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 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.

Assessment of government health center needs to implement long-acting reversible contraception services in rural Rwanda

2019 ◽  
Author(s):  
Amelia Mazzei ◽  
Rosine Ingabire ◽  
Etienne Karita ◽  
Jeannine Mukamuyango ◽  
Julien Nyombayire ◽  
...  
Keyword(s):  
Family Planning ◽  
Health Center ◽  
Rural Health ◽  
Health Centers ◽  
Power Supplies ◽  
Government Health ◽  
Family Planning Counseling ◽  
Rural Health Centers ◽  
Long Acting ◽  
Gynecological Exam

Abstract Background. There is unmet need for family planning in Rwanda. We previously developed an evidence-based couples’ family planning counseling (C)FPC program in the capital city that combines: 1) fertility goal-based family planning counseling with a focus on long-acting reversible contraceptive (LARC) for couples wishing to delay pregnancy; 2) health center capacity building for provision of LARC methods, and 3) LARC promotion by community health workers (CHW) trained in community-based provision (CBP) of oral and injectable contraception. From 2015-2016, this service was integrated into eight government health centers in Kigali, reaching 6,072 clients and resulting in 5,743 LARC insertions. Methods. From May-July 2016, we conducted health center needs assessments in 30 rural health centers using surveys, key informant interviews, logbook extraction, and structured observations. The assessment focused on the infrastructure, materials, and human resources needed for LARC demand creation and provision.Results. Few nurses had received training in LARC insertion (41% implant, 27% intrauterine device (IUD)). All health centers reported working with CHW, but none trained in LARC promotion. Health centers had limited numbers of IUDs (average 16.4), implants (average 56.1), functional gynecological exam tables (average 2.3), and lamps for viewing the cervix (average <1). Many did not have backup power supplies (40%). Most health centers reported no funding partners for family planning assistance (60%). Per national guidelines, couples’ voluntary HIV counseling and testing (CVCT) was provided at the first antenatal visit at all clinics, reaching over 80% of pregnant women and their partners. However, only 10% of health centers had integrated family planning and HIV services. Conclusions. To successfully implement (C)FPC and LARC services in rural health centers across Rwanda, material and human resource capacity for LARC provision will need to be greatly strengthened through equipment (gynecological exam tables, sterilization capacity, lamps, and backup power supplies), provider trainings and follow-up supervision, and new funding partnerships. Simultaneously, awareness of LARC methods will need to be increased among couples through education and promotion to ensure that demand and supply scale up together. The potential for integrating (C)FPC with ongoing CVCT in antenatal clinics is unique in Africa and should be pursued.

scholarly journals Prevalence and factors associated with postpartum use of long-acting reversible contraception in Bukombe District, Geita Region, Tanzania: a community- based study

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Kiondo Solomon Kiondo ◽  
Eusebious Maro ◽  
Sophia Kiwango ◽  
Julius Pius Alloyce ◽  
Benjamin C. Shayo ◽  
...  
Keyword(s):  
Family Planning ◽  
Unmet Need ◽  
Sub Saharan Africa ◽  
Postpartum Women ◽  
Community Based ◽  
Factors Associated ◽  
Lake Zone ◽  
Family Planning Counseling ◽  
Formal Employment ◽  
Long Acting

Abstract Background Globally, approximately half of all pregnancies occur before 24 months after child birth. In Sub Saharan Africa the unmet need for family planning is highest among postpartum women. There is a dearth of information regarding factors associated with postpartum use of long acting reversible contraception (LARC) in Tanzania particularly in the Lake zone. This study aimed to determine the prevalence and factors associated with postpartum use of LARC (< 24 months) in Bukombe District, Geita Region in the Lake zone, in 2018. Methodology Community based analytical cross-sectional study was conducted between May and June 2018 among women with less than 24 months since delivery. Multistage sampling technique was used to recruit participants. Face to face interviews with 768 postpartum women was conducted using standardized questionnaire. Data were analyzed using Stata Version 13.0. Multivariable logistic regression model was used to determine factors associated with postpartum use of LARC. Results Prevalence of postpartum use of LARC was 10.4%. Urban residence (AOR = 2.94, 95% CI: 1.07–8.06), having formal employment (AOR = 4.81, 95% CI: 1.85–12.57) and receiving family planning counseling (AOR = 4.39, 95% CI: 1.89–10.20) were significantly associated with postpartum LARC use. Conclusion The postpartum use of LARC was low in the studied population with implants being the most commonly used method. Urban residency, formal employment and receiving family planning counseling were associated with postpartum LARC use. Improving prenatal and quality of family planning counseling is warranted to increase postpartum LARC utilization in Bukombe.

Understanding the Fertility Behavior of Bengali-speaking Hindu and Hindi-speaking Hindu Populations Occupying Similar Urban Locale of Kolkata, West Bengal: A Snapshot Regarding Family Planning Decision-making Process

2021 ◽  
pp. 0972558X2199468
Author(s):  
Deepa Routh ◽  
Suvendu Maji
Keyword(s):  
Decision Making ◽  
Family Planning ◽  
West Bengal ◽  
Dominant Role ◽  
Structured Interview ◽  
Fertility Behavior ◽  
Decision Making Process ◽  
Contraception Use ◽  
Sociodemographic Profile ◽  
Planning Decision

This study was conducted to understand the fertility behavior between the two population groups speaking different languages: Bengali-speaking Hindus and Hindi-speaking Hindus. The study further attempts to study the perception and practice regarding contraception use and their decision-making ability. The present study was conducted in Kolkata, West Bengal. A total of 64 women (Bengali-speaking Hindus: 34 and Hindi-speaking Hindus: 30) ranging between 15 years and 44 years were chosen by convenience sampling method. Semi-structured interview schedule was employed to record the response of the participants. Sociodemographic profile of the participants and of their husbands and fertility history were collected using structured interview. Open-ended questions were asked to the participants to understand their perception about family planning. Case studies were also taken from each participant to know about their decision-making process of family planning. Descriptive statistic was carried out to analyze quantitative data, and for qualitative data, thematic analysis was carried out manually. Mean age of the participants was 33.1 years and that of their husbands was 40.2 years. Age at marriage was low in both the groups. Source of knowledge on contraceptives was mostly husband in both the populations. The husband (100%) played a dominant role in decision-making in both the groups. The role of in-laws played a dominant role in decision-making among the Hindi-speaking population. Withdrawal method was a common method of contraceptives in both the groups.

scholarly journals Cross-sectional assessment of government health center needs to implement long-acting reversible contraception services in rural Rwanda

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Amelia Mazzei ◽  
Rosine Ingabire ◽  
Etienne Karita ◽  
Jeannine Mukamuyango ◽  
Julien Nyombayire ◽  
...  
Keyword(s):  
Family Planning ◽  
Health Center ◽  
Rural Health ◽  
Health Centers ◽  
Power Supplies ◽  
Cross Sectional ◽  
Government Health ◽  
Family Planning Counseling ◽  
Rural Health Centers ◽  
Long Acting

Abstract Background There is unmet need for family planning in Rwanda. We previously developed an evidence-based couples’ family planning counseling (C)FPC program in the capital city that combines: (1) fertility goal-based family planning counseling with a focus on long-acting reversible contraceptive (LARC) for couples wishing to delay pregnancy; (2) health center capacity building for provision of LARC methods, and (3) LARC promotion by community health workers (CHW) trained in community-based provision of oral and injectable contraception. From 2015 to 2016, this service was integrated into eight government health centers in Kigali, reaching 6072 clients and resulting in 5743 LARC insertions. Methods From May to July 2016, we conducted cross-sectional health center needs assessments in 30 rural health centers using surveys, key informant interviews, logbook extraction, and structured observations. The assessment focused on the infrastructure, materials, and human resources needed for LARC demand creation and provision. Results Few nurses had received training in LARC insertion [41% implant, 27% intrauterine device (IUD)]. All health centers reported working with CHW, but none trained in LARC promotion. Health centers had limited numbers of IUDs (median 10), implants (median 39), functional gynecological exam tables (median 2), and lamps for viewing the cervix (median 0). Many did not have backup power supplies (40%). Most health centers reported no funding partners for family planning assistance (60%). Per national guidelines, couples’ voluntary HIV counseling and testing (CVCT) was provided at the first antenatal visit at all clinics, reaching over 80% of pregnant women and their partners. However, only 10% of health centers had integrated family planning and HIV services. Conclusions To successfully implement (C)FPC and LARC services in rural health centers across Rwanda, material and human resource capacity for LARC provision will need to be greatly strengthened through equipment (gynecological exam tables, sterilization capacity, lamps, and backup power supplies), provider trainings and follow-up supervision, and new funding partnerships. Simultaneously, awareness of LARC methods will need to be increased among couples through education and promotion to ensure that demand and supply scale up together. The potential for integrating (C)FPC with ongoing CVCT in antenatal clinics is unique in Africa and should be pursued.

scholarly journals Lived experience of women who underwent early removal of long-acting Contraceptive Methods in Bedesa town, Wolaita Zone, Southern Ethiopia: A phenomenological study

2020 ◽  
Author(s):  
Mohammed Suleiman Obsa ◽  
Kassahun Tekle Takiso ◽  
Tamiru Tilahun Ayele ◽  
Hailu Chare Koyra ◽  
Kasahun Tafesse Hidota ◽  
...  
Keyword(s):  
Family Planning ◽  
Phenomenological Study ◽  
Southern Ethiopia ◽  
Contraceptive Methods ◽  
Early Removal ◽  
Planning Methods ◽  
Long Acting ◽  
Study Participants ◽  
Depth Interviews ◽  
Family Planning Methods

Abstract Background Long-acting contraceptive methods can play a pivotal role in ining reducing maternal mortality. In The total fertility rate of Ethiopia is as high as 4.6 children per woman, which is manifested by short birth-interval. However, this rapid population growth is not in line with the weak economic growth of the country. Therefore, this study was done to explore the lived experiences of women who underwent early removal of long-acting contraceptive methods in Bedesa town, Southern Ethiopia. Methods A phenomenological study design was employed from April 16–22, 2020 to conduct this qualitative study among Bedessa town community. Individual In-depth interviews were used to collect data from a sampled study participants recruited through criterion sampling method. Based on the theoretical saturation of data, this study included a total of 10 in-depth interviews of sampled women.. Open code version 4.03 was used to code and facilitate analysis. The study used thematic analysis technique after the transcripts were read and re-read separately by the investigators to identify emerging themes. Results This study revealed that the majority of participants were able to mention at least three types of contraceptive methods. Participants frequently said that the side effect of the long-acting family planning methods as the main reason for early removal. Furthermore, heavy and irregular menses were mentioned as the most frequently occurring side effects. Delayed fertility after removal of long-acting contraceptive was one of frequently stated fear by the clients. Some of the participants indicated that counseling provided by health professionals was not adequate. Conclusion The majority of our study participants taught that the side effects of long-acting family planning methods outweigh than benefits. Besides, the counseling service provided by health care providers was not adequate. Therefore, proper counseling services should be given to mothers who are taking long-acting family planning methods.

scholarly journals Long-acting reversible contraception utilization and associated factors among women in extended postpartum period in southern Ethiopia

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Yibeltal Mesfin ◽  
Abraham Wallelign
Keyword(s):  
Family Planning ◽  
Sexual Intercourse ◽  
Postpartum Period ◽  
Associated Factors ◽  
Contraceptive Use ◽  
Postpartum Family Planning ◽  
Contraception Use ◽  
Family Planning Counseling ◽  
Long Acting ◽  
Long Acting Reversible Contraceptive

Abstract Background Postpartum long-acting reversible contraceptive is important to prevent unintended and closed spaced pregnancy following the first 12 months of childbirth. Few data were available on postpartum long-acting reversible contraceptive use in Ethiopia. So, this study aimed to assess the long-acting reversible contraception use and associated factors among women who gave birth in the last 12 months. Methods A community-based cross-sectional study was conducted from October 1st to November 2019. Systematic random sampling was applied to recruit a total of 416 study participants. Data were collected using a structured questionnaire. Data were entered using Epidata 4.6 and exported to SPSS version 25 for analysis. P-value < 0.05 with 95% confidence interval (CI) used to declare statistical significance. Result In this study, long acting contraceptive utilization among women in the extended postpartum period was 22.6%. Maternal age ≤ 24 years (AOR = 3.7, 95% CI: 1.5, 8.9), being married (AOR =3.5 95% CI: (1.17–10.28)), menses resumption (AOR = 4.9 95% CI: (2.92, 8.20)), sexual intercourse resumption (AOR = 7.1 95% CI: (4.03, 12.56)) and received postpartum family planning counseling (AOR = 3.2 95% (1.95, 5.28)) were the factors associated with Long-acting reversible contraception use. Conclusion This finding showed postpartum women’s long-acting reversible contraceptive use during the extended postpartum period was low. The factors significantly associated with extended postpartum modern contraceptive use were women’s age, being married, menses resumption, sexual intercourse resumption, and got postnatal family planning counseling. Strengthening Antenatal and postnatal counseling of postpartum family planning would improve long-acting reversible contraception use.

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 Awareness, Knowledge and Comprehension of Media Messages on Family Planning as Predictors of Practice among Civil Servants in Lagos State, Nigeria

2019 ◽  
Vol 12 (1) ◽  
pp. 96
Author(s):  
Helen Odunola Adekoya ◽  
Mofoluke Akoja ◽  
Charles Maduabuchi Ekeh ◽  
Nneoma Anaeto
Keyword(s):  
Family Planning ◽  
Control Method ◽  
Population Control ◽  
Civil Servants ◽  
Chi Square ◽  
Lagos State ◽  
Planning Methods ◽  
Long Acting ◽  
Study Participants ◽  
Family Planning Methods

Family planning is a population control method practiced in various countries including Nigeria; however, it cannot be practice unless people are aware of it and its methods. Thus, awareness, knowledge and comprehension of family planning messages as predictors of practice is studied. 478 copies of questionnaire were distributed to that number of civil servants at the Lagos state secretariat, Alausa from where the population for the study was drawn. With a response rate of 95.8%, 458 copies were retrieved and analyzed using the statistical package for social sciences (SPSS) version 22, while hypotheses were tested using the Pearson Chi-Square. Findings revealed that there is high awareness of family planning messages among study participants with posters as the major medium of awareness. The study also found that the long-acting family planning methods are the most known family planning methods and that the practice is well known and common among study participants.

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