scholarly journals The unmet needs for modern family planning methods among postpartum women in Sub-Saharan Africa: a systematic review of the literature

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Jumaine Gahungu ◽  
Mariam Vahdaninia ◽  
Pramod R. Regmi
Keyword(s):  
Systematic Review ◽  
Family Planning ◽  
Unmet Needs ◽  
Unmet Need ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
Factors Affecting ◽  
Sub Saharan

Abstract Background Sub-Saharan Africa has the highest fertility rate in the world, with the highest unmet need for family planning (FP). Yet, there is a lack of knowledge about the determinants for non-utilisation of modern contraceptive methods among women of reproductive age. This systematic review of literature assessed factors affecting the unmet need and reasons for non-utilisation of modern contraceptive methods during the postpartum period in Sub-Saharan African women. Methods An online literature search was conducted in several databases: MEDLINE, Cochrane Review, PubMed, Elsevier's Science Direct and Web of Science. The search was completed by hand searching. Data were extracted and summarised using the Arksey and O’Malley methodology. Results In total, 19 studies were included; one qualitative study, seventeen quantitative, and one used a mixed-methods approach. Studies were conducted in Ethiopia (n = 11), Nigeria (n = 3), Kenya (n = 2), Malawi (n = 2) and Uganda (n = 1). Factors affecting the unmet need for modern contraceptive methods were described at three levels: (a) individual; (b) household; and (c) healthcare facility level. Reasons for non-use of FP included: fear of side effects; husband’s disapproval; the absence of menses; abstinence; and low perception of risk of pregnancy. Conclusion Unmet needs in postpartum FP in women from Sub-Saharan Africa were associated with health-system and socio-demographic determinants. We suggest that there is a need to improve the awareness of modern contraceptive methods through effective interventions. Further research is needed for under-studied countries in this continent.

scholarly journals Unmet Need For Family Planning Among Married Women In Sub-Sahara Africa: A Meta-Analysis of DHS Data (1995 – 2020)

2021 ◽  
Author(s):  
Million Phiri ◽  
Clifford Odimegwu ◽  
Chester Kalinda
Keyword(s):  
Family Planning ◽  
Unmet Needs ◽  
Unmet Need ◽  
Central Africa ◽  
Married Women ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Women Of Reproductive Age ◽  
Sub Saharan

Abstract Background: Closing the gap of unmet needs for family planning (FP) in sub-Saharan Africa remains critical in improving maternal and child health outcomes. Determining the prevalence of unmet needs for family planning among married women in the reproductive age is vital for designing effective sexual reproductive health interventions and programmes. Here, we use nationally representative data drawn from sub-Saharan countries to estimate and examine heterogeneity of unmet needs for family planning among currently married women of reproductive age. Methods: This study used secondary data from Demographic and Health Surveys (DHS) conducted between January 1, 1995 to December 31, 2020 from 37 countries in sub-Saharan African. An Inverse Heterogeneity model (IVhet) in MetaXL application was used to estimate country and sub-regional level pooled estimates and confidence intervals of unmet needs for FP in SSA. Results: The overall prevalence of unmet need for family planning among married women of reproductive age in the sub-region for the period under study was 22.9% (95% CI: 20.9–25.0). The prevalence varied across countries from 10% (95% CI: 10–11%) in Zimbabwe to 38% (95% CI: 35–40) and 38 (95% CI: 37–39) (I2 = 99.8% and p-value < 0.0001) in Sao Tome and Principe and Angola, respectively. Unmet needs due to limiting ranged from 6%; (95% CI: 3–9) in Central Africa to 9%; (95% CI: 8–11) in East Africa. On the other hand, the prevalence of unmet needs due to spacing was highest in Central Africa (Prev: 18; 95% CI: 16–21) and lowest in Southern Africa (Prev: 12%; 95% CI: 8–16). Our study indicates that there was no publication bias because the Luis Furuya-Kanamori index (0.79) was within the symmetry range of -1 and +1. Conclusion: The prevalence of unmet need for FP remains high in sub-Saharan Africa suggesting the need for health policymakers to consider re-evaluating the current SRH policies and programmes with the view of redesigning the present successful strategies to address the problem.

scholarly journals IMPROVING DESIGN AND DELIVERY OF FAMILY PLANNING SERVICES TO MEET THE UNMET NEED FOR CONTRACEPTION IN QUETTA BALOCHISTAN

2019 ◽  
Vol 8 (4) ◽  
pp. 213-218
Author(s):  
Naiha Sagheer ◽  
Saleem Ullah ◽  
Noureen Latif ◽  
Tabinda Zaman
Keyword(s):  
Family Planning ◽  
Mass Media ◽  
Health Workers ◽  
Unmet Need ◽  
Monitoring And Evaluation ◽  
Cross Sectional Study ◽  
Reproductive Age ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
Cross Sectional

Background: Approximeately 24 percent of married women of reproductive age in Pakistan would like to adopt family planning, but are unable to avail the means to practice contraception. This study has been conducted to find out frequency and perception about family planning practices and further to explore and analyze the causes of failure to meet the demand for contraception. Methods: A cross-sectional study was conducted on married females of reproductive age group and married males while visiting the outpatient departments of two hospitals of Quetta from January to September 2017. They were interviewed by researchers through a structured, reliable and pretested questionnaire. The data obtained and analyzed by using SPSS 21 version. Results: 76% of participants were in favour of practicing yet only 33.8% had actually practiced it sometime during their reproductive years. The major reasons for not using family planning were the apprehension of harmful effects of contraceptive methods (52.6%), non-supportive partner (30%), unavailability of services (11.4%) and religious constraints (6%). The mass media was the main source of motivational information(69%) followed by Lady health workers. Conclusion: The current prevalence of family planning is still not at the expected level, There is a dire need of the continued use of mass media and services of community health workers to raise awareness. The practice of modern contraceptive methods can be enhanced by provision of client-centered quality services.. An increase in the number of family planning centers along with an efficient functioning, monitoring, and evaluation are also required to address unmet needs of the community near their doorstep.

scholarly journals Estimating the levels and trends of family planning indicators in 436 sub-national areas across 26 countries in sub-Saharan Africa

2021 ◽  
Author(s):  
Joshua L Proctor ◽  
Laina D. Mercer
Keyword(s):  
Family Planning ◽  
Universal Access ◽  
Unmet Need ◽  
Sub Saharan Africa ◽  
Modern Contraceptive ◽  
Model Based ◽  
Administrative Unit ◽  
Sub Saharan ◽  
Demographic Subgroup ◽  
Demographic Subgroups

Background: Scaling up access to safe, effective, and voluntary family planning (FP) services to achieve universal access for women and families will require increased commitment by countries and international organizations. On the way toward universal access, quantitative family planning goals have also been established by the United Nations through the sustainable development goals (SDGs). Here, we present a model-based framework that can help monitor progress toward these goals at the sub-national and demographic subgroup scale. Methods: We utilize 90 demographic health surveys for 26 countries that contain associated geographic position system data. We extract survey cluster level data to fit multiple small area estimation models that estimate FP indicators by administrative unit one and two regions as well as different demographic subgroups. Findings: We find significant variation of modern contraceptive prevalence rates (mCPR), unmet need, and demand satisfied by country, sub-national region, and demographic subgroup. Our model-based estimates show that on average for 436 administrative unit one regions, mCPR has increased at a rate of 0.75% per year and unmet need has decreased by 0.26% per year. There are also striking differences of FP indicators by demographic subgroup; for example, unmet need can be up to 40% different based on age and parity. Interpretation: We have developed a framework to help monitor progress, provide insights about the inequitable progress by region and demographic groups, and account for the sparsity of available data. These results and framework can help policy-makers better allocate and target interventions to help achieve family planning goals.

scholarly journals Improving Utilisation and awareness of Family Planning services in Adults of Reproductive age through Community Sensitization in Police Wing Village, Jinja District.

2021 ◽  
Author(s):  
◽  
Rodgers Isiko
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Project Implementation ◽  
Number Of Children ◽  
Planning Methods ◽  
Sub Saharan ◽  
Family Planning Methods

Background Family planning refers to a conscious effort by a couple to space the number of children they have through the use of contraceptive methods. According to WHO, an estimated 225 million women in developing countries, 24.2% of women of reproductive age have an unmet need for contraception. However, contraceptive use in sub-Saharan Africa is low at only 21%. The total fertility rate remains high for many countries in the region (4.6 in Kenya and Rwanda, 5.4 in Tanzania, 6.2 in Uganda, and 6.4 for Burundi). Methodology This was a community-based project implementation on increasing awareness and utilization of family planning methods in Police Wing village, Jinja district. Consent was gotten from the VHT, LC1, and DHO before mobilizing people to gather at the VHT’s home and her neighbour’s compound where we carried out the different educational sessions. Different team members got different roles to play as regards the health education session. One week later, we evaluated the progress of our project implementation through the administration of questionnaires to the same people we health educated. The questionnaire assessed the level of utilization, awareness, myths, misconception, and demography of the participants. Results 28% had heard about at least three family planning methods and 24.1% had at one time used family planning while 75.9% of the participants admitted not to have used it. The post-session assessment showed an increase from 28% to 93% in knowledge regarding the available methods of FP and an increase in the utilization of FP from 28% to 42%.   Conclusion and recommendations Addressing the myths and misconceptions about FP by exposing them as a fallacy would help increase the uptake as evidenced by the will of the community to take up the different methods. Organize frequent health talks about FP in the community.

scholarly journals Coverage and Determinants of Modern Contraceptive Use in Sub-saharan Africa: Further Analysis of Demographic and Health Surveys

2021 ◽  
Author(s):  
Isaac Boadu
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Modern Contraceptive ◽  
Women Of Reproductive Age ◽  
Modern Contraceptives ◽  
Modern Contraceptive Use ◽  
Sub Saharan

Abstract Background: The use of modern contraceptives (MC) in most African countries has been low despite the high fertility rate and unmet need for family planning. This study sought to determine the coverage and determinants of modern contraceptive use among women of reproductive age in Sub-Saharan Africa (SSA). Methods: Data for the study was obtained from the latest Demographic and Health Surveys (DHS) conducted between 1995-2020 across 37 SSA countries. Women of reproductive age (15-19 years) was the unit of analysis. Analyses of data was done using STATA version 16 for windows. A bivariate Rao Scott’s chi-square test of independence was done to determine factors associated with the use of modern contraceptives. Factors that showed significance (p<0.05) were included in a multilevel logistic regression to determine significant predictors of modern contraceptives. Clustering, stratification and sample weighting were accounted for in the analyses. Results: The overall prevalence of the use of MC was found to be 22.0%. This ranged from 3.5% in the Central Africa Republic to 49.7% in Namibia. The most common type of contraceptives used were injections (39.4%), condoms (17.5%) and implants (26.5%). Women were less likely to use contraceptive if they: had no education (aOR = 0.4, 95% CI: 0.38-0.44), had no children (aOR=0.27-0.42), not told of family planning at a health facility (aOR = 0.69, 95% CI: 0.67-0.71), not heard of family planning in the media (aOR = 0.77, 95% CI: 0.74-0.79) and being poor (aOR=0.76, 95%CI: 0.73-0.79). On the other hand, women were more likely to use modern contraceptive if they were between the age of 35-39 years (aOR=1.69, 95%CI: 0.73-0.79), married (aOR=2.66, 95%CI: 2.50-2.83), had seven or more children (aOR=1.27, 95%CI:1.17-0.38), had knowledge of any method of contraceptives (aOR=303.8, 95%CI: 89.9-1027.5) and when field worker visited and talked about family planning (aOR=1.53, 95%CI: 1.39-0.68).Conclusion: The study showed a low prevalence of modern contraceptive use in Sub-Sahara Africa. Findings from the study highlight the need to provide education to women to increase uptake of contraceptive use and also re-enforce contraceptive interventions to improve women’s health and well-being.

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

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

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

scholarly journals Knowledge, attitude and practice of family planning among married women of reproductive age in a VDC of eastern Nepal

2017 ◽  
Vol 6 (1) ◽  
pp. 48-53 ◽  
Author(s):  
S Uprety ◽  
I S Poudel ◽  
A Ghimire ◽  
M Poudel ◽  
S Bhattrai ◽  
...  
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Descriptive Analysis ◽  
Married Women ◽  
Reproductive Age ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
Cross Sectional ◽  
Attitude And Practice ◽  
Knowledge Attitude And Practice

Contraceptive use and fertility rates vary substantially among developing countries. An important factor, which affects the fertility of any population, is Contraceptive. Contraceptive use varies by age. Nepal over the past 15 years show an impressive increase in the use of modern contraceptive methods from 26 percent in 1996 to 43 percent in 2011. Objectives of the is to assess the knowledge, attitude regarding family planning and the practice of contraceptives among the married women of Dhabi VDC of Eastern Nepal. A descriptive cross-sectional observational study was done in Dhabi VDC. Total of 300 married women age 15-49 sample were taken from family planning center situated in Dhabi. Knowledge, attitude and practice on contraceptives were evaluated with the help of a predesigned questionnaire. Descriptive analysis was done by using SPSS 11.5 software to obtain frequencies and percentages. Out of 300 interviewed women, the mean age was 27.94 years, 98% had heard about Family planning method. Radio was the main Source of family planning information. Regarding the usage of contraceptive methods, about 79.3% had ever used and 63.3 had current using some sort of contraception, among the method used Injectables were the commonly used methods About 71% of married women other child in the further. Despite the knowledge of all family planning methods majority of the women used Injectables. Easily accessible and easily to use were the main reasons for choosing Injectables methods. 

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

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

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

scholarly journals Prevalence of child marriage and its impact on fertility outcomes in 34 sub-Saharan African countries

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Sanni Yaya ◽  
Emmanuel Kolawole Odusina ◽  
Ghose Bishwajit
Keyword(s):  
Pregnancy Termination ◽  
Binary Logistic Regression ◽  
Adverse Outcomes ◽  
Sub Saharan Africa ◽  
Child Marriage ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
African Countries ◽  
Sub Saharan ◽  
Children Ever Born

Abstract Background The issue of child marriage is a form of human rights violation among young women mainly in resource-constrained countries. Over the past decades, child marriage has gained attention as a threat to women’s health and autonomy. This study explores the prevalence of child marriage among women aged 20–24 years in sub-Saharan Africa countries and examines the association between child marriage and fertility outcomes. Methods Latest DHS data from 34 sub-Saharan African countries were used in this study. Sixty thousand two hundred and fifteen women aged 20–24 years were included from the surveys conducted 2008–2017. The outcome variables were childbirth within the first year of marriage (early fertility), first preceding birth interval less than 24 months (rapid repeat of childbirth), unintended pregnancy, lifetime pregnancy termination, the use of modern contraceptive methods, lifetime fertility and any childbirth. The main explanatory variable was child marriage (< 18 years) and the associations between child marriage and fertility outcomes were examined from the ever-married subsample to estimate odds ratios (ORs) and 95% CIs using binary logistic regression models. Results In the study population, the overall prevalence of women who experience child marriage was 54.0% while results showed large disparities across sub-Saharan African countries ranging from 16.5 to 81.7%. The prominent countries in child marriage were; Niger (81.7%), Chad (77.9%), Guinea (72.8%), Mali (69.0%) and Nigeria (64.0%). Furthermore, women who experience child marriage were 8.00 times as likely to have ≥3 number of children ever born (lifetime fertility), compared to women married at ≥18 years (OR = 8.00; 95%CI: 7.52, 8.46). Women who experience child marriage were 1.13 times as likely to use modern contraceptive methods, compared to adult marriage women (OR = 1.13; 95%CI: 1.09, 1.19). Those who married before the legal age were 1.27 times as likely to have lifetime terminated pregnancy, compared to women married at ≥18 years (OR = 1.27; 95%CI: 1.20, 1.34). Also women married at < 18 years were more likely to experience childbirth, compared to women married later (OR = 5.83; 95%CI: 5.45, 6.24). However, women married at < 18 years had a reduction in early childbirth and a rapid repeat of childbirth respectively. Conclusion Implementing policies and programmmes against child marriage would help to prevent adverse outcomes among women in sub-Saharan Africa. Also, social change programmes on child-marriage would help to reduce child marriage, encourage the use of modern contraceptive, which would minimize lifetime terminated pregnancy and also children ever born.

Sign in / Sign up

Export Citation Format

Share Document