scholarly journals Missed opportunity for family planning counselling along the continuum of care in Arusha region, Tanzania

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0250988
Author(s):  
Caroline Amour ◽  
Rachel N. Manongi ◽  
Michael J. Mahande ◽  
Bilikisu Elewonibi ◽  
Amina Farah ◽  
...  

Introduction Adequate sexual and reproductive health information is vital to women of reproductive age (WRA) 15 to 49 years, for making informed choices on their reproductive health including family planning (FP). However, many women who interact with the health system continue to miss out this vital service. The study aimed to identify the extent of provision of FP counselling at service delivery points and associated behavioral factors among women of reproductive age in two districts of Arusha region. It also determined the association between receipt of FP counselling and contraceptive usage. Methods Data were drawn from a cross-sectional survey of 5,208 WRA residing in two districts of Arusha region in Tanzania; conducted between January and May 2018. Multistage sampling technique was employed to select the WRA for the face-to-face interviews. FP counseling was defined as receipt of FP information by a woman during any visit at the health facility for antenatal care (ANC), or for post-natal care (PNC). Analyses on receipt of FP counseling were done on 3,116 WRA, aged 16–44 years who were in contact with health facilities in the past two years. A modified Poisson regression model was used to determine the Prevalence Ratio (PR) as a measure of association between receipt of any FP counseling and current use of modern contraception, controlling for potential confounders. Results Among the women that visited the health facility for any health-related visit in the past two years, 1,256 (40%) reported that they received FP counselling. Among the women who had had births in the last 30 months; 1,389 and 1,409 women had contact with the service delivery points for ANC and PNC visits respectively. Of these 31% and 26% had a missed FP counseling at ANC and PNC visit respectively. Women who were not formally employed were more likely to receive FP counselling during facility visit than others. WRA who received any FP counseling at PNC were significantly more likely to report current use of modern contraception than those who did not (adjusted PR [adj. PR] = 1.28; 95% Confidence Interval [CI]: 1.09, 1.49). Conclusion Overall, only 40% women reported that they received any form of FP counseling when they interfaced with the healthcare system in the past two years. Informally employed women were more likely to receive FP counselling, and women who received FP counselling during PNC visits were significantly more likely to use contraceptive in comparison to the women who did not receive FP counselling. This presents a missed opportunity for prevention of unintended pregnancies and suggests a need for further integration of FP counseling into the ANC and PNC visits.

2016 ◽  
Vol 1 (4) ◽  
Author(s):  
Jacob Daube ◽  
Viktoria Chamberman ◽  
Eliza Raymond

<p><strong>Background</strong>: Improving access to family planning in the Pacific region has been slow, especially for those living in remote and rural areas. Pacific countries consistently report contraceptive prevalence rates well below the United Nations’ global averages for ‘less developed’ regions.  The most recent data available on family planning usage in Kiribati from 2009 reported that the modern contraceptive prevalence rate was just 18.0% and total contraceptive prevalence rate just 22.3%.</p><div><p>The aim of the study was to investigate knowledge and use of family planning and identify barriers to contraceptive uptake for men and women of reproductive age in South Tarawa, Kiribati, to inform future approaches aimed at increasing access to family planning.</p><p><strong>Methods:</strong> A mixed methods approach was used. A community survey of men and women of reproductive age (15-49 years) (n=500) was carried out to identify current levels of knowledge, contraceptive use and barriers to use. Focus groups (n=4) of target populations (men 15-24, men 25-49, women 15-24, women 25-49) were undertaken and in-depth interviews (n=14) were conducted with health professionals and government officials to interpret survey results, further investigate barriers and generate ideas for improving service delivery.</p><p><strong>Findings:</strong> Considerable barriers to family planning use were observed in the community survey and explored in the interviews and focus groups. They can be categorised into four thematic groups: disinterest in family planning; knowledge gaps; personal, family and social objections; and unsuitable service delivery.<strong><em></em></strong></p></div><p><strong>Conclusion:</strong> A broad range of solutions were identified and fourteen service delivery recommendations were made for family planning service providers in South Tarawa. The recommendations may also hold relevance to other Pacific countries, however we encourage service providers to consider their country context before initiating any recommendations provided in this study. </p>


BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e017621 ◽  
Author(s):  
Wu Junqing ◽  
Yu Chuanning ◽  
Li Yuyan

ObjectivesAlthough family planning in China has changed gradually since 1994, there are few studies about family planning and women’s reproductive rights. The main objective of this study was to examine awareness of sexual and reproductive healthcare rights (SRHCRs), and learn how factors related to family planning influence awareness of SRHCRs among married women of reproductive age in China.Methods and participantsInner Mongolia, Chongqing, Guangdong and Henan were selected for the study, and a total of 2504 married women of reproductive age were recruited. A self-administered anonymous questionnaire was used to collect information on participants’ awareness of SRHCRs.ResultsThere were a total of 10 843 (≤6×2504) responses, with a response rate of 72.17% (10 843/15 024) on average among participants regarding SRHCRs (a multiple response set). The highest response rate was for choice (Right 3) (90.64%, 95% CI 89.47%, 91.81%), followed by privacy (Right 5) (86.11%, 95% CI 84.72%, 87.50%) and information (Right 1) (84.47%, 95% CI 83.02%, 85.93%). Only 43.39% (95% CI 41.40%, 45.38%) of participants gave responses to safety (Right 4). Participants without children showed more interest in Right 1, in access (Right 2) and in Right 4. Those who utilised tests for fetal sex determination paid more attention to Rights 2 and 4. Women who accepted informed choice were more likely to be aware of all six rights except for Right 3 and dignity (Right 6). Those individuals who were satisfied or very satisfied with comprehensive sexual and reproductive health counselling services were more likely to show interest in all six rights.ConclusionsAwareness of SRHCRs among reproductive aged women in China is still inadequate. Family planning service providers might strengthen the service awareness of sex and reproductive health rights according to the different needs of women.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Muhammad Farhan Asif ◽  
Zahid Pervaiz ◽  
Jawad Rahim Afridi ◽  
Ghulam Abid ◽  
Zohra S. Lassi

Abstract Background Family planning services deliver a wide range of benefits to the well-being of females and the community. It can curtail the risk of maternal and neonatal mortality through the reduction in abortions and pregnancies. The government of Pakistan has been struggling to convince people about the usefulness of family planning programs. However, different factors related to social norms, values, and culture are important to determine the success of these programs. One such factor is the patriarchal structure of Pakistani society where most of the household decisions are made by men. The objective of this research is to examine the role of the husband’s attitude towards the usage of contraceptives for the unmet need of family planning (UMNFP) among married women of reproductive age (MWRA) in Pakistan. Method The dataset of Pakistan Demographic and Health Survey 2017–18 is utilized to examine the role of the husband’s attitude towards the usage of contraceptives in UMNFP among MWRA in Pakistan. Results The UMNFP was considerably lower among MWRA between 40 years and above compared to women 15–19 years. The odds of UMNFP were higher among women and men who were educated up to the primary level compared to those with no education. Odds of UMNFP were higher among women from the poor wealth quintile compared to the poorest wealth quintile; similarly, it was significantly lower among women who were from the richer and the richest wealth quintile compared to the poorest wealth quintile. The odds of UMNFP were lower among women who were employed compared to those who were not employed. Lastly, the odds of UMNFP were higher among women whose husbands opposed to using contraceptives, who perceived that there was a religious prohibition for such use and when a decision on the contraception use was solely made by the husband. Conclusions Husband’s attitude towards the usage of contraceptives is an important predictor of UMNFP. Liaising with the community and religious leaders to persuade people particularly men about the usefulness of family planning programs and encouraging men to understand their women’s say in using contraceptives should be encouraged.


Author(s):  
Mahvish Qazi ◽  
Najmus Saqib ◽  
Sachin Gupta

Background: India with 1.35 billion people is the second most populated country in the world next to China. Total fertility rate of India is 2.2 and the current total fertility rate of Jammu and Kashmir is 1.7 which is still lagging behind various states. This study was conducted to investigate the knowledge, attitude and practices of contraception in women of reproductive age in this set up.Methods: The present cross-sectional study was carried out in patients attending OPD (outpatient department) of Obstetrics and Gynecology at ASCOMS, Jammu, Jammu and Kashmir, India from 1st September 2017 to 31st August 2018. 200 married women aged between 18-49 years were included in this study. Socio-demographic characteristics of the women, their knowledge, attitude and practices on contraception were evaluated with the help of predesigned questionnaire.Results: Out of 200 women, maximum respondents belong to age group of 21-25 years (75.6%). Most of the contraceptive non-users belongs to age below 20 years (62.5%). Majority of respondents were Hindu (70.37%), maximum studied up to secondary level education (84.61%), 70.30% were housewives and 56.58% belongs to middle class. In 45% of respondents, media was the main source of information. Preferred spacing method was condom in 85% of cases. 68% women had knowledge of female sterilization. According to most women, family planning methods are meant for limitations of birth (43%) and 36% meant for spacing of birth. 80% women had positive attitude towards contraceptive usage. 50% experienced side effects with the use of contraceptives. The most common side effect was menstrual irregularities in 25% of cases. Most common reason for not using contraceptive methods among non-respondents were lack of knowledge in 50% of cases.Conclusions: The study showed that inspite of having good knowledge, utilization of contraceptives were less because of large family norm, religious myth, cultural and political barriers. Ignorance regarding use and side effects of various contraceptive methods is another reason for inadequate practice of family planning methods.


2021 ◽  
Author(s):  
Jennifer J. Frost ◽  
Jennifer Mueller ◽  
Zoe H. Pleasure

Key Points Seven in 10 U.S. women of reproductive age, some 44 million women, make at least one medical visit to obtain sexual and reproductive health (SRH) services each year. While the overall number of women receiving any SRH service remained relatively stable between 2006–2010 and 2015–2019, the number of women receiving preventive gynecologic care fell and the number receiving STI testing doubled. Disparities in use of SRH services persist, as Hispanic women are significantly less likely than non-Hispanic White women to receive SRH services, and uninsured women are significantly less likely to receive services than privately insured women. Publicly funded clinics remain critical sources of SRH care for many women, with younger women, lower income women, women of color, foreign-born women, women with Medicaid coverage and women who are uninsured especially likely to rely on publicly funded clinics. Among women who go to clinics for SRH care, two-thirds report that the clinic is their usual source for medical care. Among those relying on both private providers and public clinics, the proportion of women who reported receiving a combination of contraceptive and STI/HIV care increased between 2006–2010 and 2015–2019. Implementation of the Affordable Care Act has likely contributed to some of the changes observed in where women receive contraceptive and other SRH services and how they pay for that care: The share of women receiving contraceptive services who go to private providers rose from 69% to 77% between 2006–2010 and 2015–2019, in part because more women gained private or public health insurance coverage and there was a greater likelihood that their health insurance would cover SRH services. There was a complementary drop in the share of women receiving contraceptive services who went to a publicly funded clinic, from 27% in 2006–2010 to 18% in 2015–2019. For non-Hispanic Black women, immigrant women and uninsured women, there was no increase in the use of private providers for contraceptive care from 2006–2010 to 2015–2019. Among women served at publicly funded clinics between 2006–2010 and 2015–2019, there were significant increases in the use of both public and private insurance to pay for their care.


2019 ◽  
Vol 1 (1) ◽  
pp. 15-20
Author(s):  
Umme Kulsoom Khattak ◽  
Saima Perwaiz Iqbal ◽  
Ahmed Abdullah ◽  
Ayesha Chowhan

Objective: To determine the prevalence of utilization of family planning methods among married women of reproductive age in a semi urban community of Islamabad. Methodology: A cross-sectional survey was done using two stage sampling, including cluster and consecutive sampling techniques. A proportionate sample from each mohallas of Nurpur Shahan was taken to achieve our sample size. All married women of the reproductive age group (15-45 years) living with their husbands, not diagnosed as a case of infertility and permanent residents of Nurpur Shahan were included. Results: Total of 550 women were included in the study with mean age of 31.64 years. Majority of women 497 (94.7%) were currently married while 322 (59.9 %) were literate. Of all the women, 72 (13.2%) women were currently pregnant and only 62 (11.3%) had a planned pregnancy. Induced abortion was practiced once by 9 (1.8%) women and 21 (4.1%) had done it twice. 394 (72.8%) had knowledge of family planning methods and only 102 (19.5%) women were using family Planning methods currently. Conclusion: Miscellaneous challenges are involved to increase involvement of the women and their families in the use of family planning services. Health education campaigns at community level to increase awareness regarding different family planning methods are highly needed. Government needs to improve the LHWs services to increase the use of family planning methods and combat induced abortions as a method of contraception. Controlling population through sterilization after attaining a large family size should not be the preferred method of family Planning.


PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0242046
Author(s):  
Jacques B. O. Emina ◽  
Parfait Gahungu ◽  
Francis Iyese ◽  
Rinelle Etinkum ◽  
Brigitte Kini ◽  
...  

Introduction Delivering integrated sexual and reproductive health services (SRHS) in emergencies is important in order to save lives of the most vulnerable as well as to combat poverty, reduce inequities and social injustice. More than 60% of preventable maternal deaths occur in conflict areas and especially among the internally displaced persons (IDP). Between 2016 and 2018, unprecedented violence erupted in the Kasaï’s region, in the Democratic Republic of Congo (DRC), called the Kamuina Nsapu Insurgency. During that period, an estimated three million of adolescent girls and women were forced to flee; and have faced growing threat to their health, safety, security, and well-being including significant sexual and reproductive health challenges. Between August 2016 and May 2017, the “Sous-Cluster sur les violences basées sur le genre (SC-VBG)” in DRC (2017) reported 1,429 Gender Based Violence (GBV) incidents in the 49 service delivery points in the provinces of Kasaï, Kasaï Central and Kasaï Oriental. Rape cases represented 79% of reported incidents whereas sexual assault and forced marriage accounted for respectively 11% and 4% of Gender Based Violence (GBV) among women and adolescent girls. This study aims to assess the availability of SRHS in the displaced camps in Kasaï; to evaluate the SRHS needs of young girls and women in the reproductive age (12–49). Studies of sexual and reproductive health (SRH) in the Democratic Republic of Congo (DRC) have often included adolescent girls under the age of 15 because of high prevalence of child marriage and early onset of childbearing, especially in the humanitarian context. According to the 2013 Demographic and Health Survey (DHS), about 16% of surveyed women got married by age 14 while the prevalence of early child marriage (marriage by 15) was estimated at 30%; to assess the use of SRHS services and identify barriers as well as challenges for SRH service delivery and use. Findings from this study will help provide evidence to inform towards more needs-based and responsive SRH service delivery. This is hoped for ultimately improve the quality and effectiveness of services, when considering service delivery and response in humanitarian settings. Data and methods We will conduct a mixed-methods study design, which will combine quantitative and qualitative approaches. Based on the estimation of the sample size, quantitative data will be drawn from the community-based survey (500 women of reproductive age per site) and health facility assessments will include assessments of 45 health facilities and 135 health providers’ interviews. Qualitative data will comprise materials from 30 Key Informant Interviews (KII) and 24 Focus Group Discussions (FGDs), which are believed to achieve the needed saturation levels. Data analysis will include thematic and content analysis for the KIIs and FGDs using ATLAS.ti software for the qualitative arm. For the quantitative arm, data analysis will combine frequency and bivariate chi-square analysis, coupled with multi-level regression models, using Stata 15 software. Statistic differences will be established at the significance level of 0.05. We submitted this protocol to the national ethical committee of the ministry of health in September 2019 and it was approved in January 2020. It needs further approval from the Scientific Oversee Committee (SOC) and the Provincial Ministry of Health. Prior to data collection, informed consents will be obtained from all respondents.


2010 ◽  
Vol 42 (4) ◽  
pp. 549-562 ◽  
Author(s):  
MELLISSA WITHERS ◽  
MEGUMI KANO ◽  
GDE NGURAH INDRAGUNA PINATIH

SummaryExploring fertility preferences in relation to contraceptive use can increase the understanding of future reproductive behaviour and unmet family planning needs. This knowledge can help assist women in meeting their reproductive goals. The influences on the desire for more children and current contraceptive use were examined among 1528 married women of reproductive age in an isolated community in Bali, Indonesia, using multivariate logistic regression analysis. Women who were younger, had fewer living children, had given birth in the past year and had regular access to health services were more likely to desire children. Being older, having fewer living children, not having regular access to health services, having given birth in the past year and having the desire for more children were associated with a lower likelihood of using contraception. Women with regular access to health care are more likely to desire more children, probably because they are confident in their ability to have successful birth outcomes. However, specialized clinics or family planning outreach workers may be required to reduce barriers to service utilization among some groups. The findings of this study identify key target populations for family planning, including older women and postpartum women – groups that may not perceive themselves to be at risk for unintended pregnancy. Meeting unmet need for family planning among these groups could help women meet their fertility goals, as well as reduce maternal morbidity and mortality.


Author(s):  
Aliyu Sokoto Sabo ◽  
Lawali Yakubu ◽  
Aliyu Alkammawa Luba ◽  
Samira L. Ya`u ◽  
A. T. Bakare ◽  
...  

Background: A contraceptive choice that couples make is a key component of the Sustainable Development Goal agenda and a major contributor to national health. In spite of the importance of increased contraceptive uptake among couples of reproductive ages, meeting the reproductive health rights of women remains an issue due to multi-faceted obstacles within complex environments. The issues which impact women’s reproductive health rights in relation to contraception relate to availability, accessibility, affordability, literacy, tradition, and culture. This study explores the influence of socio-demographic data on the choice of contraceptives among women who are accessing family planning services at a Specialist hospital, Sokoto-Nigeria.Methods: A cross sectional study was used in this quantitative research to generate data on contraceptive choices of women within the reproductive age (18-49 years) who are accessing family planning services at Specialist hospital, Sokoto. A structured questionnaire was used to elicit information from 352 respondents who were randomly sampled at a Specialist hospital, Sokoto-Nigeria. Data was analyzed using SPSS version 20.0. Descriptive statistics, correlation and regression analyses were used in the data analyses.Results: The findings of this study established age, occupation and level of education to be related with the usage and choice of contraceptives among women attending family planning unit at a Specialist hospital in Sokoto.Conclusions: The result of the study indicated that the socio–demographic data of the respondent, has a significant role in the choice of contraceptives among the women attending family planning unit of Specialist Hospital Sokoto.


2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Violeta Alarcão ◽  
Miodraga Stefanovska-Petkovska ◽  
Ana Virgolino ◽  
Osvaldo Santos ◽  
Sofia Ribeiro ◽  
...  

Abstract Background The existing knowledge on the interplay between reproductive and sexual health, migration and acculturation is recent and inconsistent, particularly on the sociocultural motives and constraints regarding fertility. Therefore, sexual and reproductive health (SRH) surveys are needed to provide accurate and comparable indicators to identify and address SRH inequalities, with specific focus on under researched aspects, such as the interrelation between migration and gender. FEMINA (FErtility, MIgratioN and Acculturation) aims to investigate intersectional SRH inequalities among Cape Verdean immigrant and Portuguese native families and how they impact on fertility in Portugal. This study will use a comprehensive approach exploring simultaneously the components of SRH, namely regarding identities, perceptions and practices of both women and men among lay people and relevant experts and stakeholders. The project has three main goals: 1) to identify social determinants of SRH among Cape Verdean immigrant and Portuguese native men and women of reproductive age; 2) to gain understanding of the diversity of the sexual and reproductive experiences and expectations of Cape Verdean immigrant and Portuguese native men and women of reproductive age, considering the singularities of their migratory, social and family dynamics; and 3) to produce recommendations for policy makers, employers and service providers on how to better address the SRH needs of Portuguese-born and immigrant populations. Methods The study will address these goals using a mixed methods approach, including: a cross-sectional telephone survey with a probabilistic sample of 600 Cape Verdean immigrant and 600 Portuguese native women and men (women aged 18 to 49 and men aged 18 to 54), residents of the Greater Lisbon Area; a qualitative research through in-depth interviews with a subsample of 30 Cape Verdean immigrants and 30 Portuguese native men and women; and a Delphi technique for finding consensus on good practices in SRH for the entire population with a special emphasis on immigrants, namely extra-EU migrants. Discussion Data will be used to produce a comprehensive set of indicators to monitor SRH in Portugal, to foster a greater understanding of its specificities and challenges to policy and decision makers, and to provide targeted recommendations to promote inclusive and migrant sensitive SRH services.


Sign in / Sign up

Export Citation Format

Share Document