scholarly journals Service delivery point and individual characteristics associated with the adoption of modern contraceptive: A multi-country longitudinal analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0254775
Author(s):  
Philip Anglewicz ◽  
Carolina Cardona ◽  
Titilope Akinlose ◽  
Peter Gichangi ◽  
Funmilola OlaOlorun ◽  
...  
Keyword(s):  
Family Planning ◽  
Service Delivery ◽  
Health Facility ◽  
Performance Monitoring ◽  
Democratic Republic Of Congo ◽  
Individual Characteristics ◽  
Modern Contraceptive ◽  
Modern Contraception ◽  
The Future

Background Women who start using contraception (“adopters”) are a key population for family planning goals, but little is known about characteristics that predict the adoption of contraception as opposed to current use. We used prospective data from women and facilities for five countries, (Democratic Republic of Congo, India, Kenya, Nigeria, and Burkina Faso) and identified baseline characteristics that predicted adoption of modern contraception in the short term. Methods We used data from the Performance Monitoring for Action (PMA) Agile Project. PMA Agile administered service delivery point (SDP) client exit interview (CEI) surveys in urban sites of these five countries. Female clients responding to the CEI were asked for phone numbers that were used for a phone follow-up survey approximately four months later. For our analysis, we used data from the SDP and CEI baseline surveys, and the phone follow up to compare women who start using contraception during this period with those who remain non-users. We used characteristics of the facility and the woman at baseline to predict her contraception adoption in the future. Results Discussing FP with a partner at baseline was associated with greater odds of adoption in DRC (OR 2.34; 95% CI 0.97–5.66), India (OR 2.27; 95% CI 1.05–4.93), and Kenya (OR 1.65; 95% CI 1.16–2.35). Women who discussed family planning with any staff member at the health facility had 1.72 greater odds (95% CI 1.13–2.67) of becoming an adopter in Nigeria. The odds of adoption were lower in Nigerian facilities that had a stockout (OR 0.66 95% CI 0.44–1.00) at baseline. Other characteristics associated with contraception adoption across settings were education, age, wealth, parity, and marital status. Conclusions Characteristics of both the woman and the health facility were associated with adoption of modern contraception in the future. Some characteristics, like discussing family planning with a spouse, education, and parity, were associated with contraceptive adoption across settings. Other characteristics that predict contraceptive use, such as health facility measures, varied across countries.

scholarly journals A qualitative exploration of contraceptive use and discontinuation among women with an unmet need for modern contraception in Kenya

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Susan Ontiri ◽  
Lilian Mutea ◽  
Violet Naanyu ◽  
Mark Kabue ◽  
Regien Biesma ◽  
...  
Keyword(s):  
Family Planning ◽  
Side Effects ◽  
Peer Influence ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Modern Contraceptive ◽  
Modern Contraception ◽  
Modern Contraceptives ◽  
Family Planning Programs ◽  
Contraceptive Discontinuation

Abstract Background Addressing the unmet need for modern contraception underpins the goal of all family planning and contraception programs. Contraceptive discontinuation among those in need of a method hinders the attainment of the fertility desires of women, which may result in unintended pregnancies. This paper presents experiences of contraceptive use, reasons for discontinuation, and future intentions to use modern contraceptives. Methods Qualitative data were collected in two rural counties in Kenya in 2019 from women with unmet need for contraception who were former modern contraceptive users. Additional data was collected from male partners of some of the women interviewed. In-depth interviews and focus group discussions explored previous experience with contraceptive use, reasons for discontinuation, and future intentionality to use. Following data collection, digitally recorded data were transcribed verbatim, translated, and coded using thematic analysis through an inductive approach. Results Use of modern contraception to prevent pregnancy and plan for family size was a strong motivator for uptake of contraceptives. The contraceptive methods used were mainly sourced from public health facilities though adolescents got them from the private sector. Reasons for discontinued use included side effects, method failure, peer influence, gender-based violence due to covert use of contraceptives, and failure within the health system. Five reasons were provided for those not willing to use in the future: fear of side effects, cost of contraceptive services, family conflicts over the use of modern contraceptives, reduced need, and a shift to traditional methods. Conclusion This study expands the literature by examining reasons for contraceptive discontinuation and future intentionality to use among women in need of contraception. The results underscore the need for family planning interventions that incorporate quality of care in service provision to address contraceptive discontinuation. Engaging men and other social influencers in family planning programs and services will help garner support for contraception, rather than focusing exclusively on women. The results of this study can inform implementation of family planning programs in Kenya and beyond to ensure they address the concerns of former modern contraception users.

scholarly journals Performance monitoring and accountability: The Agile Project’s protocol, record and experience

2020 ◽  
Vol 4 ◽  
pp. 30
Author(s):  
Amy Tsui ◽  
Philip Anglewicz ◽  
Titilope Akinlose ◽  
Varsha Srivatsan ◽  
Pierre Akilimali ◽  
...  
Keyword(s):  
Performance Monitoring ◽  
Democratic Republic Of Congo ◽  
Total Sample ◽  
Health Facilities ◽  
Childbearing Age ◽  
Public And Private ◽  
Male Clients ◽  
Early Experiences ◽  
Female Clients

The Performance Monitoring and Accountability 2020 (PMA2020) project implemented a multi-country sub-project called PMA Agile, a system of continuous data collection for a probability sample of urban public and private health facilities and their clients that began November 2017 and concluded December 2019.  The objective was to monitor the supply, quality and consumption of family planning services.  In total, across 14 urban settings, nearly 2300 health facilities were surveyed three to six times in two years and a total sample of 48,610 female and male clients of childbearing age were interviewed in Burkina Faso, Democratic Republic of Congo, India, Kenya, Niger and Nigeria.  Consenting female clients with access to a cellphone were re-interviewed by telephone after four months; two rounds of the client exit, and follow-up interviews were conducted in nearly all settings.  This paper reports on the PMA Agile data system protocols, coverage and early experiences.  An online dashboard is publicly accessible, analyses of measured trends are underway, and the data are publicly available.

scholarly journals Contraceptive prevalence and factors influencing utilization among women in Pakistan: a focus on gender-based violence

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Thao Thi Nguyen ◽  
Sarah Neal
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Modern Contraceptive ◽  
Gender Based Violence ◽  
Contraceptive Methods ◽  
Content Type ◽  
Modern Contraception ◽  
Factors Influencing ◽  
Contraceptive Prevalence ◽  
Gender Based

PurposeIn this study, the authors determined the prevalence of contraceptive use among Pakistani women and assessed factors influencing the utilization of contraception with a particular focus on the experience of gender-based violence.Design/methodology/approachThe dataset used in this study was the Pakistan Demographic Health Survey 2018, which includes married women only. Bivariate analysis and multivariate logistic regression were used to investigate the association between contraceptive use and a number of explanatory variables including experience of gender-based violence.FindingsFrom 2006 to 2018, the contraceptive prevalence rate (CPR) and the use of modern contraceptive methods increased slowly. The findings of this study demonstrated that higher educational level and wealth index increased the likelihood of contraceptive uptake and the use of modern contraception. Media exposure to family planning and spousal communication were protective factors that encouraged women to use contraception, including modern contraception, to avoid unwanted pregnancy. Women who experienced gender-based violence (GBV) were more likely to use contraception than women who did not experience GBV.Research limitations/implicationsThe use of secondary data limited the variety of important variable that should be investigated including knowledge of women on SRH, the attitude of women toward SRH and family planning, the skills of a healthcare provider on counseling family planning, and other barrier variables such as transportation and willingness to pay for contraceptive methods. 10;The sensitivity of the topic is considered as another challenge when collecting data. Women might be hesitant to share about their GBV experience. The experience to GBV is also hard to define and depends on the feeling of each person, especially emotional violence.Originality/valueThis paper is one of the very few studies to examine the association between GBV and contraceptive use, and thus is valuable in opening up debate about the links between these two factors.

scholarly journals The abortion culture issue in Serbia

Stanovnistvo ◽  
2011 ◽  
Vol 49 (1) ◽  
pp. 1-13
Author(s):  
Mirjana Rasevic ◽  
Katarina Sedlecki
Keyword(s):  
Family Planning ◽  
Sex Education ◽  
Birth Control ◽  
Modern Science ◽  
Modern Concept ◽  
Social Aspect ◽  
Modern Contraceptive ◽  
Individual Level ◽  
Modern Contraception ◽  
The Individual

The problem of a large number of abortions in our country was first pointed out as far back as 1935 at the 17th Congress of Yugoslav Physicians. The abortion problem in Serbia is still present today, even though modern science has provided new methods and means which are a logical solution to the dilemma on birth control methods from the health and social aspect. Namely, total abortion rate in Serbia was estimated at 2.76 in the year 2007. It is very high; double the number of the total fertility rate and among the highest in Europe and the world. The term abortion culture was first used, as far as we know, by Henry David in the introduction of the book From Abortion to Contraception - A Resource to Public Policies and Reproductive Behavior in Central and Eastern Europe from 1917 to the Present in 1999, without specifically determining it. The aim of this paper is to identify the most important factors of the deterministic basis of endemic induced abortions in Serbia together with indirectly estimating their connection with the existence, namely nonexistence, of the abortion culture in our country. In that sense, potential factors of abortion incidence in Serbia which emerge from the social system and those connected to the individual level have been considered. In other words, a series of laws and other legal and political documents have been analyzed which are significant for perceiving the abortion matter, as well as institutional frameworks for family planning, health services, educating the youth regarding reproductive health, including findings of numerous researches carried out among women of various age and doctors from 1990 till present day in Serbia. The following most significant factors for the long duration of the abortion problem have been singled out: insufficient knowledge of modern contraception, a belief that modern contraceptive methods are harmful to health and a number of psychological barriers as well as those arising from relationships with partners. Gynecological attitudes about modern contraception and behavior do not differ significantly from the rest of the population. Additionally, there are few organized efforts to promote sex education, as well as limitations in the family planning programme. Distinguished macro and micro factors of traditional birth control in Serbia confirm the existence of the abortion culture. The nature of these factors though, indicate to the presence of the abortion culture in our country on the political, educational, health and individual level. The abortion culture obstructs the adoption of a modern concept of family planning and points out to the persistence of the abortion problem in our country in the years to come.

scholarly journals Analysing the factors favoring the use of modern contraceptive methods among Kinoise women in the Democratic Republic of Congo

2020 ◽  
Vol 9 (4) ◽  
pp. 304-313
Author(s):  
Lukau Matezo Espoir ◽  
Malimingi Muhole Amantha
Keyword(s):  
Family Planning ◽  
Urban Areas ◽  
Democratic Republic Of Congo ◽  
Family Health ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
Attitudes And Practices ◽  
Provincial City ◽  
Level Of Knowledge ◽  
The City

This study aims to identify the factors that favor the use of modern contraceptive methods in non-pregnant women who need to space or limit births. The analyzes were made using SPSS software (statistical package for social sciences) version 25. The data used in this publication comes from a TRAC survey on family planning carried out by the Family Health Association / Population Service international (ASF / PSI) in DRC. Continuously Tracking Results surveys are knowledge surveys, attitudes, and practices of women in matters of family planning but with the introduction of questions on scales as mentioned above. This survey concerned 1965 women aged 15 to 49 selected in urban and peri-urban areas of the provincial city of Kinshasa. Our results show that the discussion between partner or spouse on the use of modern contraceptive methods positively influences the majority of women (OR = 4.28; p <0.001),being part of a social norm (OR = 3.30; p <0.01) and having a high socioeconomic level (OR = 2.54; p <0.01), also favor positively the use of modern contraceptives. The paper concludes that any effort to increase contraceptive prevalence should target attitude, level of knowledge of methods, and spousal support to optimize the use of modern contraception in the city of Kinshasa.

scholarly journals Performance monitoring and accountability: The Agile Project’s protocol, record and experience

2020 ◽  
Vol 4 ◽  
pp. 30
Author(s):  
Amy Tsui ◽  
Philip Anglewicz ◽  
Titilope Akinlose ◽  
Varsha Srivatsan ◽  
Pierre Akilimali ◽  
...  
Keyword(s):  
Performance Monitoring ◽  
Democratic Republic Of Congo ◽  
Total Sample ◽  
Health Facilities ◽  
Childbearing Age ◽  
Public And Private ◽  
Male Clients ◽  
Early Experiences ◽  
Female Clients

The Performance Monitoring and Accountability 2020 (PMA2020) project implemented a multi-country sub-project called PMA Agile, a system of continuous data collection for a probability sample of urban public and private health facilities and their clients that began November 2017 and concluded December 2019.  The objective was to monitor the supply, quality and consumption of family planning services.  In total, across 14 urban settings, nearly 2300 health facilities were surveyed three to six times in two years and a total sample of 48,610 female and male clients of childbearing age were interviewed in Burkina Faso, Democratic Republic of Congo, India, Kenya, Niger and Nigeria.  Consenting female clients with access to a cellphone were re-interviewed by telephone after four months; two rounds of the client exit, and follow-up interviews were conducted in nearly all settings.  This paper reports on the PMA Agile data system protocols, coverage and early experiences.  An online dashboard is publicly accessible, analyses of measured trends are underway, and the data are publicly available.

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 ◽  
...  
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Service Delivery ◽  
Health Facility ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
The Past ◽  
Arusha Region ◽  
To Receive ◽  
Missed Opportunity

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.

scholarly journals Family Planning Knowledge, Attitudes, and Practices among Married Men and Women in Rural Areas of Pakistan: Findings from a Qualitative Need Assessment Study

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Ghulam Mustafa ◽  
Syed Khurram Azmat ◽  
Waqas Hameed ◽  
Safdar Ali ◽  
Muhammad Ishaque ◽  
...  
Keyword(s):  
Family Planning ◽  
Rural Areas ◽  
Healthcare Providers ◽  
Health Facilities ◽  
Qualitative Assessment ◽  
Modern Contraceptive ◽  
Modern Contraception ◽  
Attitudes And Practices ◽  
The Government ◽  
Knowledge Attitudes And Practices

This paper presents the findings of a qualitative assessment aimed at exploring knowledge, attitudes, and practices regarding family planning and factors that influence the need for and use of modern contraceptives. A descriptive exploratory study was conducted with married women and men aged between 15 and 40. Overall, 24 focus group discussions were conducted with male and female participants in three provinces of Pakistan. The findings reveal that the majority knew about some modern contraceptive methods, but the overall contraceptive use was very low. Knowledge and use of any contraceptive method were particularly low. Reasons for not using family planning and modern contraception included incomplete family size, negative perceptions, in-laws’ disapproval, religious concerns, side-effects, and lack of access to quality services. The majority preferred private facilities over the government health facilities as the later were cited as derided. The study concluded the need for qualified female healthcare providers, especially for long term family planning services at health facilities instead of camps arranged occasionally. Addressing issues around access, affordability, availability, and sociocultural barriers about modern contraception as well as involving men will help to meet the needs and ensure that the women and couples fulfill their childbearing and reproductive health goals.

scholarly journals Impact of home-based family planning counselling and referral on modern contraceptive use in Karachi, Pakistan: a retrospective, cross-sectional matched control study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e039835
Author(s):  
Kristy Hackett ◽  
Elizabeth Henry ◽  
Imtiaz Hussain ◽  
Mirbaz Khan ◽  
Khalid Feroz ◽  
...  
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Community Level ◽  
Secondary Outcome ◽  
Modern Contraceptive ◽  
Cross Sectional ◽  
Percentage Point Increase ◽  
Point Increase ◽  
The Cost

ObjectivesTo assess: (1) the impact of a reproductive health program on modern contraceptive use from baseline to program close; (2) the sustained impact from baseline to follow-up 36 months later; and (3) the exposure-adjusted impact at program close and follow-up.DesignRetrospective, cross-sectional matched control study.SettingKarachi, Pakistan.Participants2561 married women aged 16–49 years.InterventionsThe Willows Program, a community-based family planning counselling and referral program implemented from 2013 to 2015.Primary and secondary outcome measuresThe primary outcome was community-level modern contraceptive prevalence rate (mCPR), measured for January 2013 (baseline), June 2015 (program close) and at follow-up 36 months later. A secondary outcome was exposure-adjusted mCPR (among women reporting a family planning home visit) at program close and at follow-up.ResultsThere was no significant effect on community-level mCPR at program close (2.4 percentage point increase in intervention over comparison; 95% CI −2.2 to 7.0) or at follow-up (1.9 percentage point decrease; 95% CI −6.7 to 2.8). Only 18% of women in the intervention area reported receiving a family planning visit in the preceding 5 years. Among those reporting a visit, we observed a significant 10.3 percentage point increase (95% CI 4.6 to 15.9) from baseline to close, and a non-significant 2.0 percentage point increase (95% CI −3.8 to 7.8) from baseline to follow-up, relative to matched women in the comparison area. The cost per new modern method user was US$1089, while the cost per user-year during the intervention period was US$455.ConclusionsThe program had a positive short-term effect on women who received a family planning visit; however, this effect was not sustained. Program coverage was low and did not significantly increase community-level family planning use. Findings highlight the need to increase community coverage of high-quality counselling and contextually relevant interventions for family planning demand generation.

scholarly journals The aggregate effect of implementation strength of family planning programs on modern contraceptive use at the health systems level in rural Malawi

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0232504
Author(s):  
Anooj Pattnaik ◽  
Diwakar Mohan ◽  
Amy Tsui ◽  
Sam Chipokosa ◽  
Hans Katengeza ◽  
...  
Keyword(s):  
Family Planning ◽  
Health Facility ◽  
Catchment Area ◽  
Contraceptive Use ◽  
Modern Contraceptive ◽  
Summary Measure ◽  
Modern Contraceptives ◽  
Family Planning Programs ◽  
Modern Contraceptive Use ◽  
Combined Impact

To explore the association between the strength of implementation of family planning (FP) programs on the use of modern contraceptives. Specifically, how strongly these programs are being implemented across a health facility’s catchment area in Malawi and the odds of a woman in that catchment area is using modern contraceptives. This information can be used to assess whether the combined impact of multiple large-scale FP programs is leading to change in the health outcomes they aim to improve. We used data from the 2017 Implementation Strength Assessment (ISA) that quantified how much of family planning programs at the health facility and community health worker levels were being implemented across every district of Malawi. We used a summary measure developed in a previous study that employs quantitative methods to combine data across FP domains and health system levels. We tested the association of this summary measure for implementation strength with household data from the 2015 Malawi Demographic Health Survey (DHS). We found that areas with stronger implementation of FP programs had higher odds of women using modern contraceptives compared with areas with weaker implementation. The association of ISA with use of modern contraception was different by education, marital status, and geography. After controlling for these factors, we found that the adjusted odds of using a modern contraceptive was three times higher in catchment areas with high implementation strength compared to those with lower strength. Metrics that summarize how strongly FP programs are being implemented were used to show a statistically significantly positive relationship between increasing implementation strength and higher rates of modern contraceptive use. Decisionmakers at the various levels of health authority can use this type of summary measure to better understand the combined impact of their diverse FP programming and inform future programmatic and policy decisions. The findings also reinforce the idea that having a well-supported and supplied cadre of community health workers supplementing FP provision at the health facility can be an important health systems mechanism, especially in rural settings and to target youth populations.

Sign in / Sign up

Export Citation Format

Share Document