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

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 ◽  
Contraceptive Prevalence ◽  
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.

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

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 ◽  
Contraceptive Prevalence

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.

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

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 ◽  
Contraceptive Prevalence

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.

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

2020 ◽  
Author(s):  
SONIA HAKIZIMANA ◽  
Emmanuel Nene Odjidja
Keyword(s):  
Family Planning ◽  
Side Effects ◽  
Fertility Rate ◽  
Religious Leaders ◽  
Household Level ◽  
Unintended Pregnancies ◽  
Negative Beliefs ◽  
Contraceptive Prevalence ◽  
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.

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

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 ◽  
Contraceptive Prevalence ◽  
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.

scholarly journals What mechanisms drive uptake of family planning when integrated with childhood immunisation in Ethiopia? A realist evaluation

2021 ◽  
Author(s):  
Shari Krishnaratne ◽  
Jessie K. Hamon ◽  
Jenna Hoyt ◽  
Tracey Chantler ◽  
Justine Landegger ◽  
...  
Keyword(s):  
Family Planning ◽  
Child Health ◽  
Maternal And Child Health ◽  
Realist Evaluation ◽  
Religious Leaders ◽  
Community Members ◽  
Theoretical Frameworks ◽  
Programme Theory ◽  
Integrated Delivery ◽  
And Child Health

Abstract Background: Maternal and child health are key priorities among the Sustainable Development Goals, which include a particular focus on reducing morbidity and mortality among women of reproductive age, newborns, and children under the age of five. Two components of maternal and child health are family planning (FP) and immunisation. Providing these services through an integrated delivery system could increase the uptake of vaccines and modern contraceptive methods (MCMs) particularly during the post-partum period. Methods: A realist evaluation was conducted in two woredas in Ethiopia to determine the key mechanisms and their triggers that drive successful implementation and service uptake of an intervention of integrated delivery of immunisations and FP. The methodological approach included the development of an initial programme theory and the selection of relevant, published implementation related theoretical frameworks to aid organisation and cumulation of findings. Data from 23 semi-structured interviews were then analysed to determine key empirical mechanisms and drivers and to test the initial programme theory. These mechanisms were mapped against published theoretical frameworks and a revised programme theory comprised of context-mechanism-outcome configurations was developed. A critique of theoretical frameworks for abstracting empirical mechanisms was also conducted. Results: Key contextual factors identified were: the use of trained Health Extension Workers (HEWs) to deliver FP services; a strong belief in values that challenged FP among religious leaders and community members; and a lack of support for FP from male partners based on religious values. Within these contexts, empirical mechanisms of acceptability, access, and adoption of innovations that drove decision making and intervention outcomes among health workers, religious leaders, and community members were identified to describe intervention implementation. Conclusions: Linking context and intervention components to the mechanisms they triggered helped explain the intervention outcomes, and more broadly how and for whom the intervention worked. Linking empirical mechanisms to constructs of implementation related theoretical frameworks provided a level of abstraction through which findings could be cumulated across time, space, and conditions by theorising middle-range mechanisms.

scholarly journals What mechanisms drive uptake of family planning when integrated with childhood immunisation in Ethiopia? A realist evaluation

2020 ◽  
Author(s):  
Shari Krishnaratne ◽  
Jessie K. Hamon ◽  
Jenna Hoyt ◽  
Tracey Chantler ◽  
Justine Landegger ◽  
...  
Keyword(s):  
Family Planning ◽  
Child Health ◽  
Maternal And Child Health ◽  
Realist Evaluation ◽  
Religious Leaders ◽  
Community Members ◽  
Theoretical Frameworks ◽  
Programme Theory ◽  
Integrated Delivery ◽  
And Child Health

Abstract Background:Maternal and child health are key priorities among the Sustainable Development Goals, which include a particular focus on reducing morbidity and mortality among women of reproductive age, newborns, and children under the age of five. Two components of maternal and child health are family planning (FP) and immunisation. Providing these services through an integrated delivery system could increase the uptake of vaccines and modern contraceptive methods (MCMs) particularly during the post-partum period. Methods:A realist evaluation was conducted in two woredas in Ethiopia to determine the key mechanisms and their triggers that drive successful implementation and service uptake of an intervention of integrated delivery of immunisations and FP. The methodological approach included the development of an initial programme theory and the selection of relevant, published implementation related theoretical frameworks to aid organisation and cumulation of findings. Data from 23 semi-structured interviews were then analysed to determine key empirical mechanisms and drivers and to test the initial programme theory. These mechanisms were mapped against published theoretical frameworks and a revised programme theory comprised of context-mechanism-outcome configurations was developed. A critique of theoretical frameworks for abstracting empirical mechanisms was also conducted. Results:Key contextual factors identified were: the use of trained Health Extension Workers (HEWs) to deliver FP services; a strong belief in values that challenged FP among religious leaders and community members; and a lack of support for FP from male partners based on religious values. Within these contexts, empirical mechanisms of acceptability, access, and adoption of innovations that drove decision making and intervention outcomes among health workers, religious leaders, and community members were identified to describe intervention implementation.Conclusions:Linking context and intervention components to the mechanisms they triggered helped explain the intervention outcomes, and more broadly how and for whom the intervention worked. Linking empirical mechanisms to constructs of implementation related theoretical frameworks provided a level of abstraction through which findings could be cumulated across time, space, and conditions by theorising middle-range mechanisms.

scholarly journals Powerful Influencers: Kenyan & Zambia Religious Leaders Advocate for Family Planning

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Bormet
Keyword(s):  
Family Planning ◽  
Faith Communities ◽  
Religious Leaders ◽  
Culturally Appropriate ◽  
Community Members ◽  
Low Literacy ◽  
Family Planning Services ◽  
Faith Based ◽  
A Value ◽  
External Stakeholders

Abstract Faith-based organizations (FBOs) provide approximately 40% of healthcare in Kenya and 30% in Zambia. Promoting healthy families is a value at the heart of faith communities. This intervention focused on equipping and encouraging religious leaders (RLs), whose churches own and operate faith-based health facilities, to advocate for family planning (FP) within their congregations, communities, governments. This project included baseline assessments, FP sensitization, and media trainings. Religious leaders were trained through an adaptation of the AFP SMART training by ensuring culturally appropriate messaging for religious audiences were included (i.e. using scripture to discuss and develop messages on families, planning, having children, etc.). Training RLs provides an entree into government fora as culturally respected leaders in positions of power. In order for external advocacy to take place outside of church settings, it is crucial to identify how each church defines FP before meeting with external stakeholders. Creation of low-literacy terms in English and local languages that equipped RLs to interact with community members in-person (i.e. church services, weddings, funerals, community barazas, etc.) and via TV and radio shows was key in addressing myths and misconceptions. Eighty-six religious leaders from 16 denominations in Kenya and Zambia were engaged to sensitize communities and advocate with their Ministries of Health on behalf of the faith community to ensure family planning services reach communities. Equipping RLs in culturally and language appropriate contexts builds stronger advocates for healthy families and communities. Key messages To demonstrate how religious leaders in Kenya and Zambia are equipped to advocate for family planning from a faith perspective. Words and definitions and messengers matter in Family Planning Advocacy from a faith perspective.

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

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 ◽  
Contraceptive Prevalence

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.

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

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 ◽  
Contraceptive Prevalence ◽  
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.

scholarly journals Contraceptive Practice and Protection of Women’s Health

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 Prevalence ◽  
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

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