Beyond knowledge acquisition: factors influencing family planning utilization among women in conservative communities in Rural Burundi.

Desired Family Size ◽

Study Participants

Abstract Background With a fertility rate of 5.4 children per woman, Burundi has been ranked as seventh highest country with the highest fertility rate in the world. Family planning is known to allow couples to achieve the desired family size, appropriate space birth and the limitation of pregnancies. Also, family planning can contribute to mitigating some health issues such as unintended pregnancies and abortions all of which, are often associated with multi-parity. In conservative community in rural Burundi, knowledge on family planning is high and such services are free yet utilisation is low. Employing a mixed methods, this study first quantifies contraceptive prevalence and second, explore the contextual multilevel factors associated with low family planning utilisation among married women.Methods An explanatory sequential mixed study was conducted. Five hundred and thirty women in union were interviewed using structured and pre-tested questionnaire. Next, 11 focus group discussions were held with community members composed of married men and women, administrative and religious leaders (n=132). The study was conducted in eighteen collines of two health districts of Vyanda and Rumonge in provinces of Bururi and Rumonge respectively. Quantitative data was analysed with SPSS and qualitative data was coded and deductive thematic methods were applied to find themes and codes.Results The overall contraceptive prevalence was 22.6%. Injectables (40%), Implants (24.6%), Male condom (10.8%) and pills (6.2%) were the major contraceptive methods utilized by study participants. Factors inhibiting family planning use emanated from a range of issues which were identified during the qualitative phase. Notable among those was experiencing side effects and costs associated with its management in the health system. Religious conceptualisation and ancestral negative beliefs of family planning had also shaped how people perceived it. Furthermore, at the household level, gender imbalances between spouses had resulted in break in communication, also serving as a factor for non-use of family planning. Conclusion The study suggests that low uptake of family planning can be attributed to perceived or experienced side effects as well as deeply rooted negative beliefs which are reinforced by religious beliefs. Men and religious leaders’ involvement in family planning initiatives can positively impact behaviour change and increase family planning acceptance.

Beyond knowledge acquisition: factors influencing family planning utilization among women in conservative communities in Rural Burundi.

10.21203/rs.3.rs-24210/v3 ◽

2021 ◽

Author(s):

SONIA HAKIZIMANA ◽

Emmanuel Nene Odjidja

Keyword(s):

Family Planning ◽

Cultural Practices ◽

Fertility Rate ◽

Religious Leaders ◽

Community Members ◽

Household Level ◽

Unintended Pregnancies ◽

Negative Beliefs ◽

Desired Family Size

Abstract BackgroundWith a fertility rate of 5.4 children per woman, Burundi has been ranked as seventh highest country with the highest fertility rate in the world. Family planning is known to allow couples to achieve the desired family size, appropriate space birth and the limitation of pregnancies. Also, family planning can contribute to mitigating some health issues such as unintended pregnancies and abortions all of which, are often associated with multi-parity. In conservative community in rural Burundi, knowledge on family planning is high and such services are free yet utilisation is low. Employing a mixed methods, this study first quantifies contraceptive prevalence and second, explore the contextual multilevel factors associated with low family planning utilisation among married women.Methods An explanatory sequential mixed study was conducted. Five hundred and thirty women in union were interviewed using structured and pre-tested questionnaire. Next, 11 focus group discussions were held with community members composed of married men and women, administrative and religious leaders (n=132). The study was conducted in eighteen collines of two health districts of Vyanda and Rumonge in Bururi and Rumonge provinces in Burundi. Quantitative data was analysed with SPSS and qualitative data was coded and deductive thematic methods were applied to find themes and codes.ResultsThe overall contraceptive prevalence was 22.6%. From logistic modelling analysis, it was found that women aged 25 to 29, those completed secondary school and having four or less children was significantly associated with use of family planning. Among factors why family planning was unused included experience with side effects and costs associated with its management in the health system. Religious conceptualisation and ancestral negative beliefs of family planning had also shaped how people perceived it. Furthermore, at the household level, gender imbalances between spouses had resulted in break in communication, also serving as a factor for non-use of family planning. ConclusionGiven that use of family planning is rooted in negative beliefs emanating mainly from religious and cultural practices, engaging local religious leaders and community actors may trigger positive behaviours change needed to increase its use.

Beyond knowledge acquisition: factors influencing family planning utilization among women in conservative communities in Rural Burundi

Reproductive Health ◽

10.1186/s12978-021-01150-7 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Sonia Hakizimana ◽

Emmanuel Nene Odjidja

Keyword(s):

Family Planning ◽

Rural Communities ◽

Cultural Practices ◽

Fertility Rate ◽

Religious Leaders ◽

Community Members ◽

Household Level ◽

Unintended Pregnancies ◽

Negative Beliefs ◽

Abstract Background With a fertility rate of 5.4 children per woman, Burundi ranked as seventh country with the highest fertility rate in the world. Family planning is an effective way of achieving desirable family size, appropriate birth spacing and significant reduction in unintended pregnancies. Furthermore, family planning has been linked to improvements in maternal health outcomes. Yet, in spite of the overwhelming evidence on the benefits of family planning and despite high knowledge and free services, utilisation is low especially in rural communities with conservative people. Employing a mixed methods approach, this study first quantifies contraceptive prevalence and second, explores the contextual multilevel factors associated with low family planning utilisation among community members. Methods An explanatory sequential mixed study was conducted. Five hundred and thirty women in union were interviewed using structured and pre-tested questionnaire. Next, 11 focus group discussions were held with community members composed of married men and women, administrative and religious leaders (n = 132). The study was conducted in eighteen collines of two health districts of Vyanda and Rumonge in Bururi and Rumonge provinces in Burundi. Quantitative data was analysed with SPSS and qualitative data was coded and deductive thematic methods were applied to find themes and codes. Results The overall contraceptive prevalence was 22.6%. From logistic modelling analysis, it was found that women aged 25 to 29 (aOR 5.04 (95% CI 2.09–10.27 p = 0.038), those that have completed secondary school and having four or less children were significantly associated with use of family planning (aOR 1.72 (95%1.35–2.01) p = 0.002). Among factors why family planning was unused included experience with side effects and costs associated with its management in the health system. Religious conceptualisation and ancestral negative beliefs of family planning had also shaped how people perceived it. Furthermore, at the household level, gender imbalances between spouses had resulted in break in communication, also serving as a factor for non-use of family planning. Conclusion Given that use of family planning is rooted in negative beliefs emanating mainly from religious and cultural practices, engaging local religious leaders and community actors may trigger positive behaviours change needed to increase its use.

Beyond knowledge acquisition: factors influencing family planning utilization among women in conservative communities in Rural Burundi.

10.21203/rs.3.rs-24210/v4 ◽

2021 ◽

Author(s):

SONIA HAKIZIMANA ◽

Emmanuel Nene Odjidja

Keyword(s):

Family Planning ◽

Rural Communities ◽

Cultural Practices ◽

Fertility Rate ◽

Religious Leaders ◽

Community Members ◽

Household Level ◽

Unintended Pregnancies ◽

Negative Beliefs ◽

Abstract Background With a fertility rate of 5.4 children per woman, Burundi ranked as seventh country with the highest fertility rate in the world. Family planning is an effective way of achieving desirable family size, appropriate birth spacing and significant reduction in unintended pregnancies. Furthermore, family planning has been linked to improvements in maternal health outcomes. Yet, in spite of the overwhelming evidence on the benefits of family planning and despite high knowledge and free services, utilisation is low especially in rural communities with conservative people. Employing a mixed methods approach, this study first quantifies contraceptive prevalence and second, explores the contextual multilevel factors associated with low family planning utilisation among community members.Methods An explanatory sequential mixed study was conducted. Five hundred and thirty women in union were interviewed using structured and pre-tested questionnaire. Next, 11 focus group discussions were held with community members composed of married men and women, administrative and religious leaders (n=132). The study was conducted in eighteen collines of two health districts of Vyanda and Rumonge in Bururi and Rumonge provinces in Burundi. Quantitative data was analysed with SPSS and qualitative data was coded and deductive thematic methods were applied to find themes and codes.Results The overall contraceptive prevalence was 22.6%. From logistic modelling analysis, it was found that women aged 25 to 29 (aOR 5.04 (95% CI 2.09 – 10.27 p=0.038)), those that have completed secondary school and having four or less children were significantly associated with use of family planning (aOR 1.72 (95%1.35 – 2.01) p=0.002). Among factors why family planning was unused included experience with side effects and costs associated with its management in the health system. Religious conceptualisation and ancestral negative beliefs of family planning had also shaped how people perceived it. Furthermore, at the household level, gender imbalances between spouses had resulted in break in communication, also serving as a factor for non-use of family planning. Conclusion Given that use of family planning is rooted in negative beliefs emanating mainly from religious and cultural practices, engaging local religious leaders and community actors may trigger positive behaviours change needed to increase its use.

Beyond knowledge acquisition: multilevel factors influencing family planning utilization among women in conservative communities in Rural Burundi.

10.21203/rs.3.rs-24210/v1 ◽

2020 ◽

Author(s):

SONIA HAKIZIMANA ◽

Emmanuel Nene Odjidja

Keyword(s):

Family Planning ◽

Side Effects ◽

Religious Beliefs ◽

Fertility Rate ◽

Cultural Barriers ◽

Modern Contraceptive ◽

Contraceptive Methods ◽

Unintended Pregnancies ◽

Desired Family Size

Abstract BackgroundWith a fertility rate of 5.5 children per woman, Burundi has been ranked as fourth highest country with the highest fertility rate in the world. Family planning is known to allow couples to achieve the desired family size, appropriate space birth and the limitation of pregnancies. Also, family planning can contribute to mitigating some health issues such as unintended pregnancies and abortions all of which, are often associated with multi-parity. In conservative community in rural Burundi, knowledge on family planning is high and such services are free yet utilisation is low. Employing a mixed methods, this study first quantifies contraceptive prevalence and second, explore the contextual multilevel factors associated with low family planning utilisation MethodsAn explanatory sequential mixed study was conducted. Five hundred and thirty women in union were interviewed using structured and pre-tested questionnaire. Next, 11 focus group discussions were held with community members (n=132). The study was conducted in eighteen collines of two health districts of Vyanda and Rumonge in provinces of Bururi and Rumonge respectively. Quantitative data was analysed with SPSS and qualitative data was coded and deductive thematic methods were applied to find themes and codes.ResultsThe overall contraceptive prevalence was 22.6%. Injectables (40%), Implants (24.6%), Male condom (10.8%) and pills (6.2%) were the major contraceptive methods utilized by study participants. Natural contraceptive methods were used by 13.8% of women interviewed. The reasons for not using modern contraceptive methods were side effects (51%), perceived postpartum (18.8%), religious beliefs (12.9%), partner’s opposition (8.4%), partner absenteeism (6.4%) and lack of awareness (2.5%). The qualitative component identified fear of side effects, religious beliefs, cultural barriers, spousal communication gap and refusal of family planning services by health practitioners as factors.ConclusionThe study suggests that low uptake of family planning can be attributed to perceived or experienced side effects as well as deeply rooted negative beliefs which are reinforced by religious beliefs. Men and religious leaders’ involvement in family planning initiatives can positively impact behaviour change and increase family planning acceptance.

Study on knowledge and experience about emergency contraception at a tertiary care centre family planning clinic

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20185414 ◽

2018 ◽

Vol 8 (1) ◽

pp. 155

Author(s):

Lakshmidevi M. ◽

Sheela H. S. ◽

Shreedhar Venkatesh

Keyword(s):

Family Planning ◽

Side Effects ◽

Emergency Contraception ◽

Tertiary Care ◽

Basic Knowledge ◽

Research Centre ◽

Rank Test ◽

Family Planning Clinic ◽

Tertiary Care Centre ◽

Unintended Pregnancies

Background: Unintended pregnancies and unsafe abortions are the major reproductive health challenges faced by women of developing countries. According to WHO 42 million induced abortions occur annually and out of which 20 million are performed in unsafe condition and by unskilled providers.Methods: It is a questionnaire-based study planned to be conducted in the family planning clinic of Department Of Obstetrics and Gynaecology, at Vydehi Institute of Medical Sciences and Research Centre, Bangalore. Statistical analysis is done by percentage analysis, paired T test or Wilckoxer signed rank test and Mcnemer test.Results: This is a questionnaire-based study conducted on 300 urban educated women seeking termination of pregnancy. Among 300 women studied majority were in the age group of 21-30 years i.e. 174 women (58%). Among 300 women studied about 126 women who had some knowledge about EC and Medias (like TV, radio and magazine) constitutes the major source of knowledge i.e. 60 women (47.6%) then Doctors and nurse i.e. 36 women (28.5%) and other sources like friends, relative and Teachers i.e. 30 women (23.8%). Knowledge about the side effects of EC was very limited in present study, i.e. 30 women (23.8%) were unaware of side effects, 60 women (47.6%) were aware of minor side effects like nausea, vomiting and pain abdomen, and only 36 women (28.5%) were aware of hormonal side effects like menstrual irregularity.Conclusions: From present study it is shown that even among urban educated women knowledge about emergency contraception is very limited. For the proper use of emergency contraception, women should have basic knowledge about fertility and contraception. According to present study only 23.8% of urban educated women have knowledge about safe and unsafe period only (42.8%) had knowledge about timing of use of Emergency contraception.

Shifting dynamics: Changes in the relationship between total fertility rate and contraceptive prevalence rate in Jordan between 2012 and 2017

Gates Open Research ◽

10.12688/gatesopenres.13188.2 ◽

2021 ◽

Vol 4 ◽

pp. 160

Author(s):

Kristin Bietsch ◽

Ali Arbaji ◽

Jennifer Mason ◽

Rebecca Rosenberg ◽

Malak Al Ouri

Keyword(s):

Family Planning ◽

Total Fertility Rate ◽

Prevalence Rate ◽

Contraceptive Use ◽

Unmet Need ◽

Family Health ◽

Fertility Rate ◽

Modern Contraceptive ◽

Contraceptive Prevalence Rate ◽

Background: Between the two most recent Population and Family Health Surveys, Jordan saw a dramatic decline in the Total Fertility Rate (TFR) from 3.5 to 2.7 in 5.5 years. Over the same period, modern contraceptive use also declined, from 61.2% to 51.8% among married women. This decrease in both TFR and the contraceptive prevalence rate (CPR) diverges from the typical relationship seen between these two factors whereby historically as CPR increases, TFR decreases. This paper explores this unique pattern using multiple methodologies. Methods: First, we validate the survey data using nationally collected data on fertility and contraceptive distribution. Second, we look to changes that have historically influenced changes in CPR and TFR, including changes in ideal family size and wanted fertility rates. Third, we explore proximate determinants and other influences on fertility and changes in contraception, examining the changes in the method mix and unmet need; marriage patterns, including the demographics of the married population, spousal separation, and time since last sex; postpartum insusceptibility; infecundity, both primary and secondary; and abortion, to see if any have shifted significantly enough to allow for fertility to decline with less contraceptive use. Results: We find that the decline in fertility in Jordan was driven by a reduction in mistimed or unwanted pregnancies and there was a significant increase in the share of reproductive aged women who are infecund. We also concluded that the changes in fertility and contraceptive use are driven by changes in Jordanian nationals, not by the growing Syrian refugee population. Conclusions: Jordan is not the only country to be experiencing a shift in the typical relationship between CPR and TFR. Results can inform both future approaches for family planning programs and our expectations regarding what kind of change our family planning investments might buy.

QUADRANT ANALYSIS OF TOTAL FERTILITY RATE AND CONTRACEPTIVE PREVALENCE RATE OF DISTRICT AND CITY IN EAST JAVA

Jurnal Biometrika dan Kependudukan ◽

10.20473/jbk.v9i2.2020.87-94 ◽

2020 ◽

Vol 9 (2) ◽

pp. 87

Author(s):

Kiki Adi Mutiari ◽

Kuntoro Kuntoro

Keyword(s):

Family Planning ◽

Total Fertility Rate ◽

Prevalence Rate ◽

Family Planning Program ◽

Fertility Rate ◽

Quadrant Analysis ◽

Planning Program ◽

Contraceptive Prevalence Rate ◽

The Government

One of the indicators determine the wellness of Family Planning Program is the high number of participants enrolling, or commonly known as the Contraceptive Prevalence Rate (CPR) and the number of children born known as the Total Fertility Rate (TFR) of a maximum of 2 children. There are several regions in East Java where the situation of TFR and CPR does not show the ideal conditions. This shows that there are problems in the current family planning program. This research was conducted to map districts and cities in East Java based on TFR and CPR data respectively in quadrant form. This type of research is on-reactive research which utilizes secondary data from Indonesia - National Socio-Economic Survey in 2015. The research method used is recapitulating data and classifying districts and cities in the form of quadrants by comparing to data on achievement of TFR and CPR in East Java using SPSS. The results of the study have mapped districts and cities in East Java which are described in quadrant form. The regions that need major attention from the government are regions in quadrants I and II. Quadrant III is included in an abnormal condition and quadrant IV is a quadrant that has an area where TFR and CPR conditions are ideal. The conclusions of this study are the areas in quadrant I, namely: Sampang (district), Blitar (city), Blitar (district), Tulungagung (district), Ponorogo (district), Madiun (city), and Pasuruan (city) are the priority in getting the FP program improvements. The advice that can be given is to evaluate the ongoing family planning program to find out the factors that cause the TFR and CPR conditions are not in line with government expectations.

Evaluation of subdermal implants among family planning acceptors in a tertiary hospital, Nigeria

World Journal of Advanced Research and Reviews ◽

10.30574/wjarr.2020.8.2.0434 ◽

2020 ◽

Vol 8 (2) ◽

pp. 271-278

Author(s):

Nonye-Enyidah Esther Ijeoma ◽

Enyidah Nonyenim Solomon

Keyword(s):

Family Planning ◽

Side Effects ◽

Formal Education ◽

Tertiary Hospital ◽

The Body ◽

University Teaching ◽

Unintended Pregnancies ◽

Subdermal Implants ◽

Pearl Index ◽

Contraceptive Implants

Background: Subdermal contraceptive implants are safe, convenient, very effective and reversible. Though they have numerous benefits, their use is still discontinued due to various reasons including side effects in the body of acceptors. Objective: To determine and compare the prevalence rates, side effects, discontinuation rates and indications for discontinuation of two subdermal implants (Jadelle and Implanon) at Rivers State University Teaching Hospital (RSUTH), Port Harcourt, Nigeria. Methods: A retrospective study of 874 clients attending family planning clinic at the RSUTH from 1st January, 2015 – 31st December, 2019 was conducted. Their records were retrieved from the clinic and reviewed. Data was extracted, coded and analyzed using the statistical package for social sciences (SPSS) IBM version 25.0 (Armonk, NY). Result: Four hundred and twenty five women used subdermal implants out of 874 acceptors of contraceptives within the study period giving an uptake rate of 48.6%. Implanon was more preferred accounting for 66.6% and Jadelle 33.4%. The mean age was 33.24+4.13 years. Most age group was 30-34 years accounting for 51.3%. Age range was 20-48 years and most (80%) were multiparous. Most (99.1%) were Christians and 98.4% were married. Only one client (0.2%) had no formal education. Seventy three (26.4%) acceptors discontinued the use. Most were due to desire for pregnancy (46.4%) and menorrhagia (24.1%). Four unintended pregnancies occurred giving a Pearl index of 0.9. Conclusion: Subdermal implants are safe and effective. Menstrual abnormality and desire for pregnancy were the commonest reasons for discontinuation.

Identifying barriers to accessing family planning contraceptives among women aged 15-49 years in Maprik District, East Sepik Province, Papua New Guinea, 2014.

Pacific Journal of Reproductive Health ◽

10.18313/2017.902 ◽

2017 ◽

Vol 1 (5) ◽

pp. 232 ◽

Cited By ~ 2

Author(s):

James Flint ◽

Margaret Morisause

Keyword(s):

Family Planning ◽

Side Effects ◽

Papua New Guinea ◽

Contraceptive Use ◽

Health Information System ◽

New Guinea ◽

Population Based ◽

Awareness Campaigns ◽

Modern Contraceptives ◽

IntroductionFamily Planning is central to the empowerment of women and a key factor reducing poverty. However, millions of women around the world are not accessing safe and effective family planning methods. This study determined contraceptive prevalence and identified barriers to using modern contraception in the Maprik district of East Sepik Province, Papua New Guinea. MethodsData from the National Health Information System (NHIS) and a survey of women presenting to outpatient clinics was used to estimate contraceptive prevalence. The in-person interviews, which also sought to understand barriers to using modern contraceptives, included women aged 15-49 years from three different health facility catchments. A population based awareness campaign promoting family planning was undertaken through mass media (local radio) and targeted information sessions. FindingsThe retrospective review of NHIS data indicated a contraceptive prevalence of 38% while the survey indicated a prevalence of 30%. Of the women interviewed, 46% indicated having an unintended pregnancy and 16% had sought to end a pregnancy. Of those women who were not using modern contraceptives, 19% lacked knowledge on methods to avoid pregnancy and 13% were concerned about side effects from using modern contraceptives. A family planning awareness program resulted in a notable increase in the number of men having a vasectomy. ConclusionThis study confirmed low contraceptive prevalence estimates in Maprik District and identified the key barriers to contraceptive use that can be effectively addressed. Continued awareness campaigns are necessary to address key knowledge gaps and alleviate fears about the side effects of contraceptive use.

Contraceptive Practice and Protection of Womens Health

Bangladesh Medical Journal ◽

10.3329/bmj.v39i1.6227 ◽

1970 ◽

Vol 39 (1) ◽

pp. 11-15

Author(s):

Rabeya Akther

Keyword(s):

Family Planning ◽

Fertility Control ◽

Modern Method ◽

Cross Sectional Study ◽

Fertility Rate ◽

Barrier Method ◽

Childbearing Age ◽

Cross Sectional ◽

Contraceptive Practice

Family planning is an essential tool for reducing fertility rate. An increase in contraceptive prevalence results in reduction of population growth, which in turn contributes significantly to the improvement of maternal health. It is a cross-sectional study done during period of April-July 2007 in a large Medical Centre at Motijheel, Dhaka. Information on reproductive history was obtained to find out their contraceptive prevalence and regulation of fertility. Two hundred and thirty one (231) women (childbearing age) were selected randomly to find out their contraceptive prevalence. Eighty four (n=197) percent women needs family planning service .Among them 87.82 percent (N-173) use any method of contraception. 79.76% ( N-138) women use modern method and 20.23 percent ( N-35) couple use natural method .Thirty three (33.53 %)percent couple practice barrier method, twenty two (22.54%) percent use oral pill. Present study revealed that contraceptive practice and fertility rate both are low among servicing women. Contraception and fertility control is an underlying factor for the achievement of several Millennium Development Goals (MDGs). For reduction of infant mortality (4th MDG) and maternal mortality (5th MDG) contraception is essential. Finally it plays a role in combating poverty within the first MDG. DOI: 10.3329/bmj.v39i1.6227 Bangladesh Medical Journal 2010; 39(1): 11-15