scholarly journals Postpartum family planning in Rwanda: a cost effectiveness analysis

2019 ◽  
Vol 3 ◽  
pp. 887
Author(s):  
Pamela Williams ◽  
Katie Morales ◽  
Vikram Sridharan ◽  
Alekya Tummala ◽  
Elliot Marseille
Keyword(s):  
Cost Effectiveness ◽  
Family Planning ◽  
Unmet Need ◽  
Cost Effectiveness Analysis ◽  
Reproductive Age ◽  
World Health ◽  
Effectiveness Analysis ◽  
Postpartum Family Planning ◽  
Planning Methods ◽  
Family Planning Methods

Background: Globally, there is a large unmet need for family planning in the postpartum period: 90% of women in this group want family planning for birth spacing or to avoid unintended pregnancies and stop child bearing once desired family size has been reached. Women spend on average about 30 years, or three-quarters of their reproductive lives, attempting to avoid pregnancy. In total 76% of Rwandan women want family planning postpartum, yet a 26% unmet need remains. Methods: This cost effectiveness analysis compared the two most frequently-used family planning methods in Rwanda, longer-acting reversible contraception (LARC), injections and subdermal implants, and shorter-acting reversible contraceptives (non-LARC), pills and condoms. Women who do not use contraception postpartum were also represented. A time horizon of 24 months was used to reflect the World Health Organization suggested two-year spacing from birth until the next pregnancy, and the analysis was conducted from a health systems perspective. Results: For women of reproductive age (12-49 years) in Rwanda, including LARC postpartum family planning methods in the options, saves $18.73 per pregnancy averted, compared to family planning options that offer non-LARC methods exclusively. Conclusion: $2.8 million US$ per year can be saved if LARC is included as a contraceptive choice across all health centers in Rwanda; this cost savings provides the opportunity for these funds to be allocated to other high value interventions. Potential inclusion of these methods at Rwanda’s faith-based health facilities warrants further attention.

scholarly journals Postpartum family planning in Rwanda: a cost effectiveness analysis

2019 ◽  
Vol 3 ◽  
pp. 887
Author(s):  
Pamela Williams ◽  
Katie Morales ◽  
Vikram Sridharan ◽  
Alekya Tummala ◽  
Elliot Marseille
Keyword(s):  
Public Health ◽  
Cost Effectiveness ◽  
Family Planning ◽  
Unmet Need ◽  
Cost Effectiveness Analysis ◽  
World Health ◽  
Effectiveness Analysis ◽  
Postpartum Family Planning ◽  
Planning Methods ◽  
Family Planning Methods

Background: Globally, there is a large unmet need for family planning in the postpartum period: 90% of women in this group want family planning for birth spacing or to avoid unintended pregnancies and stop child bearing once desired family size has been reached. Women spend on average about 30 years, or three-quarters of their reproductive lives, attempting to avoid pregnancy. In total 76% of Rwandan women want family planning postpartum, yet a 26% unmet need remains. Methods: This cost effectiveness analysis compared the two most frequently-used family planning methods in Rwanda, longer-acting reversible contraception (LARC), injections and subdermal implants, and shorter-acting reversible contraceptives (non-LARC), pills and condoms. Women who do not use contraception postpartum were also represented. A time horizon of 24 months was used to reflect the World Health Organization suggested two-year spacing from birth until the next pregnancy, and the analysis was conducted from a health systems perspective. Results: For women of reproductive age (15-49 years) in Rwanda, including LARC postpartum family planning methods in the options, saves $18.73 per pregnancy averted, compared to family planning options that offer non-LARC methods exclusively. Conclusion: There is an opportunity to avert unplanned pregnancies associated with the increased utilization of LARC methods. Despite the availability of LARC methods in many of Rwanda’s health facilities, the full benefits are not yet realized. LARC is cost-saving compared with non-LARC methods. Effective public health messaging campaigns and other promotion targeting current resistance to LARC use for the postpartum population could both enhance health and save public health funds.

scholarly journals Postpartum family planning in Rwanda: a cost effectiveness analysis

2019 ◽  
Vol 3 ◽  
pp. 887
Author(s):  
Pamela Williams ◽  
Katie Morales ◽  
Vikram Sridharan ◽  
Alekya Tummala ◽  
Elliot Marseille
Keyword(s):  
Cost Effectiveness ◽  
Family Planning ◽  
Unmet Need ◽  
Cost Effectiveness Analysis ◽  
Service Package ◽  
Effectiveness Analysis ◽  
Postpartum Family Planning ◽  
Planning Methods ◽  
Subdermal Implants ◽  
Family Planning Methods

Background: Globally, there is a large unmet need for family planning in the postpartum period: 90% of women in this group want family planning for birth spacing or to avoid unintended pregnancies and stop child bearing once desired family size has been reached. In total 76% of Rwandan women want family planning postpartum, yet a 26% unmet need remains. Currently, the four most commonly used postpartum family planning methods in Rwanda are injections, subdermal implants, pills, and condoms. The economic and health benefit impact of the current method selection has not yet been evaluated. Methods: To evaluate the impact of current usage rates and method types, this cost effectiveness analysis (CEA) compared the most frequently used family planning methods in Rwanda broken into two categories, longer-acting reversible contraception (LARC) (injections and subdermal implants) and shorter-acting reversible contraceptives (non-LARC) (pills and condoms). A time horizon of 24 months was used to reflect the World Health Organization suggested two-year spacing from birth until the next pregnancy, and was conducted from a health systems perspective. This CEA compared two service package options to provide a comparator for the two method types, thus enabling insights to differences between the two. Results: For women of reproductive age (15-49 years) in Rwanda, including LARC postpartum family planning methods in the options, saves $18.73 per pregnancy averted, compared to family planning options that offer non-LARC methods exclusively. Conclusion: There is an opportunity to avert unplanned pregnancies associated with increased utilization of LARC methods. The full benefits of LARC are not yet realized in Rwanda. Under the conditions presented in this study, a service package that includes LARC has the potential to be cost-saving compared with one non-LARC methods. Effective health messaging of LARC use for the postpartum population could both enhance health and reduce costs.

scholarly journals Barriers and missed opportunities towards immediate and early post-partum family planning methods in Pakistan.

2020 ◽  
Vol 27 (07) ◽  
pp. 1448-1453
Author(s):  
Yasmeen Abbasi ◽  
Shaiza Rahman Shaikh ◽  
Khalida Naz Memon
Keyword(s):  
Family Planning ◽  
Post Partum ◽  
Reproductive Age ◽  
Antenatal Visit ◽  
Missed Opportunities ◽  
Postpartum Family Planning ◽  
Early Postpartum ◽  
Planning Methods ◽  
Barriers And Opportunities ◽  
Family Planning Methods

The postpartum family planning (PPFP) services are offered immediately after delivery (immediate PPFP), within 40 days after delivery (early PPFP) and within 12 month after delivery (extended PPFP). To promote PPFP the counselling during antenatal visit, before discharge from maternity ward, during postnatal visit and visit during immunization of their babies are the opportunities where health providers help them to decide about the post-partum contraception. Objectives: To compare the coverage of immediate and early postpartum family planning to extended postpartum family planning. To analyze the socio demographic barriers for adopting immediate and early postpartum family planning methods. To identify the missed opportunities for immediate and early postpartum family planning. Study Design: Community Based Comparative Cross Sectional study. Setting: Tando Jam and Hali Road Hyderabad, Sindh. Period: Three months from 01-07-2017 to 30-09-2017. Material & Methods: Three Hundred females of reproductive age (15 to 49 years) during immediate, early and extended postpartum period residing in study area were selected through Purposive Sampling Technique. A pre-designed questionnaire was used as a data collection tool. The data was analyzed using SPSS version 16. The participants were inquired about the usage and concerns towards immediate and early post-partum family planning methods. Barriers and opportunities were identified. The association between various socio-demographic variables and family planning method was determined by applying Chi-square test at ≤0.05 level of significance. Results: Highest number of the study participants were practicing extended method of post-partum family planning i.e. 223(74.33%), only 65(21.67%) had adopted early PPFP and 12 (4%) were practicing immediate post-partum family planning.  Low socio-economic status, low literacy rate of both partner, young age of women, and permission from husband, fear of health problem due to contraception and previous bad experience with contraceptive methods were identified barriers towards family planning adoption. Deliveries in homes or in maternity home, facilitated by Dais, not going through ante-natal checkups and not bringing the last born for vaccination were reported with non-adoption of immediate post-partum family planning. Conclusion: The coverage of immediate and early postpartum family planning is very low in the community so the barriers and opportunities identified should be addressed to overcome the hindrances.

scholarly journals Knowledge, Attitude and Practice on Family Planning among Married Muslim Women of Reproductive Age

2020 ◽  
Vol 18 (2) ◽  
pp. 238-242
Author(s):  
Usha Dhakal ◽  
Ram Bahadur Shrestha ◽  
Surendra Kumar Bohara ◽  
Samir Neupane
Keyword(s):  
Family Planning ◽  
Unmet Need ◽  
Muslim Women ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Cross Sectional ◽  
Attitude And Practice ◽  
Planning Methods ◽  
Knowledge Attitude And Practice ◽  
Family Planning Methods

Background: Maternal mortality is associated with the unmet need of family planning. Family planning has been subjected as taboos in the Muslim community with low use of its methods. Gulariya Municipality is the second largest community for Muslim. This research focuses on knowledge, attitude and practice of family planning among Muslim women of reproductive age.Methods: Descriptive cross-sectional study design was undertaken in Gulariya Municipality. Married Muslim women of reproductive age group from 164 households were interviewed using systematic random sampling. Key informant interview was also applied.Results: The percentage of women who have knowledge on family planning methods was found 94.5%. On the means of contraception, most of the women (73.2%) knew about Depo. The attitude of the respondents was seen positive. A total of 79.3% of women were found to have practiced temporary means of family planning while none of the women surveyed were found using permanent family planning methods. Association between all socio-economic and demographic factors with knowledge of family planning methods were found insignificant at 0.05 level of significance. However, association between wealth rank and practices on family planning shows statistically significant association. Conclusions: Majority of women have knowledge on family planning, but still lack knowledge on few method like condom. Most of them found practicing family planning, despite the practice was not seen being done regularly. Language barrier seems to be influencing knowledge, attitude and practice of family planning. The research warrants newer strategies to be developed and employed to deal with the multi-disciplinary prospective of family planning among Muslim women.Keywords: Family planning; knowledge, attitude and practice; muslim women

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 Family Planning Uptake in Kagera and Mara Regions in Tanzania: A Cross-Sectional Community Survey

2021 ◽  
Vol 18 (4) ◽  
pp. 1651
Author(s):  
Joseph Massenga ◽  
Rita Noronha ◽  
Bayoum Awadhi ◽  
Dunstan R. Bishanga ◽  
Oliva Safari ◽  
...  
Keyword(s):  
Health Care ◽  
Family Planning ◽  
Antenatal Care ◽  
Health Workers ◽  
Unmet Need ◽  
Reproductive Age ◽  
Mixed Effect ◽  
Factors Associated ◽  
Planning Methods ◽  
Family Planning Methods

In Tanzania, 27.1% of all women of reproductive age are currently using modern contraception and 16.8% have an unmet need for family planning. We therefore examined factors associated with family planning uptake after giving birth in two regions of Tanzania. The survey, which collected information beyond that collected in the Tanzania Demographic Health Survey, used a two-stage, stratified-cluster sampling design, conducted in April 2016 in Mara and Kagera regions in Tanzania. A total of 1184 women aged 15–49 years, who had given birth less than two years prior to the survey were included. Logistic regression mixed effect modelling was used to examine factors associated with family planning uptake. A total of 393 (33.2%) women used family planning methods and 929 (79%) required prior approval from their partners. Participation of men in utilization of maternal health care was low, where 680 (57.8%) women responded that their partners accompanied them to at least one antenatal care (ANC) counselling visit and 120 (10%) responded that their partners participated in family planning counselling. Women who did not want to disclose whether they had discussed family planning with their partners, strikingly had the highest percentage of using family planning methods after birth. Factors independently associated with family planning uptake included: having discussed family planning with the partner (aOR 3.22; 95% CI 1.99–5.21), having been counselled on family planning during antenatal care (aOR 2.68; 95% CI 1.78–4.05), having discussed family planning with a community health worker (CHW) (aOR 4.59; 95% CI 2.53–8.33) and with a facility health care worker (aOR 1.93; 95% CI 1.29–2.90), having primary or higher educational level (aOR 1.66; 95% CI 1.01–2.273), and being in union (aOR 1.86; 95% CI 1.02–3.42). Educational interaction with community and facility health workers, as well as having a supportive partner as facilitator increased uptake of family planning. This needs to be prioritized in regions with similar socio-cultural norms in Tanzania and beyond.

scholarly journals Unmet Need of Family Planning Among Rural Women in Bangladesh

1970 ◽  
Vol 19 (1) ◽  
pp. 11-15 ◽  
Author(s):  
SK Ferdousi ◽  
MA Jabbar ◽  
SR Hoque ◽  
SR Karim ◽  
AR Mahmood ◽  
...  
Keyword(s):  
Family Planning ◽  
Rural Women ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Married Women ◽  
Reproductive Age ◽  
Cross Sectional ◽  
Planning Methods ◽  
Contraceptive Prevalence ◽  
Family Planning Methods

Objective: This study aims to find out the unmet need of family planning among the rural women. To explore the obstacles to use family planning methods and to estimate the prevalence of contraceptive use. Study design: Cross-sectional type of descriptive study. Settings: The study was conducted at Sreepur upazila under Gazipur district. Subjects: All the married women of reproductive age, residing in a selected village of Sreepur upazila, were selected as the study subject. Results: The study revealed that unmet need was (22.4%). Most of the respondents (72.1%) were using contraceptive methods. Among those who used contraceptives, OCP was the most commonly used method (61.7%). About 28% were not using any method. The main reason was fear of side effects (46.1%). Conclusion: The study concluded that a nationwide contraceptive prevalence study may be carried out to explore the problem in detail. Key words: Unmet need; family planning; contraceptive prevalence rate. DOI: 10.3329/jdmc.v19i1.6244 J Dhaka Med Coll. 2010; 19(1) : 11-15.

scholarly journals DETERMINANTS OF UNMET NEED FOR FAMILY PLANNING METHODS AMONG MARRIED WOMEN OF REPRODUCTIVE AGE IN OMBADA LOCALITY, KHARTOUM STATE, SUDAN. 2019

2021 ◽  
Vol 9 (10) ◽  
pp. 1159-1166
Author(s):  
Sarra E. Saied ◽  
◽  
Nada G.O. Ahmed ◽  
Elmuez E.A ◽  
Egbal A.B.A. Karaig ◽  
...  
Keyword(s):  
Public Health ◽  
Family Planning ◽  
Unmet Need ◽  
Married Women ◽  
Health Facilities ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
The Public ◽  
Planning Methods ◽  
Family Planning Methods

Introduction:The unmet need for family planning reflects the gap between womens reproductive intentions and their contraceptive behavior. Its a useful indicator for tracking progress towards the target of achieving universal access to reproductive health. Aim:This study aimsat measuringthe level of unmet need for family planning in Ombada locality to identify the determinants that affectutilization of FP methodsand to assessthe readiness of the public health facilities to the provision of FP services. Methods:The study was a descriptive cross-sectional health facility and community-based studyusinga multistage sampling technique.The study collected data from married women of reproductive age (15-49 years)and from the public health facilities providingfamily planning services in the study area using structured questionnaire and checklist respectively. The data were analyzed using the Statistical Package for Social Sciences version20. Results:Currently users for family planning methods were (21.55%). The total unmet need for family planning was high and measured as (39.26%), while the total demand for family planning was (60.8%). Factors such as age, age at marriage, living children, knowledge about family planning methods and discussion with husband were found to be significantly related to the high total unmet need. Major reasons for the non-use of family planning methods were husband/family objection, fear of side effects and a lack of knowledge about family planning methods. Assessment of health facilities revealed poor infrastructure readiness. Conclusion: Women in the surveyed locality are still not empowered regarding their reproductive health choices, as they are still under the control of husbands and families concerning the use of contraceptive methods. In addition, the lack of counsellingcomponent, which was the weakest link in the provision of family planning services, lead to voluntary or un-voluntary avoid of using FP methods, or adopting unprofessional sources or methods as alternatives. Thus, policymakers and directorates managers have to carefully consider such findings when planning for FP interventions.

scholarly journals Survey on understanding of socio-demographic factors responsible for unmet need of family planning from the selected locality in Agra

2020 ◽  
pp. 7-12
Author(s):  
Shilpy Shakya ◽  
Bindhya Chal Yadav
Keyword(s):  
Family Planning ◽  
Unmet Need ◽  
Reproductive Potential ◽  
Uttar Pradesh ◽  
Reproductive Age ◽  
World Health ◽  
Mortality And Morbidity ◽  
Planning Methods ◽  
Socio Demographic Factors ◽  
Health Organization

Despite the progress that has been recorded in area of family planning, an increasing number of women reporting the need for the contraceptives tells the urgency of the situation. Data collected from both developing and developed world put forth a whooping number as 120 million women who have reported that they are willing to delay the pregnancy but are not using any method of contraception. According to world health organization (WHO) Unmet need for family planning is defined as the percentage of women of reproductive age, either married or in a union, who have an unmet need for family planning. The concept of unmet need has already been defined through many studies, as it is the percentage of the women who wish to delay the childbirth but are not using any form of contraception. Since reporting of the unmet need of family planning depends upon the desire of the women to report such an issue which is still considered a taboo in Indian families. It is for this reason; unmet need is called as an inconsistent and fluid indicator of the reproductive potential of the women. It is postulated that, if the unmet need of the selected population is met through interventions, it could help in reducing the population and also help in bringing down child mortality in addition to maternal mortality and morbidity. This study from the selected location from Agra in Uttar Pradesh has brought in light certain observations among the women who were not using any method of contraception. We have through this study have reported that more than 73 percent of the women wanted to stop childbearing. Women who were using any of the choicest method of contraception, among them 34 percent of the women were reporting desire to become pregnant. 67 percent of the women wanted to delay the pregnancy for one to two years, 48 percent of the women from among the selected population in this category did not want to have any more children. The aim of this study was to establish a co-relation between various factors that exerts their affects on presence of unmet need for family planning and use of family planning methods with a reported decrease in pregnancy among the women who did not want any more children.

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