scholarly journals Addressing socio-cultural barriers to family planning and co-designing services to improve utilization: evidence from northern Nigeria

2019 ◽  
Author(s):  
Olugbenga Oguntunde ◽  
Jabulani Nyenwa ◽  
Sikiratu Kilani-Ahmadu ◽  
Abdulsamad Salihu ◽  
Issa Yusuf

Abstract BACKGROUND: Family planning is a proven cost-effective intervention that has contributed to women empowerment and overall human development. Demand factors and women’s expectations and experiences at health facility for family planning services may influence their uptake and utilisation of these services. Increased awareness and positive community perception and quality of family planning services that meet clients’ expectations may greatly improve utilization. The aim of this study was to identify ways to improve family planning service users' experience at primary health care centres towards improving utilization of family planning services in two northern Nigerian states. METHODS: This qualitative study was part of a larger operations research that explored married women’s and service providers’ perception of quality of care along the RMNCH pathway to inform improvements in service delivery. The study utilised Experience-based co-design (EBCD) methodology that employed qualitative methods to explore clients and service providers’ experiences of healthcare services. A total of 92 IDIs and 4 FGDswere conducted in two communities each in Kano and in Yobe states. ‘Touch points’ from service providers’ and respondents’ experiences were extracted using thematic analysis. Joint workshops were further conducted with clients and providers to co-design a user-driven service pathway to improve service utilization. RESULTS: Key 'touch points' from providers’ experiences included stock out of family planning commodities, inadequate equipment and infrastructure and cultural and religious believes that prevent utilization of family planning services. In addition, clients reported challenges securing husband permission to utilize services, poor provider attitude and lack of female providers at health facility as obstacles to service utilization. Co-designing a service improvement plan by service providers and clients that involved increasing community awareness about the benefits of family planning by service providers, improving providers’ attitude, increasing family planning outreach and promoting men involvement in family planning programmes. CONCLUSION: EBCD provides a platform that make clients active contributors to family planning service improvement plans at the health facility thereby ensuring provision of quality services that meet the need of women.

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Lemessa Assefa ◽  
Zemenu Shasho ◽  
Habtamu Kebebe Kasaye ◽  
Edao Tesa ◽  
Ebisa Turi ◽  
...  

Abstract Background Men involvement is one of the important factors in family planning (FP) service utilization. Their limitation in the family planning program causes a decrease in service utilization as well as the discontinuation of the method which eventually leads to failure of the program. Family planning uptake is low but there is no enough study conducted on the parameters of husband involvement in Ethiopia. Hence, this study focused to assess men’s involvement in family planning service utilization in Kondala district, western Ethiopia. Methods Community based comparative cross-sectional study design was employed in urban and rural kebeles of kondala district using quantitative and qualitative data collection tools. The multi-stage sampling method was employed to select 370 participants from each of the four urban and eight rural kebeles. Logistic regression analysis was used to identify variables that affect husbands’ involvement in FP service utilization. Statistical significance was declared at p-value of < 0.05 with 95% confidence interval (CI) and strength of association was reported by odds ratio (OR). Results The study showed that 203(55.6%) men from urban and 178(48.8%) from rural were involved in FP service utilization. The median age of the respondents was 36+ 8.5 years (IQR: 27.5–44.5) in urban and 35 years (IQR: 25–45) in rural parts. Respondents who had four and above current children (AOR = 3.25, 95%CI = 1.51–7.02) in urban and (AOR = 4.20, 95%CI = 1.80–9.79) in rural were positively associated with men’s involvement in FP service utilization. In the urban setting, being government employee (AOR = 2.58, 95%CI = 1.25–5.33), wishing less than two children (AOR = 3.08, 95%CI = 1.80–5.24) and having a better attitude towards FP methods (AOR = 1.86, 95%CI = 1.16–2.99) were positively associated with FP service utilization. While good educational background (AOR = 2.13, 95%CI = 1.02–4.44), short distance from home to health facility (AOR = 2.29, 95%CI = 1.24–4.19) and having better knowledge (AOR = 4.49, 95%CI = 2.72–7.38) were positively associated with men involvement in FP service utilization in the rural area. Conclusion Low involvement of men in family planning service utilization was reported in both settings. Factors associated with husbands’ involvement were varied between the two setups, except for the current number of children. Future FP program should incorporate infrastructure associated with the health facility, knowledge, and attitudinal factors.


1993 ◽  
Vol 14 (1) ◽  
pp. 21-52 ◽  
Author(s):  
George P. Cernada ◽  
A. K. Ubaidur Rob ◽  
Sara I. Ameen ◽  
Muhammad Shafiq Ahmad

A nationally representative sample of 8 percent of the Government of Pakistan's primary family planning service facilities, the Family Welfare Centres (FWC), was carried out at the request of the Ministry of Population Welfare in mid-1992. The “situation analysis” approach used involved: 1) observation and inventory of services, facilities, supplies and record keeping reviews; 2) observation of interaction between service providers and FP clients at FWC's; 3) interviews with service providers; and 4) exit interviews with FP clients after service provision. This one-day on-site observation by teams of three interviewers provided a unique overview and baseline assessment of the availability of services, the staff functioning and the quality of service. Significant findings include a low caseload, inadequacies of facilities, some stockouts, lack of educational materials, insufficient outreach, unnecessary medical and social barriers to providing contraception as well as in some cases insufficient information to clients about contraindications to contraceptive usage and possible side-effects. The need to bolster in-service training and supervision is emphasized.


PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255080
Author(s):  
Relmah Baritama Harrington ◽  
Nichole Harvey ◽  
Sarah Larkins ◽  
Michelle Redman-MacLaren

The use of contraceptives for family planning improves women’s lives and may prevent maternal deaths. However, many women in low and middle-income countries, including the Pacific region, still die from pregnancy-related complications. While most health centres offer family planning services with some basic contraceptive methods, many people do not access these services. More than 60% of women who would like to avoid or delay their pregnancies are unable to do so. This scoping review identifies and analyses evidence about family planning service provision in Pacific Island Countries and Territories (PICTs), with the aim of better informing family planning services for improved maternal health outcomes in the Pacific. We used Arksey and O’Malley’s scoping review guidelines, supported by Levac, Colquhoun and O’Brien to identify gaps in family planning service provision. Selected studies included peer-reviewed publications and grey literature that provided information about family planning services from 1994 to 2019. Publication data was charted in MS Excel. Data were thematically analysed and key issues and themes identified. A total of 45 papers (15 peer-reviewed and 30 grey literature publications) were critically reviewed. Five themes were identified: i) family planning services in the Pacific; ii) education, knowledge and attitudes; iii) geographical isolation and access; iv) socio-cultural beliefs, practices and influences; and v) potential enabling factors for improved family planning, such as appropriate family planning awareness by health care providers and services tailored to meet individual needs. While culture and religion were considered as the main barriers to accessing family planning services, evidence showed health services were also responsible for limiting access. Family planning services do not reach everyone. Making relevant and sustainable improvements in service delivery requires generation of local evidence. Further research is needed to understand availability, accessibility and acceptability of current family planning services for different age groups, genders, social and marital status to better inform family planning services in the Pacific.


SISFORMA ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. 8
Author(s):  
Penidas Fiodinggo Tanaem ◽  
Agustinus Fritz Wijaya ◽  
Fransiska Wahyuning Kurniawati ◽  
Resa Saputri

The writing of this Journal aims to explain the design of the KB service information system that is available at the Pratama Clinic Salatiga. As for the background of making this journal because Indonesia is one of the countries that has the largest population in the world and this happens because the number of births in Indonesia that cannot be controlled. Although the government has launched a KB that is applied by using contraceptives, it has not been able to overcome the problems that occur. The number of uncontrolled births is due to the large number of families who complain about the use of contraceptives. Expensive, difficult to obtain and uncomfortable when used is an excuse for those who do not want to use contraception so that the number of births cannot be controlled, besides that along with the development of existing KB services it is increasingly ignored because people prefer things that are practical and do not like to follow complicated programs or services such as family planning services so that it causes more and more people who are lazy to attend family planning and have an impact on increasing numbers birth. Seeing from the phenomena above, the thought is formed that service information systems are really needed in the current era of development, especially to facilitate all the work that cannot be done in a short time. So from this the special information system design was made in the field of family planning services in the Pratama Clinic in the form of a journal. In this journal, it explains about how a family planning service can be accessed easily without wasting too much time so that the public wants to participate in the family planning service. One way that can be done is to establish an information system that can be used for family planning services with a system that is easily understood and accessed by the general public.


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