scholarly journals Acceptability, feasibility and utility of a Mobile health family planning decision aid for postpartum women in Kenya

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Rubee Dev ◽  
Nancy F. Woods ◽  
Jennifer A. Unger ◽  
John Kinuthia ◽  
Daniel Matemo ◽  
...  
Keyword(s):  
Family Planning ◽  
Mobile Health ◽  
Decision Aid ◽  
Postpartum Women ◽  
Planning Decision

scholarly journals Postpartum Green Star Family Planning Decision Aid for Pregnant Adolescents in Tanzania: a Qualitative Feasibility Study

2021 ◽  
Author(s):  
Stella Emmanuel Mushy ◽  
Eri Shishido ◽  
Sebalda Leshabari ◽  
Shigeko Horiuchi
Keyword(s):  
Family Planning ◽  
Decision Aid ◽  
Structured Interview ◽  
Published Data ◽  
Pregnant Adolescents ◽  
Language Data ◽  
Planning Methods ◽  
Planning Decision ◽  
Nurse Midwives ◽  
Long Acting

Abstract Background: The use of a decision aid (DA) in clinical settings has been useful as they inform and educate clients about the available options that help them to reduce decision-making conflict related to feeling uninformed and unclear about personal values compared with usual care. There is a dearth of published data about the use of decision aid during family planning (FP) counseling with postpartum women focusing on long-acting reversible family planning methods. Therefore, the researchers developed a decision aid named “Green Star” and assessed its feasibility. The study outcomes were practicality, usefulness, and acceptability as perceived by the pregnant adolescents and the nurse/midwives.Methods: An exploratory in-depth qualitative interview involving six nurse/midwives with three or more years of experience in FP services, and 12 pregnant adolescents aged 15-19 years. Purposive sampling was used to select the participants, and sampling relied on the saturation principle of data collection. Researchers used a semi-structured interview guide translated into Kiswahili language. Data were transcribed and analyzed following inductive-deductive content analysis. Results: The length of the presentation was found to be just right, with time ranging from twenty minutes to one hour. The flow of the information was stated to be good with small significant changes suggested. Kiswahili language used was reported to be appropriate and well elaborated, however, a few words were suggested to be rephrased to reduce ambiguity. The nurse/midwives reported that the DA included most of the important information clients wanted to know during FP counseling. The adolescents stated that the DA improved their knowledge and provided new information about the existence of FP immediately after childbirth. The participants said the DA clearly addressed the benefits and side effects as well as dispelled some myths and misconceptions. The DA was accepted to be useful in complementing the daily family planning counseling offered as well as in improving adolescents’ knowledge. Conclusion: The postpartum Green Star family planning decision aid was perceived to be practical, useful, and acceptable. Further research is needed to assess the effect of the DA in the choice for postpartum long acting reversible FP among the pregnant adolescents in Tanzania.

scholarly journals Postpartum Green Star family planning decision aid for pregnant adolescents in Tanzania: a qualitative feasibility study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Stella E. Mushy ◽  
Eri Shishido ◽  
Sebalda Leshabari ◽  
Shigeko Horiuchi
Keyword(s):  
Family Planning ◽  
Decision Aid ◽  
Treatment Options ◽  
Structured Interview ◽  
Published Data ◽  
Pregnant Adolescents ◽  
Family Planning Counseling ◽  
Planning Decision ◽  
Long Acting ◽  
Study Participants

Abstract Background The use of a decision aid in clinical settings has been beneficial. It informs and educates patients about the available treatment options that can help them reduce decision-making conflicts related to feeling uninformed compared with routine care. There is a scarcity of published data about using a decision aid during family planning counseling with postpartum women focusing on long-acting reversible contraception in Tanzania. Therefore, we developed a “postpartum Green Star family planning decision aid” and assessed its feasibility. The study outcomes were practicality, usefulness, and acceptability perceived by pregnant adolescents and nurses/midwives. Methods We used an exploratory qualitative in-depth interview involving six nurses/midwives with three or more years of experience in family planning services and 12 pregnant adolescents aged 15–19 years. Purposive sampling was used to select the participants, and selection relied on the saturation principle of data collection. We used a semi-structured interview guide translated into the Kiswahili language. Data were transcribed and analyzed following inductive content analysis. Results The amount of information presented was just right, with the time of reading the data ranging from 20 min to 1 h. The study participants perceived the flow of information to be good, with small significant changes suggested. Kiswahili language was used and reported to be appropriate and well elaborated. However, a few words were told to be rephrased to reduce ambiguity. The nurses/midwives said that the decision aid included most of the vital information the participants wanted to know during their family planning counseling. Pregnant adolescents stated that the decision aid improved their knowledge and provided new details on the long-acting reversible contraception methods (intrauterine copper devices and implants) offered immediately after childbirth. The participants stated that the decision aid addressed long-acting reversible contraception methods’ benefits and side effects and dispelled myths and misconceptions. The study participants considered the decision aid helpful in complementing the family planning counseling offered and improving pregnant adolescents’ knowledge. Conclusion The postpartum Green Star family planning decision aid was practical, useful, and acceptable in enhancing the objectivity of counseling about long-acting reversible contraception methods. It improved the knowledge of pregnant adolescents in Tanzania about the available contraception methods (i.e., the use of intrauterine copper devices and implants), which can be immediately used postpartum. Further research is needed to assess the effects of the decision aid on long-acting reversible contraception postpartum uptake among pregnant adolescents in Tanzania.

scholarly journals Identifying Mobile Health Technology Experiences and Preferences of Low-Income Pregnant Women with Diabetes

2021 ◽  
pp. 193229682199317
Author(s):  
Karolina Leziak ◽  
Eleanor Birch ◽  
Jenise Jackson ◽  
Angelina Strohbach ◽  
Charlotte Niznik ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Mobile Health ◽  
Low Income ◽  
Self Regulation ◽  
Health Inequities ◽  
Comparison Method ◽  
Rapid Expansion ◽  
Self Management ◽  
Postpartum Women ◽  
Design Elements

Background: Rapid expansion of mobile technology has resulted in the development of many mobile health (“mHealth”) platforms for health monitoring and support. However, applicability, desirability, and extent of tailoring of these platforms for pregnant women, particularly in populations who experience the greatest health inequities—such as women with diabetes mellitus (DM) and/or those with greater socioeconomic barriers—remains unknown. The objective is to understand low-income pregnant women’s experiences and preferences for mHealth tools to support DM health and improve DM self-management during pregnancy. Methods: Low-income pregnant and postpartum women were included in individual interviews or focus groups; women with type 2 DM, gestational DM, or no DM were included. Analysis was performed with the constant comparison method. Results: In this population of 45 ( N=37 with DM) low-income, largely minority, pregnant and postpartum women, 100% reported access to smartphones and prior experience with apps. Interest in mHealth to support health and engagement during pregnancy was high. Preferences for general mHealth features included education that reduces uncertainty, support communities, visualizing progress, convenient access to information, and support for better management of pregnancy-related tasks. Preferred design elements included personalization, interactive features, and integrated graphics. Women with DM expressed multiple additional DM-specific needs, including support tools for DM self-management and self-regulation tasks. Conclusion: Pregnant and postpartum women, especially those with DM, desire mHealth technology to support engagement and to adapt lifestyle guidelines and treatment requirements for a healthy pregnancy. Further work to develop mHealth interventions tailored for target populations remains a key step in reducing health inequities and promoting access to evidence-based perinatal health interventions.

scholarly journals Women’s empowerment for abortion and family planning decision making among marginalized women in Nepal: a mixed method study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Heera KC ◽  
Mangala Shrestha ◽  
Nirmala Pokharel ◽  
Surya Raj Niraula ◽  
Prajjwal Pyakurel ◽  
...  
Keyword(s):  
Decision Making ◽  
Family Planning ◽  
Mixed Method ◽  
Women's Empowerment ◽  
Women’S Empowerment ◽  
Key Informants ◽  
Marginalized Communities ◽  
Modern Contraceptives ◽  
Marginalized Women ◽  
Planning Decision

Abstract Background Women’s empowerment is multidimensional. Women’s education, employment, income, reproductive healthcare decision making, household level decision making and social status are vital for women’s empowerment. Nepal is committed to achieving women empowerment and gender equality, which directly affects the reproductive health issues. This can be achieved by addressing the issues of the poor and marginalized communities. In this context, we aimed to find the association of women’s empowerment with abortion and family planning decision making among marginalized women in Nepal. Methods A cross sectional study was conducted at selected municipalities of Morang district of Nepal from February 2017 to March 2018. A mixed method approach was used, where 316 married marginalized women of reproductive age (15–49 years) and 15 key informant interviews from representative healthcare providers and local leaders were taken. From key informants, data were analysed using the thematic framework method. Findings obtained from two separate analyses were drawn together and meta inferences were made. Results Women’s empowerment was above average, at 50.6%. Current use of modern contraceptives were more among below average empowerment groups (p 0.041, OR 0.593 C.I. 0.36–0.98). We could not find any statistically significant differences among levels of women’s empowerment, including those women with abortion knowledge (p 0.549); family planning knowledge (p 0.495) and women’s decision for future use of modern contraceptives (p 0.977). Most key informants reported that unsafe abortion was practiced. Conclusions Women’s empowerment has no direct role for family planning and abortion decision making at marginalized communities of Morang district of Nepal. However, different governmental and non-governmental organizations influence woman for seeking health care services and family planning in rural community of Nepal irrespective of empowerment status.

scholarly journals Prevalence of postpartum family planning utilization and associated factors among postpartum mothers in Arba Minch town, South Ethiopia

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Biresaw Wassihun ◽  
Kidist Wosen ◽  
Asmare Getie ◽  
Kalkidan Belay ◽  
Rehal Tesfaye ◽  
...  
Keyword(s):  
Family Planning ◽  
Antenatal Care ◽  
Odds Ratio ◽  
Postnatal Care ◽  
Associated Factors ◽  
Adjusted Odds Ratio ◽  
Educational Status ◽  
Postpartum Women ◽  
Postpartum Family Planning ◽  
Study Participants

Abstract Background Contraception allows women to realize their human right to decide if and when to have children and helps people to attain their desired family size. Yet 214 million women of a reproductive age in developing countries who want to avoid pregnancy are not using a modern contraceptive method. Women who have recently given birth are among the group with the highest unmet need for contraception. Therefore, this study was aimed to assess the prevalence of postpartum family planning use and associated factors among postpartum women in Southern Ethiopia. Methods Institution based cross-sectional study design was conducted. A structured and pretested interviewer-administered questionnaire was used to collect the data from study participants. Study participants were selected using a systematic random sampling technique by allocating proportionally to each health facility. The data was entered using EPI data version 3.1statistical software and exported to Statistical Package for Social Sciences version 22.0 for further analysis. Both bivariate and multivariate logistic regression analyses were performed to identify associated factors. P values < 0.05 with 95% confidence level was used to declare statistica significance. Result Overall, 44% of postpartum women utilize postpartum family planning. Having an antenatal care visit [adjusted odds ratio (AOR) =1.89(95%CI, 2.42–7.90), having planned pregnancy [adjusted odds ratio (AOR) = 1.17(95%CI, 1.60–2.28)], being married (adjusted odds ratio (AOR) =2.86(1.94–8.73), and having a college and above level educational status (AOR) =1.66(1.28–3.55) were significantly associated with utilization of postpartum family planning. Conclusion This study showed that the prevalence of postpartum family planning was 44%. Marital status, educational status of mothers, the status of pregnancy, and having an antenatal care follow-up during pregnancy were some factors associated with postpartum family planning utilization. Therefore, strengthening family planning counselling during antenatal and postnatal care visits, improving utilization of postnatal care services and improving women’s educational status are crucial steps to enhance contraceptive use among postpartum women.

scholarly journals Concordance, communication, and shared decision-making about family planning among couples in Nepal: A qualitative and quantitative investigation

2019 ◽  
Vol 37 (2) ◽  
pp. 357-376
Author(s):  
Carol R. Underwood ◽  
Lauren I. Dayton ◽  
Zoé Mistrale Hendrickson
Keyword(s):  
Decision Making ◽  
Family Planning ◽  
Shared Decision Making ◽  
Quantitative Study ◽  
Shared Decision ◽  
Partner Communication ◽  
Joint Decision ◽  
Couple Communication ◽  
Spousal Concordance ◽  
Planning Decision

Couple communication and joint decision-making are widely recommended in the family planning and reproductive health literature as vital aspects of fertility management. Yet, most studies continue to rely on women’s reports to measure couple concordance. Moreover, the association between communication and decision-making is often assumed and very rarely studied. Arguably, associations between dyadic communication and shared decision-making constitute a missing link in our understanding of how communication affects fertility-related practices. Informed by Carey’s notions of transmission and ritual communication, this study sought to address those gaps with two complementary studies in Nepal: a qualitative study of married men and women and a quantitative study of 737 couples. To assess spousal concordance on matters of family planning-related communication and decision-making in the quantitative study, responses from the couple were compared for each question of interest and matched responses were classified as concordant. Quantitative results found that more than one-third of couples reported spousal communication on all measured family planning-related topics. Nearly, 87% of couples reported joint decision-making on both family planning use and method type. Partner communication was significantly and positively associated with concordant family planning decision-making in both bivariate and multivariate models. Couples communicating about three family planning topics had more than twice the odds of concordant family planning decision-making than did those not reporting such communication. The qualitative findings provided insights into discordant as well as concordant interactions, revealing that decision-making, even when concordant, is not necessarily linear and is often complex.

scholarly journals Effect of integrating maternal health services and family planning services on postpartum family planning behavior in Ethiopia: results from a longitudinal survey

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Linnea A. Zimmerman ◽  
Yuanyuan Yi ◽  
Mahari Yihdego ◽  
Solomon Abrha ◽  
Solomon Shiferaw ◽  
...  
Keyword(s):  
Family Planning ◽  
Exclusive Breastfeeding ◽  
Postnatal Care ◽  
World Health ◽  
Maternal And Newborn Health ◽  
Postpartum Women ◽  
Care Services ◽  
Postpartum Family Planning ◽  
Delivery Location ◽  
Contraceptive Uptake

Abstract Background Very few postpartum women want to become pregnant within the next 2 years, but approximately 60% of postpartum women in low- and middle-income countries are not using contraceptive methods. The World Health Organization recommends that women receive postpartum family planning (PPFP) counseling during antenatal, immediate postpartum, and postnatal services. Our objective was to establish whether PPFP counseling is being provided in antenatal and postnatal care services in SNNPR, Ethiopia and whether receipt of PPFP counseling improved uptake of postpartum family planning use by 6 months postpartum. Methods Longitudinal data from the Performance Monitoring for Accountability 2020 – Maternal and Newborn Health study were used. At screening, 329 women were identified as six or more months pregnant; 307 completed the survey at 6 months postpartum. We used weighted parametric survival analysis with Weibull distribution to assess the effect of receipt of postpartum counseling in antenatal and/or postnatal care by 6 weeks postpartum on contraceptive uptake, after adjusting for intention to use family planning, wantedness of the index pregnancy, delivery location, amenorrhea, exclusive breastfeeding, residence, parity, and education. Results Coverage of PPFP counseling is low; by six-weeks postpartum only 20% of women had received counseling. Women who received counseling in postnatal care only and postnatal care and antenatal care took up contraception at significantly higher rates than women who did not receive any counseling (HR: 3.4, p < .01 and HR: 2.5, p = .01, respectively). There was no difference between women who received PPFP counseling only in ANC and women who did not receive counseling at all. Women who did not want the child at all took up contraception at significantly lower rates than women who wanted the child at that time (HR: 0.3, p = .04). Women who had four or more children took up contraception at significantly lower rates than woman with 1–3 children (HR: 0.3, p = .01). There were no significant differences by delivery location, exclusive breastfeeding, residence, or education. Conclusion Integration of postpartum family planning counseling into postnatal care services is an effective means to increase postpartum contraceptive uptake, but significant gaps in coverage, particularly in the delivery and postnatal period, remain.

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