility Integration Index measures facility norms that support integrated service delivery. Index scores range from zero (low) to ten (high). Results: Mean Provider Integration Index score is 5.42 (SD 3.10), and mean Facility Integration Index score is 6.22 (SD 2.72). Twenty-three percent of facilities were classified as having low Provider Integration scores, 32% as medium, and 45% as high. Fourteen percent of facilities were classified as having low Facility Integration scores, 38% as medium, and 48% as high. Conclusion: Many facilities in our sample have achieved high levels of integration, while many others have not. Results suggest that measuring integration as a binary variable does not (a) reflect the true variation in integration within and across health facilities, (b) enable nuanced measurement of the determinants or effects of integration, or (c) provide tailored, actionable information about how best to improve integration. Overall, results reinforce the importance of utilizing more nuanced measures of facility-level integration.

scholarly journals Development of integration indexes to determine the extent of family planning and child immunization services integration in health facilities in urban areas of Nigeria

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Kate L. Sheahan ◽  
Jennifer Orgill-Meyer ◽  
Ilene S. Speizer ◽  
Siân Curtis ◽  
John Paul ◽  
...  
Keyword(s):  
Family Planning ◽  
Service Delivery ◽  
Urban Areas ◽  
Health Facilities ◽  
Index Score ◽  
Child Immunization ◽  
Integrated Service Delivery ◽  
Immunization Services ◽  
The Impact ◽  
Integrated Service

Abstract Background Integrating family planning into child immunization services may address unmet need for contraception by offering family planning information and services to postpartum women during routine child immunization visits. However, policies and programs promoting integration are often based on insubstantial or conflicting evidence about its effects on service delivery and health outcomes. While integration models vary, many studies measure integration as binary (a facility is integrated or not) rather than a multidimensional and varying continuum. It is thus challenging to ascertain the determinants and effects of integrated service delivery. This study creates Facility and Provider Integration Indexes, which measure capacity to support integrated family planning and child immunization services and applies them to analyze the extent of integration across 400 health facilities. Methods This study utilizes cross-sectional health facility (N = 400; 58% hospitals, 42% primary healthcare centers) and healthcare provider (N = 1479) survey data that were collected in six urban areas of Nigeria for the impact evaluation of the Nigerian Urban Reproductive Health Initiative. Principal Component Analysis was used to develop Provider and Facility Integration Indexes that estimate the extent of integration in these health facilities. The Provider Integration Index measures provider skills and practices that support integrated service delivery while the Facility Integration Index measures facility norms that support integrated service delivery. Index scores range from zero (low) to ten (high). Results Mean Provider Integration Index score is 5.42 (SD 3.10), and mean Facility Integration Index score is 6.22 (SD 2.72). Twenty-three percent of facilities were classified as having low Provider Integration scores, 32% as medium, and 45% as high. Fourteen percent of facilities were classified as having low Facility Integration scores, 38% as medium, and 48% as high. Conclusion Many facilities in our sample have achieved high levels of integration, while many others have not. Results suggest that using more nuanced measures of integration may (a) more accurately reflect true variation in integration within and across health facilities, (b) enable more precise measurement of the determinants or effects of integration, and (c) provide more tailored, actionable information about how best to improve integration. Overall, results reinforce the importance of utilizing more nuanced measures of facility-level integration.

scholarly journals Development of Integration Indexes to Determine the Extent of Family Planning and Child Immunization Services Integration in Health Facilities in Urban Areas of Nigeria

2021 ◽  
Author(s):  
Kate L. Sheahan ◽  
Jennifer Orgill-Meyer ◽  
Ilene Speizer ◽  
Siân Curtis ◽  
John Paul ◽  
...  
Keyword(s):  
Family Planning ◽  
Service Delivery ◽  
Urban Areas ◽  
Health Facilities ◽  
Index Score ◽  
Child Immunization ◽  
Integrated Service Delivery ◽  
Immunization Services ◽  
The Impact ◽  
Integrated Service

Abstract Background Integrating family planning into child immunization services may address unmet need for contraception by offering family planning information and services to postpartum women during routine child immunization visits. However, policies and programs promoting integration are often based on insubstantial or conflicting evidence about its effects on service delivery and health outcomes. While integration models vary, many studies measure integration as binary (a facility is integrated or not) rather than a multidimensional and varying continuum. It is thus challenging to ascertain the determinants and effects of integrated service delivery. This study creates Facility and Provider Integration Indexes, which measure capacity to support integrated family planning and child immunization services and applies them to analyze the extent of integration across 400 health facilities. Methods This study utilizes cross-sectional health facility (N= 400; 58% hospitals, 42% primary healthcare centers) and healthcare provider (N= 1,479) survey data that were collected in six urban areas of Nigeria for the impact evaluation of the Nigerian Urban Reproductive Health Initiative. Principal Component Analysis was used to develop Provider and Facility Integration Indexes that estimate the extent of integration in these health facilities. The Provider Integration Index measures provider skills and practices that support integrated service delivery while the Facility Integration Index measures facility norms that support integrated service delivery. Index scores range from zero (low) to ten (high). Results Mean Provider Integration Index score is 5.42 (SD 3.10), and mean Facility Integration Index score is 6.22 (SD 2.72). Twenty-three percent of facilities were classified as having low Provider Integration scores, 32% as medium, and 45% as high. Fourteen percent of facilities were classified as having low Facility Integration scores, 38% as medium, and 48% as high. Conclusion Many facilities in our sample have achieved high levels of integration, while many others have not. Results suggest that using more nuanced measures of integration may (a) more accurately reflect true variation in integration within and across health facilities, (b) enable more precise measurement of the determinants or effects of integration, and (c) provide more tailored, actionable information about how best to improve integration. Overall, results reinforce the importance of utilizing more nuanced measures of facility-level integration.

scholarly journals Stigma as a barrier to family planning use among married youth in Ethiopia

2018 ◽  
Vol 51 (4) ◽  
pp. 505-519
Author(s):  
Aparna Jain ◽  
Hussein Ismail ◽  
Elizabeth Tobey ◽  
Annabel Erulkar
Keyword(s):  
Family Planning ◽  
Supply And Demand ◽  
Unmet Need ◽  
Principal Component ◽  
Principal Component Factor Analysis ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Adolescent Groups ◽  
Anticipated Stigma ◽  
Youth Friendly Service

AbstractNearly 33 million female youths have an unmet need for voluntary family planning (FP), meaning they are sexually active and do not want to become pregnant. In Ethiopia, age at marriage remains low: 40% and 14% of young women aged 20–24 were married by the ages of 18 and 15, respectively. Despite increases in FP use by married 15- to 24-year-olds from 5% in 2000 to 37% in 2016, unmet need remains high at 19%. Supply-and-demand factors have been shown to limit FP use, yet little is known about how stigma influences FP use among youth. This study validates an anticipated stigma (expectation of discrimination from others) index and explores its effect on unmet need. A cross-sectional survey was implemented with 15- to 24-year-old female youth in Ethiopia in 2016. The analytic sample included married respondents with a demand (met and unmet need) for FP (n=371). A five-item anticipated stigma index (Cronbach’sα=0.66) was developed using principal component factor analysis. These items related to fear, worry and embarrassment when accessing FP. The findings showed that 30% agreed with at least one anticipated stigma question; 44% had an unmet need; 58% were married before age 18; and 100% could name an FP method and knew where to obtain FP. In multivariate regression models, youth who experienced anticipated stigma were significantly more likely to have an unmet need, and those who lived close to a youth-friendly service (YFS) site were significantly less likely to have an unmet need. Interventions should address anticipated stigma while focusing on social norms that restrict married youth from accessing FP; unmet need may be mitigated in the presence of a YFS; and the anticipated stigma index appears valid and reliable but should be tested in other countries and among different adolescent groups.

scholarly journals The Prevalence and Determinants of Using Withdrawal to Avoid Pregnancy in Tabriz, Iran

2019 ◽  
Vol 7 (2) ◽  
pp. 223-227
Author(s):  
Hajiieh Bibi Razeghi Nasrabad ◽  
Malihe Alimondegari ◽  
Zeinab Mohseni Nejhad
Keyword(s):  
Logistic Regression ◽  
Family Planning ◽  
Urban Areas ◽  
Traditional Method ◽  
Unmet Need ◽  
Modern Method ◽  
Modern Contraceptive ◽  
Reproductive Health Services ◽  
Contraceptive Methods ◽  
Multivariate Logistic Regression

Objectives: Despite the increasing knowledge about family planning and modern contraceptive methods, as well as high failure rates of the traditional method, a significant percentage of couples use withdrawal for contraception. Accordingly, the present study mainly aimed to investigate the determinants of using withdrawal to avoid pregnancy in Tabriz. Materials and Methods: The sample of the study included 383 married women aged 15-49 years. Multivariate logistic regression analyses were employed to determine factors associated with using withdrawal as a contraceptive method. Results: Based on the results, about 19.5% of the women were relying on withdrawal. In addition, 55% reported that they were currently using a modern method to avoid pregnancy while the remaining 25.5% used no method in order to prevent contraception. The results of multivariate logistic regression demonstrated that university-educated couples with no child who were within the age range of 15-24 and born in urban areas were more likely to use withdrawal rather than modern contraceptive methods (P<0.05). Conclusions: In general, the rate of employing the traditional method in Iran and, especially in Tabriz is increasing. Regarding higher proportion of withdrawal use among higher educated women due to the fear of side effects resulted from other methods, family planning providers and reproductive health services should be sensitive to the women’s concern and provide programs to decrease the unmet need of family planning.

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

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nivedita Roy ◽  
Priyanka Adhikary ◽  
Rita Kabra ◽  
James Kiarie ◽  
Gitau Mburu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Family Planning ◽  
Reproductive Health ◽  
Linear Growth ◽  
Service Providers ◽  
Unmet Need ◽  
Trial Registration ◽  
Postpartum Contraception ◽  
Postpartum Family Planning ◽  
Contraception Use

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.

scholarly journals Unmet Need of Postpartum Contraceptives Use in Urban Slums

2020 ◽  
Vol 38 (2) ◽  
pp. 46-52
Author(s):  
Jennyfer Tazneen ◽  
Shaheda Hamid ◽  
Mostafizur Rahman
Keyword(s):  
Family Planning ◽  
Family Income ◽  
Post Partum ◽  
Unwanted Pregnancy ◽  
Unmet Need ◽  
Urban Slums ◽  
Dhaka City ◽  
Postpartum Contraception ◽  
Cross Sectional ◽  
Monthly Family Income

Background: Unwanted pregnancy is common in slum dwelling couples as they are less aware about postpartum contraceptive. Unmet need of postpartum contraceptive is also evident in slums. Objective: This study aims to assess the unmet need of post-partum contraceptives used in urban slums. Materials and Methods: This study was a cross-sectional study on fecund women in postpartum period (0 months to 24 month). A total of 162 postpartum women were face to face interviewed with a pretested semi structured questioner by using software SPSS- 20. Place and period: The study was conducted in slum area of Jurain and Moghbazar in Dhaka city, during the period of January 2016 to December 2016. Results: About 51.2% (83) of the respondents were in the age group of 22-26 years. Almost 53.1% (86) of the respondents were illiterate. 57.4% (93) of the respondents were housewife. 61.1% of the respondents gave history of monthly family income of 4200-5700 taka. Total unmet need of postpartum contraceptive period, among 162 respondents were 58% about 94 and met need 42% (68). Intention for contraceptives used, were 86% (81) among 94 respondents. Factors related with unmet need – All most 45.7% of the respondents were not used any contraceptives due to not approved by their husband among 94 respondents. Decision regarding family planning has given by husband 51.85% (84). There were significant association with education and unmet need of contraceptives use (p<0.05). Monthly family income was significant association with unmet need of contraceptives use (p<0.05). Conclusions: Unmet need for family planning has been a major concern for international population since several decades. Present study indicated a high unmet need for postpartum contraception in the selected area of urban slums in Dhaka city, with a scope to decrease constraints and address user perspective to meet the contraception needs.Change in the attitude of the husband, family and society to accept equity and equality of women and men can positively lead women’s unmet need of family planning during postpartum periods. JOPSOM 2019; 38(2): 46-52

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