An examination of the barriers to and benefits from collaborative couple contraceptive use in Rwanda

Abstract Background Supportive male involvement is strongly correlated with contraceptive use. In Rwanda, where the contraceptive prevalence rate among married women increased from 17 to 52% from 2005 to 2010, and stagnated at 53% in 2015, understanding the role of male partners in collaborative couple contraceptive use can help inform programs designed to further increase the use of contraception in Rwanda. Methods This study utilized qualitative methods in 2018, specifically 32 in-depth interviewers with mostly current users of modern contraceptive methods and eight focus group discussions with family planning providers—both family planning nurses and community health workers (CHWs). Respondents were from Musanze and Nyamasheke Districts, the districts with the highest and lowest modern contraceptive use, respectively, to explore the role of couple collaboration in family planning use in Rwanda. Data were analyzed using the thematic content approach in Atlas.ti (8). Results Findings demonstrate that some men are opposed to use of male methods of contraception, and some are opposed to any contraceptive use, which can lead to covert use. Women and providers prefer collaborative couple contraceptive use—as a result, providers advocate for and encourage male partner participation in contraceptive use. Women are most often burdened with seeking out information, initiating discussions, and sharing information discovered about contraceptive use with partners. Decision-making about contraceptive use, once discussed, can be collaborative and motivated by financial considerations. When couple contraceptive use is collaborative, benefits range from marital harmony to husband’s support of sustained use through reminders about appointments, joint counseling, and support in managing side effects. Conclusion Family planning providers at the community and clinic levels encourage collaborative contraceptive use among couples and some Rwandan couples communicate well about family planning use. Despite the positives, women are expected to source family planning information, share that information with their male partners, seek out family planning services, and use family planning. If more Rwandan male partners accepted use, used male methods of contraception, and participated even more in the work it takes to use family planning, the potential for sustained, and even enhanced, contraceptive use in Rwanda could be realized.

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Examining and strengthening the role of patent and proprietary medicine vendors in the provision of injectable contraception in Nigeria

10.31899/sbsr2018.1011 ◽

2018 ◽

Keyword(s):

Family Planning ◽

Contraceptive Use ◽

Scale Up ◽

Health Sector ◽

Modern Contraceptive ◽

Public And Private ◽

Care Experience ◽

Contraceptive Services ◽

Injectable Contraceptives

Results from an implementation research study in Nigeria found that with training, Patent and Proprietary Medicine Vendors (PPMVs), regardless of their previous health care experience, could competently administer injectable contraceptives and that clients reported receiving quality services from trained PPMVs. From 2015 to 2018, the Evidence Project conducted a study to better understand the role of PPMVs in offering voluntary injectable services (e.g., selling, counseling, referring to health centers, and administering). The study was conducted in response to Nigeria's family planning context and the role of PPMVs in the informal health sector. | In Nigeria, the bulk of contraceptive services are provided by private sources, including hospitals, clinics, pharmacies, and PPMVs. Of the contraceptives used, injectable contraception is the most popular, accounting for approximately 40 percent of modern contraceptive use in the country. Among both public and private sources for family planning, PPMVs are the most popular for voluntary contraceptive services. According to Nigeria's 2013 National Demographic Health Survey, 38 percent of all contraceptive users and 13 percent of injectable users received their method from a PPMV. | The knowledge generated from this study helps inform the potential scale-up of PPMV delivery of voluntary injectable contraceptive services. The evidence provides insights on how to support and mentor PPMVs to provide quality FP counseling and provision of injectable contraceptives.

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The role of structural and process quality of family planning Care in Modern Contraceptive use in Indonesia: a multilevel analysis

BMC Public Health ◽

10.1186/s12889-021-11858-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Nurjaeni Nurjaeni ◽

Yothin Sawangdee ◽

Umaporn Pattaravanich ◽

Charamporn Holumyong ◽

Aphichat Chamratrithirong

Keyword(s):

Family Planning ◽

Multilevel Analysis ◽

Contraceptive Use ◽

Process Quality ◽

Structural Quality ◽

Modern Contraceptive ◽

Contraceptive Usage ◽

Modern Contraceptive Use

Abstract Introduction Despite contraceptive behaviors are influenced by multiple and multilevel variables, studies on modern contraceptive use in Indonesia has concentrated on single-level and mostly individual and household variables, and less interest has been devoted to multilevel analysis that accounts for community and SDP characteristics that may affect woman’s decision to use modern FP method. This study aimed to assess the role of structural and process quality of family planning care in modern contraceptive use among women in reproductive ages in Indonesia. Methods This study analyzed data from the 2016 PMA2020 survey of 10,210 women in 372 enumeration areas in Indonesia. The data were analyzed using categorical principal component analysis and multilevel mixed-effects logistic regression. Results The key variables for structural quality were number of contraceptive provided, SDP supports CHWs, available water and electricity, and skilled FP personnel, while the main factors for process quality were privacy of clients and provision of post-abortion service. There were significant differences across communities in how study variables associated with modern FP adoption. The finding shows the evidence of significant roles of structural and process quality FP care in modern contraceptive use. Moreover, women with high autonomy in FP decision, those who had free national/district health insurance, and those living in a community with higher proportion of women visited by CHW, had higher odds of modern contraceptive usage. Yet, women who live in a community with higher mean ideal number of children or greater proportion of women citing personal/husband/religion opposition to FP, had lower odds of modern contraceptive use than their counterparts. Conclusion Study findings suggest improvement in structural and process quality of FP care will yield substantial growths in modern contraceptive use. Moreover, FP workers should also address adverse cultural/traditional customs in community and should target communities where the demand for modern FP was degraded by opposing social beliefs and norms. There was significant variation across communities in how individual, household, community, and SDP factors affect modern FP practice, hence, context should be taken into consideration in the development of FP intervention and promotion programs.

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Gambaran Pengetahuan Akseptor Kb Tentang Penggunaan Kontrasepsi Jangka Panjang Di Wilayah Kerja Puskesmas Pekauman

DINAMIKA KESEHATAN JURNAL KEBIDANAN DAN KEPERAWATAN ◽

10.33859/dksm.v11i1.610 ◽

2020 ◽

Vol 11 (1) ◽

pp. 120-128

Author(s):

Laurensia Yunita ◽

Ika Mardiatul Ulfa

Keyword(s):

Family Planning ◽

Health Center ◽

Contraceptive Use ◽

Health Workers ◽

Sampling Technique ◽

Total Sample ◽

Descriptive Study ◽

Work Area

Latar Belakang: Pencapaian akseptor Kb Aktif di Banjarmasin Selatan berjumlah 7.835 orang (119,4%) yaitu dari Puskesmas Pekauman 6.498 orang (57,2%), Puskesmas Kelayan Timur 500 orang (9,8%), Puskesmas Pemurus Baru 379 orang (7,4%), Puskesmas Pemurus Dalam 133 orang (4,6%), Puskesmas Kelayan Dalam 196 (32,7%), dan Puskesmas Beruntung Raya 129 orang (7,7%). Dari data tersebut bahwa di Banjarmasin Selatan memiliki 6 Puskesmas dan Puskesmas yang memiliki akseptor Kb Aktif terbanyak adalah Puskesmas Pekauman. Akseptor KB Aktif yang menggunakan Kondom sebanyak 12 orang (0,089%), suntik sebanyak 819 orang (6,06%), dan pil sebanyak 1098 orang (8,15%). Kebanyakan Aseptor KB tidak mengetahui apa itu kontasepsi jangka panjang, mereka hanya tau kontrasepsi pil, suntik, impant dan IUD tetapi tidak bisa membedakan mana untuk jangka panjang serta keamannanya bagi akseptor KB.Tujuan: Mengetahui pengetahuan akseptor KB tentang penggunaan kontrasepsi jangka panjang di wilayah kerja Puskesmas Pekauman.Metode: Penelitian ini merupakan penelitian diskriftif untuk mengetahui penegtahuan akseptor KB tentang kontrasepsi jangka panjang. Teknik pengambilan sampel adalah Acidental Sampling dengan jumlah sampel sebanyak 30 responden.Hasil: Dari 30 responden sebanyak 60% pengetahuan aksepor baik tentang kontrasepsi jangka panjang, sedangkan 40 % pengetahuan aksepor cukup tentang kontrasepsi jangka panjang.Simpulan: Peranan tenaga kesehatan dalam melakukan penyuluhan tentang alat kontrasesi jangka panjang harus dilakukan dengan maksimal mengingat akseptor kb yang berbeda-beda latarbelakang pengetahuan dan pendidikannya, sehingga capaian pengguna MKJP dapat terpenuhi.Kata Kunci: Akseptor, Kontrasepsi, KB, PengetahuanAbstract Background: Achievement of active Kb acceptors in South Banjarmasin amounted to 7,835 people (119.4%), namely from the Pekauman Health Center 6,498 people (57.2%), the East Kelayan Health Center 500 people (9.8%), the Health Center Pemurus Baru 379 people ( 7.4%), Health Center Pemurus Dalam 133 people (4.6%), Health Center Kelayan Dalam 196 (32.7%), and Health Center Beruntung Raya 129 people (7.7%). Health center Pekauman acceptors of active birth control using condoms were 12 people (0.089%), injected 819 people (6.06%), and 1098 people (8.15%) pills. Most contraception acceptors do not know what long-term contraception is, they only know the contraceptive pill, injection, impant and IUD but cannot distinguish which for the long term and its safety for family planning acceptors.Objective: Knowing the knowledge of family planning acceptors about contraceptive use in the work area of the Health center Pekauman.Method: This research is a descriptive study to study the knowledge of family planning acceptors about long-term contraception. The sampling technique is accidental sampling with a total sample of 30 respondents.Results:Of the 30 respondents, 60% of acceptor knowledge is good about long-term contraception, while 40% of acceptor knowledge is enough about long-term contraception.Conclusion: The role of health workers in conducting counseling about long-term contraction tools must be carried out with a maximum ofacceptors who have different background knowledge and education, so that the achievements of MKJP users can be fulfilled. Keywords: Acceptor, Contraception, KB, Knowledge

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Determinants of modern contraceptive use among postpartum women in two health facilities in urban Ghana: a cross-sectional study

Contraception and Reproductive Medicine ◽

10.1186/s40834-019-0098-9 ◽

2019 ◽

Vol 4 (1) ◽

Cited By ~ 2

Author(s):

Jonathan Ian Coomson ◽

Abubakar Manu

Keyword(s):

Family Planning ◽

Antenatal Care ◽

Contraceptive Use ◽

Male Partner ◽

Postpartum Women ◽

Modern Contraceptive ◽

Cross Sectional ◽

Modern Methods ◽

Modern Contraceptive Use ◽

Contraceptive Uptake

Abstract Background Postpartum contraception is important for spacing and limiting childbirth. Although the use of modern contraception has been shown to reduce maternal and child morbidities and mortalities, postpartum women have one of the highest unmet needs for family planning. Inter-birth intervals less than 24 months have adverse effects on both the mother and the child, yet very limited empirical evidence exist on contraceptive use among postpartum women in Ghana. This study sought to determine the prevalence and determinants of modern contraceptive use among postpartum women in the Tema Metropolis, Ghana. Methods A facility-based cross-sectional survey was conducted among 320 postpartum women with babies aged between three and 15 months. Participants were recruited from child welfare clinics in two government health facilities in the Tema metropolitan area using a simple random sampling technique. Data were analyzed using STATA version 15. Chi-square and multiple logistic regressions techniques were used to examine associations between postpartum contraceptive use and key independent variables. Statistical significance was set at p = 0.05. Adjusted odds ratios and their 95% confidence intervals were used to assess the strength of association. Results The prevalence rate of modern contraceptive use among postpartum women was 26.3%. Postpartum contraceptive use was significantly associated with past contraceptive use [AOR = 7.7 (95%CI: 3.4–17.5)]; return of menses [AOR = 4.3 (95%CI: 1.7–11.3)]; resumption of sexual activity [AOR = 4.7 (95%CI: 1.4–15.4)]; discussion of family planning with male partner [AOR = 3.1 (95%CI: 1.03–9.2)]; male partners’ approval of modern contraception [AOR = 18.1 (95%CI: 6.3–51.6)]; family planning counselling received during antenatal care [AOR = 3.5 (95%CI: 1.3–9.9)] and knowledge of at least one modern methods of contraception available at the health facility [AOR = 4.7 (95%CI: 1.9–11.5)]. Conclusions Postpartum contraceptive uptake is low among women in the Tema area. Factors that influence modern contraceptive uptake among postpartum women include past modern contraceptive use, resumption of sexual activity and menstruation, male partner involvement in contraception, family planning counselling during antenatal care and knowledge of the modern methods of contraception available at the health facility. Strengthening family planning education and counselling during antenatal care and using a multi-prong strategy to engage men as partners in family planning will improve postpartum contraceptive uptake.

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Male Perception and Participation in Family Planning Among Tribal Communities of Maharashtra, India: A Mixed-Method Study

International Quarterly of Community Health Education ◽

10.1177/0272684x19875017 ◽

2019 ◽

Vol 40 (3) ◽

pp. 163-169

Author(s):

Suresh Jungari ◽

Balram Paswan

Keyword(s):

Family Planning ◽

Quantitative Methods ◽

Contraceptive Use ◽

Male Involvement ◽

Planning Method ◽

Family Planning Method ◽

Modern Contraceptive ◽

Qualitative And Quantitative Methods ◽

Modern Family ◽

Modern Family Planning

This study examined male perceptions and awareness about family planning. The study also investigated male involvement in family planning and contraceptive use decision-making. Furthermore, in this study, we assessed men’s awareness, attitude, and practice of modern contraceptive methods and determined the level of spousal communication. In this study, a field survey was conducted among the tribal population of Maharashtra. Both qualitative and quantitative methods were used for data collection. A sample of 385 men whose wives had given birth in the last 2 years were interviewed. Almost two thirds of the surveyed men (64%) had heard about modern family planning. The main source of information for family planning was the multipurpose worker in the village for 48% of men, followed by friends 16% and the auxiliary nurse midwife and accredited social health activist for 11% and 10%, respectively. Results show that the current use of any modern family planning method, including male and female methods, was 18.4%. Among the currently used modern methods, the major modern family planning method was male sterilization (67%), followed by oral pills (11%) and male condom use (10%). This study indicated that the acceptance of male modern family planning methods is very high.

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“… the way we welcome them is how we will lead them to love family planning.”: family planning providers in Rwanda foster compassionate relationships with clients despite workplace challenges

BMC Health Services Research ◽

10.1186/s12913-021-06282-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hilary M. Schwandt ◽

Angel Boulware ◽

Julia Corey ◽

Ana Herrera ◽

Ethan Hudler ◽

...

Keyword(s):

Data Analysis ◽

Family Planning ◽

Contraceptive Use ◽

Health Workers ◽

Government Support ◽

Modern Contraceptive ◽

Group Discussions ◽

Short Period ◽

Study Participants ◽

Depth Interviews

Abstract Background Rwanda has markedly increased the nation’s contraceptive use in a short period of time, tripling contraceptive prevalence in just 5 years between 2005 and 2010. An integral aspect of family planning programs is the interactions between family planning providers and clients. This study aims to understand the client-provider relationship in the Rwandan family planning program and to also examine barriers to those relationships. Methods This qualitative study in Rwanda utilized convenience sampling to include eight focus group discussions with family planning providers, both family planning nurses and community health workers, as well as in-depth interviews with 32 experienced modern contraceptive users. Study participants were drawn from the two districts in Rwanda with the highest and lowest modern contraceptive rates, Musanze and Nyamasheke, respectively Data analysis was guided by the thematic content approach, Atlas.ti 8 was utilized for coding the transcripts and collating the coding results, and Microsoft Excel for analyzing the data within code. Results Data analysis revealed that, despite workplace related challenges – including inadequate staffing, training, and resources, relationships between providers and clients are strong. Family planning providers work hard to understand, learn from, and support clients in their initiation and sustained use of contraceptives. Conclusion Given the existing context of purposeful efforts on the part of family planning providers to build relationships with their clients, if the current level of government support for family planning service provision is enhanced, Rwanda will likely sustain many current users of contraception and engage even more Rwandans in contraceptive services in the future.

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Factors That Influence Contraceptive Use Among Women Aged 35 - 49 Years and Their Male Partners in Gomoa West District, Ghana: A Qualitative Study

10.21203/rs.3.rs-951360/v1 ◽

2021 ◽

Author(s):

Amy Takyi ◽

Miho Sato ◽

Michael Adjabeng ◽

Chris Smith

Keyword(s):

Family Planning ◽

Side Effects ◽

Contraceptive Use ◽

Service Providers ◽

Unplanned Pregnancy ◽

Male Partner ◽

Obstetric Outcomes ◽

Age Group ◽

Male Partners ◽

Modern Contraceptives

Abstract BackgroundThe use of contraception among women aged 35 to 49 years is imperative due to the risk of unplanned pregnancy and poor obstetric outcomes. However, the use of contraceptives in this age group has been reported to be low. In Ghana, studies are limited that determine factors influencing contraception among women in this age group, in particular the influence of husbands. This study aims to ascertain factors that influence contraception among women aged 35 to 49 years and their male partners. ObjectivesThe objective of the study was to describe factors that influence contraceptive use among women aged 35 to 49 years and their male partners in Gomoa West District of Ghana.MethodsA total of 44 informants participated in the study. In-depth interviews were conducted remotely for 22 women, 15 male partners of women interviewed, and seven family planning service providers. 21 informants participated in four focus group discussions organized. A simple thematic analysis was undertaken. ResultsFactors that influenced the use of contraceptives were achieved desired family size, counselling by health professionals, experience and/or fear of side effects, health reasons and influence of male partner. Barriers to using modern contraceptives included religious or socio-cultural reasons, experience or fear of side effects, rumors or misconceptions, and the belief that contraceptive use is a matter for women. ConclusionsThis study described factors that influence contraception among women 35 to 49 years and their male partners. All informants used some form of contraception. Strengthening male involvement in family planning activities and health educational activities could alleviate fear and reduce misconceptions about using modern contraceptives.

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Factors that Influence Modern Contraceptive use Among Women Aged 35 - 49 Years and their Male Partners in Gomoa West District, Ghana: A Qualitative Study

10.21203/rs.3.rs-1103240/v1 ◽

2021 ◽

Author(s):

Amy Takyi ◽

Miho Sato ◽

Michael Adjabeng ◽

Chris Smith

Keyword(s):

Family Planning ◽

Contraceptive Use ◽

Service Providers ◽

Obstetric Outcomes ◽

Modern Contraceptive ◽

Age Group ◽

Male Partners ◽

Contraceptive Methods ◽

Modern Contraceptives ◽

Modern Contraceptive Use

Abstract Background: The use of contraception among women aged 35 to 49 years is imperative due to the risk of unplanned pregnancy and poor obstetric outcomes. However, the use of contraceptives in this age group has been reported to be low. In Ghana, studies are limited that determine factors influencing contraception among women in this age group, in particular the influence of husbands. This study aims to ascertain factors that influence contraception among women aged 35 to 49 years and their male partners. Objectives: The objective of the study was to describe factors that influence modern contraceptive use among women aged 35 to 49 years and their male partners in the Gomoa West District of Ghana. Methods: A total of 44 informants participated in the study. In-depth interviews were conducted remotely for 22 women, 15 male partners of women interviewed, and seven family planning service providers. Twenty-one informants participated in four focus group discussions organized. A simple thematic analysis was undertaken. Results: Factors that influenced the use of modern contraceptives were achieved desired family size, counselling by health professionals, health reasons, and influence of male partner. Barriers to using modern contraceptives included religious or socio-cultural reasons, experience or fear of side effects, rumors or misconceptions, and the belief that contraceptive use is a matter for women. Conclusions: This study described factors that influence contraception among women 35 to 49 years and their male partners. All informants used some form of contraception, although traditional contraceptive method users (TCMUs) did not consider traditional contraceptive methods (TCMs) as a form of contraception. Education on effective TCMs as an alternative for non-users of modern contraceptive methods (MCMs) is needed. Strengthening male involvement in family planning and health educational activities could alleviate fear and reduce misconceptions about using modern contraceptives.

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The Role of Structural and Process Quality of Family Planning Care in Modern Contraceptive Use in Indonesia: A Multilevel Analysis

10.21203/rs.3.rs-379186/v1 ◽

2021 ◽

Author(s):

Nurjaeni Nurjaeni ◽

Yothin Sawangdee ◽

Umaporn Pattaravanich ◽

Charamporn Holumyong ◽

Aphichat Chamratrithirong

Keyword(s):

Family Planning ◽

Multilevel Analysis ◽

Contraceptive Use ◽

Process Quality ◽

Structural Quality ◽

Modern Contraceptive ◽

Contraceptive Usage ◽

Modern Contraceptive Use

Abstract Introduction Relatively low modern contraceptive prevalence and high unintended childbearing pose substantial encounters for Indonesia to achieve sustainable development goals. Despite contraceptive behaviors are influenced by multiple and multilevel variables, studies on modern contraceptive use in Indonesia has concentrated on single-level and mostly individual and household variables, and less interest has been devoted to multilevel analysis that accounts for community and SDP characteristics that may affect woman’s decision to use modern FP method.Methods This study analyzed data from the 2016 PMA2020 survey of 10,210 women in 372 communities in Indonesia. The data were analyzed using a multilevel mixed-effects logistic regression to assess the role of structural quality and process quality of family planning care and other factors in modern contraceptive utilization.Result The highest loading factors for structural quality were number of contraceptive provided, SDP supports CHWs, available water and electricity, and skilled FP personnel, while the highest loading factors for process quality were privacy of clients and provision of post-abortion service. There were significant differences across communities in how study variables associated with modern FP adoption. The finding shows the evidence of significant roles of structural and process quality FP care in modern contraceptive use. Moreover, women with high autonomy in FP decision, those who had free national/district health insurance, and those living in a community with higher proportion of women visited by CHW had higher odds of modern contraceptive usage, yet, women who live in a community with higher mean ideal number of children or greater proportion of women citing personal/husband/religion opposition to FP, had lower odds of modern contraceptive use than their counterparts.Conclusions Study findings suggest improvement in structural and process quality of FP care will yield substantial growths in modern contraceptive use. Moreover, FP workers should also address prevailing cultural/traditional customs in community and should target communities where the demand for modern FP was deprived by social beliefs and norms. There was significant variation across communities in how individual, household, community, and SDP factors affect modern FP practice, hence, context should be taken into consideration in the development of FP intervention and promotion programs.

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Measuring Men’s Gender Norm Beliefs Related to Contraception: Development of the Masculine Norms and Family Planning Acceptance Scale

Archives of Sexual Behavior ◽

10.1007/s10508-021-01941-w ◽

2021 ◽

Author(s):

Sara J. Newmann ◽

Jennifer Monroe Zakaras ◽

Shari L. Dworkin ◽

Mellissa Withers ◽

Louisa Ndunyu ◽

...

Keyword(s):

Family Planning ◽

Contraceptive Use ◽

Gender Norms ◽

Male Partner ◽

Masculine Norms ◽

Pregnancy Spacing ◽

Key Factor ◽

Acceptance Scale ◽

Future Work ◽

Positive Engagement

AbstractMale partner resistance is identified as a key factor that influences women’s contraceptive use. Examination of the masculine norms that shape men’s resistance to contraception—and how to intervene on these norms—is needed. To assess a gender-transformative intervention in Kenya, we developed and evaluated a masculinity-informed instrument to measure men’s contraceptive acceptance—the Masculine Norms and Family Planning Acceptance (MNFPA) scale. We developed draft scale items based on qualitative research and administered them to partnered Kenyan men (n = 150). Item response theory-based methods were used to reduce and psychometrically evaluate final scale items. The MNFPA scale had a Cronbach’s α of 0.68 and loaded onto a single factor. MNFPA scores were associated with self-efficacy and intention to accept a female partner’s use of contraception; scores were not associated with current contraceptive use. The MNFPA scale is the first rigorously developed and psychometrically evaluated tool to assess men’s contraceptive acceptance as a function of male gender norms. Future work is needed to test the MNFPA measure in larger samples and across different contexts. The scale can be used to evaluate interventions that seek to shift gender norms to increase men’s positive engagement in pregnancy spacing and prevention.

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