scholarly journals Side Effect Concerns and their Impact on Women’s Uptake of Modern Family Planning Methods in Rural Ghana: A Mixed Methods Study

2020 ◽  
Author(s):  
Leah A. Schrumpf ◽  
Maya J. Stephens ◽  
Nathaniel E. Nsarko ◽  
Eric Akosah ◽  
Joy Noel Baumgartner ◽  
...  
Keyword(s):  
Family Planning ◽  
Side Effects ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Mixed Methods Study ◽  
Modern Contraceptive ◽  
Modern Family ◽  
Depth Interviews ◽  
Modern Family Planning

Abstract Background: Despite availability of modern contraceptive methods and documented unmet need for family planning in Ghana, many women still report forgoing modern contraceptive use due to anticipated side effects. The goal of this study was to examine the use of modern family planning, in particular hormonal methods, in one district in rural Ghana, and to understand the role that side effects play in women’s decisions to start or continue use. Methods: This exploratory mixed-methods study included 281 surveys and 33 in-depth interviews of women 18-49 years old in the Amansie West District of Ghana between May and July 2018. The survey assessed contraceptive use and potential predictors of use. In-depth interviews examined the context around uptake and continuation of contraceptive use, with a particular focus on the role of perceived and experienced side effects. Results: The prevalence of unmet need for modern family planning among sexually active women who wanted to avoid pregnancy (n=135) was 68.9%. No factors were found to be significantly different in comparing those with a met need and unmet for modern family planning. Qualitative interviews revealed significant concerns about side effects stemming from previous method experiences and/or rumors regarding short-term impacts and perceived long-term consequences of family planning use. Side effects mentioned include menstrual changes (heavier bleeding, amenorrhea or oligomenorrhea), infertility and childbirth complications. Conclusion: As programs have improved women’s ability to access modern family planning, it is paramount to address patient-level barriers to uptake, in particular information about side effects and misconceptions about long-term use. Unintended pregnancies can be reduced through comprehensive counseling about contraceptive options including accurate information about side effects, and the development of new contraceptive technologies that meet women’s needs in low-income countries.

scholarly journals Side Effect Concerns and their Impact on Women’s Uptake of Modern Family Planning Methods in Rural Ghana: A Mixed Methods Study

2019 ◽  
Author(s):  
Leah A. Schrumpf ◽  
Maya J. Stephens ◽  
Nathaniel E. Nsarko ◽  
Eric Akosah ◽  
Joy Noel Baumgartner ◽  
...  
Keyword(s):  
Family Planning ◽  
Side Effects ◽  
Contraceptive Use ◽  
Mixed Methods Study ◽  
Modern Family ◽  
Planning Methods ◽  
Depth Interviews ◽  
Modern Family Planning ◽  
Family Planning Methods

Abstract Background: Despite availability of modern family planning methods and a desire for smaller families, many women decide to forgo modern methods due to anticipated side effects. The goal of this study was to examine the use of modern family planning in one district in rural Ghana, and to understand the role that side effects play in women’s decisions to start or continue use. Methods: This exploratory mixed-methods study included 281 surveys and 33 in-depth interviews of women 18-49 years old from the Amansie West District of Ghana. The survey assessed contraceptive use and potential predictors of use. In-depth interviews examined the context around uptake and continuation of contraceptive use, with a particular focus on the role of perceived and experienced side effects. Results: The prevalence of unmet need for modern family planning among sexually active women who wanted to avoid pregnancy (n=135) was 68.9%. No factors were found to be significantly different in comparing those with a met need and unmet for modern family planning. Qualitative interviews revealed significant concerns about side effects stemming from previous method experiences and/or rumors regarding short-term impacts and perceived long-term consequences of family planning use. Conclusion: As programs have improved women’s ability to access modern family planning, it is paramount to address patient-level barriers to uptake, in particular information about side effects and misconceptions about long-term use. Unintended pregnancies can be reduced through comprehensive counseling about contraceptive options including accurate information about side effects, and the development of new contraceptive technologies that meet women’s needs in low-income countries.

scholarly journals Side Effect Concerns and their Impact on Women’s Uptake of Modern Family Planning Methods in Rural Ghana: A Mixed Methods Study

2019 ◽  
Author(s):  
Leah A. Schrumpf ◽  
Maya J. Stephens ◽  
Nathaniel E. Nsarko ◽  
Eric Akosah ◽  
Joy Noel Baumgartner ◽  
...  
Keyword(s):  
Family Planning ◽  
Side Effects ◽  
Contraceptive Use ◽  
Mixed Methods Study ◽  
Modern Family ◽  
Planning Methods ◽  
Depth Interviews ◽  
Modern Family Planning ◽  
Family Planning Methods

Abstract Background: Despite availability of modern family planning methods and a desire for smaller families, many women decide to forgo modern methods due to anticipated side effects. The goal of this study was to examine the use of modern family planning in one district in rural Ghana, and to understand the role that side effects play in women’s decisions to start or continue use. Methods: This exploratory mixed-methods study included 281 surveys and 33 in-depth interviews of women 18-49 years old from the Amansie West District of Ghana. The survey assessed contraceptive use and potential predictors of use. In-depth interviews examined the context around uptake and continuation of contraceptive use, with a particular focus on the role of perceived and experienced side effects. Results: The prevalence of unmet need for modern family planning among sexually active women who wanted to avoid pregnancy (n=135) was 68.9%. No factors were found to be significantly different in comparing those with a met need and unmet for modern family planning. Qualitative interviews revealed significant concerns about side effects stemming from previous method experiences and/or rumors regarding short-term impacts and perceived long-term consequences of family planning use. Conclusion: As programs have improved women’s ability to access modern family planning, it is paramount to address patient-level barriers to uptake, in particular information about side effects and misconceptions about long-term use. Unintended pregnancies can be reduced through comprehensive counseling about contraceptive options including accurate information about side effects, and the development of new contraceptive technologies that meet women’s needs in low-income 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 Family planning providers and contraceptive users in Rwanda employ strategies to prevent discontinuation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hilary Schwandt ◽  
Angel Boulware ◽  
Julia Corey ◽  
Ana Herrera ◽  
Ethan Hudler ◽  
...  
Keyword(s):  
Family Planning ◽  
Side Effects ◽  
Contraceptive Use ◽  
First Year ◽  
Modern Contraceptive ◽  
Group Discussions ◽  
Program Success ◽  
Family Planning Programs ◽  
Contraceptive Discontinuation

Abstract Background In Rwanda, nearly a third of contraceptive users discontinue within the first year of use. Family planning programs often focus more on recruitment of new users as opposed to maintaining use among current users. A focus on sustaining users and minimizing discontinuation is imperative for long-term family planning program success. This study explores the efforts providers and contraceptive users in Rwanda employ to prevent one of the greatest challenges to family planning programs: contraceptive discontinuation. Methods This was a qualitative study conducted in Rwanda between February and July 2018. It included eight focus group discussions with 88 family planning providers and 32 in-depth interviews with experienced modern contraceptive users. Data were collected in two districts with the highest (Musanze) and lowest (Nyamasheke) rates of contraceptive use. Data were analyzed using thematic content approach. Results Family planning providers in this study used the following strategies to prevent discontinuation: counseling new users on the potential for side effects and switching, reminding clients about appointments for resupply, as well as supporting dissatisfied users by providing counseling, medicine for side effects, and discussing options for switching methods. Users, on the other hand, employed the following strategies to prevent discontinuation: having an understanding that experiences of side effects vary by individuals, supporting peers to sustain use, persisting with use despite experiences of side effects, and switching methods. Conclusions The strategies used by family planning providers and users in Rwanda to prevent discontinuation suggest the possibility of long-term sustained use of contraception in the country. Harnessing and supporting such strategies could contribute to sustaining or improving further contraceptive use in the country.

scholarly journals Quality of Family Planning Care as Enabling Factor for Modern Contraceptive Use in Indonesia: Evidence from PMA2020 Survey

2021 ◽  
Author(s):  
Nurjaeni Nurjaeni ◽  
Yothin Sawangdee ◽  
Umaporn Pattaravanich ◽  
Charamporn Holumyong ◽  
Aphichat Chamratrithirong
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Modern Method ◽  
Modern Contraceptive ◽  
Number Of Children ◽  
Modern Family ◽  
Modern Contraceptive Use ◽  
Ideal Number ◽  
Modern Family Planning

Abstract BackgroundThe utilization of modern family planning methods is a key pointer that mirrors universal access to reproductive health cares. Fulfilling unmet needs for modern contraceptives may decrease the level of maternal mortality by almost a third. This research employed the 2016 PMA2020 survey to assess multilevel variables related to modern family planning method use among women of reproductive age in Indonesia. MethodData from interviews of female and Service Delivery Point (SDP) of the 2016 Performance Monitoring and Accountability 2020 (PMA2020) survey were linked to generate a merged dataset comprising women’s individual, cluster and SDP factors (N=10,210). Multilevel analysis was done to assess the influence of contextual factors including a summary index of SDP quality FP care on woman’s modern family planning practice. Adjusted odds ratios and 95% CIs were analysed and interpreted.ResultsModern contraceptive prevalence among women of childbearing age was 42.3% in 2016. There was a considerable variation in the likelihood of modern method use across the 372 clusters/EAs. Age, education, marital status, parity, residency, region, woman’s FP decision autonomy, cluster’s average ideal number of children, percentage of females dissatisfied with FP, and percent of females visited by CHVs were significant factors for modern FP use after adjusting for multilevel characteristics. Quality of FP care was revealed to be a significant enabling factor for modern contraceptive use in Indonesia. ConclusionsModern contraceptive prevalence among females aged 15-49 years was relatively low in 2016. The findings indicate that an advancement in modern method use can be gained by improving quality of family planning care. Likewise, an enhancement in women’s FP decision autonomy and their level of education, decline in women’s ideal number of children and diminution of the dissatisfaction with family planning are all major concerns to be addressed. Family planning policies must tackle adverse cultural norms and inequities in quality of family planning care and women’s education that would produce welfares to women, children, and communities.

Male Perception and Participation in Family Planning Among Tribal Communities of Maharashtra, India: A Mixed-Method Study

2019 ◽  
Vol 40 (3) ◽  
pp. 163-169
Author(s):  
Suresh Jungari ◽  
Balram Paswan
Keyword(s):  
Family Planning ◽  
Quantitative Methods ◽  
Contraceptive Use ◽  
Male Involvement ◽  
Planning Method ◽  
Family Planning Method ◽  
Modern Contraceptive ◽  
Qualitative And Quantitative Methods ◽  
Modern Family ◽  
Modern Family Planning

This study examined male perceptions and awareness about family planning. The study also investigated male involvement in family planning and contraceptive use decision-making. Furthermore, in this study, we assessed men’s awareness, attitude, and practice of modern contraceptive methods and determined the level of spousal communication. In this study, a field survey was conducted among the tribal population of Maharashtra. Both qualitative and quantitative methods were used for data collection. A sample of 385 men whose wives had given birth in the last 2 years were interviewed. Almost two thirds of the surveyed men (64%) had heard about modern family planning. The main source of information for family planning was the multipurpose worker in the village for 48% of men, followed by friends 16% and the auxiliary nurse midwife and accredited social health activist for 11% and 10%, respectively. Results show that the current use of any modern family planning method, including male and female methods, was 18.4%. Among the currently used modern methods, the major modern family planning method was male sterilization (67%), followed by oral pills (11%) and male condom use (10%). This study indicated that the acceptance of male modern family planning methods is very high.

Method Related Attributes and Contraceptive Discontinuation: Results from A Prospective Study from Nairobi and Homa Bay Counties in Kenya.

2021 ◽  
Author(s):  
Yohannes Dibaba Wado ◽  
Martin K. Mutua ◽  
George Odwe ◽  
Francis Obare ◽  
Kazuyo Machiyama ◽  
...  
Keyword(s):  
Survival Analysis ◽  
Side Effects ◽  
Contraceptive Use ◽  
Longitudinal Design ◽  
Unmet Need ◽  
Health Problems ◽  
Competing Risk ◽  
Modern Contraceptive ◽  
Fertility Preferences ◽  
Contraceptive Discontinuation

Abstract Background: Rates of contraceptive discontinuation are high in many low and middle countries contributing to unmet need for contraception and other adverse reproductive health outcomes. Few studies have investigated how method specific beliefs and strength of fertility preferences affect discontinuation rates. This study examines this question using primary data collected in Nairobi and Homa Bay counties in Kenya.Methods: We used data from two rounds of a longitudinal study of married women ages 15-39 years (2812 and 2424 women from Nairobi and Homa Bay respectively at round 1) from two communities in Kenya. Information on fertility preferences, past and current contraceptive behavior, and method-related beliefs about six modern contraceptive methods were collected, along with a monthly calendar of contraceptive use between the two interviews. The analysis focused on discontinuation of the two most commonly used methods in both sites, injectable and implants. We carry out competing risk survival analysis to identify which method related beliefs predict discontinuation among women using at the first round. Results: The percentages of episodes discontinued in the 12 months between the two rounds was 36%, with a higher rate of discontinuation in Homa Bay (43%) than in the Nairobi slums (32%) and higher for injectables than implants. Method related concerns and beliefs were the major self-reported reasons for discontinuation in both sites. The competing risk survival analysis showed that the probability of method related discontinuation of implants and injectables was significantly lower among respondents who believed that the methods do not cause serious health problems (SHR=0.78, 95% CI 0.62-0.98), do not interfere with regular menses (SHR=0.76, 95% CI 0.61 - 0.95) and do not cause unpleasant side effects (SHR=0.72, 95% CI 0.56-0.89). By contrast, there were no net effects of three method related beliefs that are commonly cited as obstacles to contraceptive use in African societies: safety for long-term use, ability to have children after stopping the method, and the approval of the husband.Conclusion: This study is unique in its examination of the effect of method specific beliefs on subsequent discontinuation for a method-related reason, using a longitudinal design. The single most important result is that concerns about serious health problems, which are largely unjustified and only moderately associated with beliefs about side effects, are a significant influence on discontinuation. The negative results for other beliefs show that the determinants of discontinuation differ from the determinants of method adoption and method choice.

scholarly journals Predictors of modern contraceptive use among women and men in Uganda: a population-level analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034675 ◽  
Author(s):  
Amrita Namasivayam ◽  
Sarah Lovell ◽  
Sarah Namutamba ◽  
Philip J Schluter
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Secondary Data ◽  
Population Level ◽  
Modern Contraceptive ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Logistic Regression Models ◽  
Modern Contraceptive Use

Objective(s)Despite substantial and rapid improvements in contraceptive uptake in Uganda, many women continue to have unmet need for contraception. As factors affecting contraceptive use are dynamic and complex, this study seeks to identify current predictors and provide effect size estimates of contraceptive use among women and men in Uganda.Study designA nationally representative cross-sectional population survey, using secondary data from Uganda’s 2016 Demographic and Health Survey. Stratified by sex, weighted bivariable and multivariable logistic regression models were derived from a suite of potential predictor variables. Predictive abilities were assessed via 10-fold cross-validated area under the receiver operating characteristic curves (AUCs).SettingUganda.ParticipantsAll women aged 15–49 years who were permanent residents of the selected households or stayed in the household the night before the survey were eligible to participate. In one-third of the sampled households, all men aged 15–54 years who met the same residence criteria were also eligible.Primary outcome measuresModern contraceptive use.ResultsOverall, 4914 (26.6%) women and 1897 (35.6%) men reported using a modern contraceptive method. For women and men, both demographic and proximate variables were significantly associated with contraceptive use, although notable differences in effect sizes existed between sexes—especially for age, level of education and parity. Predictively, the multivariable model was acceptable for women with AUC=0.714 (95% CI 0.704 to 0.720) but less so for men with AUC=0.654 (95% CI 0.636 to 0.666).Conclusion(s)Contemporary significant predictors of contraceptive use among women and men were reported, thereby enabling key Ugandan subpopulations who would benefit from more targeted family planning initiatives to be identified. However, the acceptable AUC for women and modest AUC for men suggest that other important unmeasured predictors may exist. Nonetheless, these evidence-based findings remain important for informing future programmatic and policy directions for family planning in Uganda.

scholarly journals Trends in contraceptive demands and unmet need for family planning in migrant population of Uttarakhand

2018 ◽  
Vol 5 (2) ◽  
pp. 590 ◽  
Author(s):  
Sadhna Singh ◽  
Neha Priya ◽  
Debabrata Roy ◽  
Anurag Srivastava ◽  
Surekha Kishore
Keyword(s):  
Side Effects ◽  
Failure Rate ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Reproductive Age ◽  
Modern Contraceptive ◽  
Migrant Population ◽  
High Failure Rate ◽  
Cross Sectional Survey ◽  
Traditional Methods

Background: The knowledge of contraceptive use and unmet need is important to know the constraints for unmet need based on user perspective. The aim of the study was to find the prevalence of Contraceptive use, Contraceptive preferred and the Un-met demand for contraceptives. Methods: Married, non-pregnant women of reproductive age group (15-49 years) from the migrant population were interviewed by Census method using pre-designed and pre-tested instrument by cross-sectional survey. Operational definitions for unmet need for spacing, limiting and unfelt need used in the study were as per NFHS -4 findings and traditional methods of contraception like abstinence, withdrawal were included in Un-met need for contraceptive due to its very high failure rate. Results: 58.44% study subjects had ‘Ever Used FP’ and 56.78% are currently using FP methods. The CPR is 56.7% by ‘Any Method’ and 43.0% by ‘Modern method’. The method which is most popular is ‘Sterlisation 29% and 20.96% and ‘Others’ i.e. highly unreliable methods like coitus interruptus, calendar method etc. found high number of users. The reasons for non use were apprehension of complication/side effects in 39%) and inconvenience or the difficulties with modern contraceptive methods or lack of knowledge by 7.67% and 6.95% respectively, 16% were relied on traditional methods, such as periodic abstinence, withdrawal and herbal mixtures from traditional healers as well as LAM 8% for a FP method, all of which have high failure rate. Only 24.8% Women were decision maker regarding the time and type of contraceptive to be used. The unmet need was 29.7% out of which the unmet needs for spacing and limiting were 9.6 per cent and 20.1 per cent, respectivelyConclusions: The unmet need is high and can be addressed by removing the constraints such as poor accessibility to the knowledge thus removing apprehension for side effects, improve accessibility to resources and low decision-making autonomy. 

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