scholarly journals Postpartum Green Star Family Planning Decision Aid for Pregnant Adolescents in Tanzania: a Qualitative Feasibility Study

2021 ◽  
Author(s):  
Stella Emmanuel Mushy ◽  
Eri Shishido ◽  
Sebalda Leshabari ◽  
Shigeko Horiuchi
Keyword(s):  
Family Planning ◽  
Decision Aid ◽  
Structured Interview ◽  
Published Data ◽  
Pregnant Adolescents ◽  
Language Data ◽  
Planning Methods ◽  
Planning Decision ◽  
Nurse Midwives ◽  
Long Acting

Abstract Background: The use of a decision aid (DA) in clinical settings has been useful as they inform and educate clients about the available options that help them to reduce decision-making conflict related to feeling uninformed and unclear about personal values compared with usual care. There is a dearth of published data about the use of decision aid during family planning (FP) counseling with postpartum women focusing on long-acting reversible family planning methods. Therefore, the researchers developed a decision aid named “Green Star” and assessed its feasibility. The study outcomes were practicality, usefulness, and acceptability as perceived by the pregnant adolescents and the nurse/midwives.Methods: An exploratory in-depth qualitative interview involving six nurse/midwives with three or more years of experience in FP services, and 12 pregnant adolescents aged 15-19 years. Purposive sampling was used to select the participants, and sampling relied on the saturation principle of data collection. Researchers used a semi-structured interview guide translated into Kiswahili language. Data were transcribed and analyzed following inductive-deductive content analysis. Results: The length of the presentation was found to be just right, with time ranging from twenty minutes to one hour. The flow of the information was stated to be good with small significant changes suggested. Kiswahili language used was reported to be appropriate and well elaborated, however, a few words were suggested to be rephrased to reduce ambiguity. The nurse/midwives reported that the DA included most of the important information clients wanted to know during FP counseling. The adolescents stated that the DA improved their knowledge and provided new information about the existence of FP immediately after childbirth. The participants said the DA clearly addressed the benefits and side effects as well as dispelled some myths and misconceptions. The DA was accepted to be useful in complementing the daily family planning counseling offered as well as in improving adolescents’ knowledge. Conclusion: The postpartum Green Star family planning decision aid was perceived to be practical, useful, and acceptable. Further research is needed to assess the effect of the DA in the choice for postpartum long acting reversible FP among the pregnant adolescents in Tanzania.

scholarly journals Postpartum Green Star family planning decision aid for pregnant adolescents in Tanzania: a qualitative feasibility study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Stella E. Mushy ◽  
Eri Shishido ◽  
Sebalda Leshabari ◽  
Shigeko Horiuchi
Keyword(s):  
Family Planning ◽  
Decision Aid ◽  
Treatment Options ◽  
Structured Interview ◽  
Published Data ◽  
Pregnant Adolescents ◽  
Family Planning Counseling ◽  
Planning Decision ◽  
Long Acting ◽  
Study Participants

Abstract Background The use of a decision aid in clinical settings has been beneficial. It informs and educates patients about the available treatment options that can help them reduce decision-making conflicts related to feeling uninformed compared with routine care. There is a scarcity of published data about using a decision aid during family planning counseling with postpartum women focusing on long-acting reversible contraception in Tanzania. Therefore, we developed a “postpartum Green Star family planning decision aid” and assessed its feasibility. The study outcomes were practicality, usefulness, and acceptability perceived by pregnant adolescents and nurses/midwives. Methods We used an exploratory qualitative in-depth interview involving six nurses/midwives with three or more years of experience in family planning services and 12 pregnant adolescents aged 15–19 years. Purposive sampling was used to select the participants, and selection relied on the saturation principle of data collection. We used a semi-structured interview guide translated into the Kiswahili language. Data were transcribed and analyzed following inductive content analysis. Results The amount of information presented was just right, with the time of reading the data ranging from 20 min to 1 h. The study participants perceived the flow of information to be good, with small significant changes suggested. Kiswahili language was used and reported to be appropriate and well elaborated. However, a few words were told to be rephrased to reduce ambiguity. The nurses/midwives said that the decision aid included most of the vital information the participants wanted to know during their family planning counseling. Pregnant adolescents stated that the decision aid improved their knowledge and provided new details on the long-acting reversible contraception methods (intrauterine copper devices and implants) offered immediately after childbirth. The participants stated that the decision aid addressed long-acting reversible contraception methods’ benefits and side effects and dispelled myths and misconceptions. The study participants considered the decision aid helpful in complementing the family planning counseling offered and improving pregnant adolescents’ knowledge. Conclusion The postpartum Green Star family planning decision aid was practical, useful, and acceptable in enhancing the objectivity of counseling about long-acting reversible contraception methods. It improved the knowledge of pregnant adolescents in Tanzania about the available contraception methods (i.e., the use of intrauterine copper devices and implants), which can be immediately used postpartum. Further research is needed to assess the effects of the decision aid on long-acting reversible contraception postpartum uptake among pregnant adolescents in Tanzania.

scholarly journals Evaluation of a pilot program for task sharing short and long-acting contraceptive methods in Burkina Faso

2020 ◽  
Vol 3 ◽  
pp. 1499
Author(s):  
Dawn S. Chin-Quee ◽  
Kathleen Ridgeway ◽  
Yentéma Onadja ◽  
Georges Guiella ◽  
Guy Martial Bai ◽  
...  
Keyword(s):  
Family Planning ◽  
Burkina Faso ◽  
Health Workers ◽  
Scale Up ◽  
Family Health ◽  
Pilot Project ◽  
Steady Increase ◽  
Task Sharing ◽  
Planning Methods ◽  
Long Acting

Background: The Family Health Directorate of the Ministry of Health  and Marie Stopes Burkina Faso, with implementing partners, Association Burkinabè pour le Bien-être Familial  and Equilibres & Populations  collaboratively conducted a pilot project in Burkina Faso focused on “increasing access to family planning (FP) services through task-sharing short- and long-acting family planning methods to primary care cadres.” Four cadres of providers  provided intrauterine devices (IUDs) and implants, while community health workers (CHWs)  provided pills and subcutaneous injectables. FHI 360 and the Institut Supérieur des Sciences de la Population  evaluated the project’s impact on method uptake, client satisfaction, safety, acceptability and the feasibility of task sharing. Methods: The evaluation employed FP service statistics on new users and conducted 425 client exit interviews  and 27 in-depth interviews . New FP clients, community representatives, MoH officials, and pilot project-trained FP providers from Dandé and Tougan districts participated in these interviews. Results: Providers, community representatives and government officials all spoke favorably of the pilot project and considered it a boon to women and the communities in which they lived. FP clients were satisfied with their methods and the services they received from their respective providers, and they reported no safety concerns. However, service statistics did not show a clear and steady increase in method uptake for the four methods beyond spikes coinciding with pre-existing free contraceptive weeks. Conclusions:  A scale-up plan for 2020-2022 is in place and will purposefully implement sensitization and demand generation activities to improve FP uptake beyond free contraceptive weeks.

scholarly journals Lived Experience of Women Who Underwent Early Removal of Long-Acting Family Planning Methods in Bedesa Town, Wolaita Zone, Southern Ethiopia: A Phenomenological Study

2021 ◽  
Vol Volume 13 ◽  
pp. 645-652
Author(s):  
Mohammed Suleiman Obsa ◽  
Kassahun Tekle Takiso ◽  
Tamiru Tilahun Ayele ◽  
Hailu Chare Koyra ◽  
Kassahun Tafesse Hidoto ◽  
...  
Keyword(s):  
Family Planning ◽  
Lived Experience ◽  
Phenomenological Study ◽  
Southern Ethiopia ◽  
Early Removal ◽  
Planning Methods ◽  
Long Acting ◽  
Family Planning Methods

scholarly journals Effectiveness of task-sharing in providing comprehensive long-acting reversible contraceptives through Level IV health extension workers in rural Ethiopia

2021 ◽  
Author(s):  
Alula Teklu ◽  
Awol Seid ◽  
Kassahun Mormu ◽  
Tesfa Demlew ◽  
Ephrem Tekle ◽  
...  
Keyword(s):  
Family Planning ◽  
Health Extension Workers ◽  
Chi Square ◽  
New Family ◽  
Positive Attitudes ◽  
Desire To Have Children ◽  
Modern Family ◽  
Planning Methods ◽  
Long Acting ◽  
Long Acting Reversible Contraceptives

Abstract Background: Modern family planning uptake in Ethiopia, primarily short-acting injectables, has increased after the engagement of community health extension workers (HEWs). The aim of this study was to investigate the effectiveness of using Level IV health extension workers to deliver long-acting reversible contraceptives (LARCs) at the community level. Methods: A retrospective cohort study design was used to recruit 710 women who received LARC insertion services at pilot health posts within eight months before survey time. The interviewer administered a data collection tool to collect the required data through a house-to-house survey. The questionnaire had sections covering demographic and socioeconomic characteristics, reproductive history, use of family planning methods, knowledge about LARC methods (i.e., IUCD and Implanon), and service satisfaction. Descriptive statistics were used to analyze data. Chi-square test was used to identify the determinants of LARC use. Results: Out of 702 LARC users included in the study, 92.7% received services from Level IV HEWs. The median age of clients was 30 years (IQR: 25–35), 92.7% were married, and 22.6% were new family planning users (75% Implanon users and 19.4% Jaddelle users). Of the aggregated variables, 67.38% had good knowledge of LARC, 92.28% had positive attitudes in availing services at health posts, and 92.76% was the satisfaction score of clients. New users tended to be young, Muslim, less likely to want more children, and more likely to decide on contraception on their own. At eight months post insertion, LARC use was effective in preventing pregnancy (99.7%) with low removal (n = 36, 5.1%) and expulsion rates (n = 1, 0.1%). No infection was reported. The major reasons for removal were side effects and the desire to have children. Client knowledge, attitude, and satisfaction were found to be high. In conclusion, trained Level IV HEWs provided LARCs safely and effectively at the health post level as an alternative service delivery outlet.

scholarly journals Lived experience of women who underwent early removal of long-acting Contraceptive Methods in Bedesa town, Wolaita Zone, Southern Ethiopia: A phenomenological study

2020 ◽  
Author(s):  
Mohammed Suleiman Obsa ◽  
Kassahun Tekle Takiso ◽  
Tamiru Tilahun Ayele ◽  
Hailu Chare Koyra ◽  
Kasahun Tafesse Hidota ◽  
...  
Keyword(s):  
Family Planning ◽  
Side Effects ◽  
Phenomenological Study ◽  
Southern Ethiopia ◽  
Counseling Services ◽  
Contraceptive Methods ◽  
Early Removal ◽  
Planning Methods ◽  
Long Acting ◽  
Family Planning Methods

Abstract Background Long-acting contraceptive methods can play a pivotal role in reducing maternal mortality. In Etiopia, the total fertility rate per woman is 4.6. However, this rapid population growth is not in line with the weak economic growth of the country. Therefore, this study was done to explore the lived experiences of women who underwent early removal of long-acting contraceptive methods in Bedesa town, Southern Ethiopia. Methods A phenomenological study design was employed to include a total of 10 in-depth interviews of sampled women. Participants were recruited through criterion sampling method. Open code version 4.03 was used to code and facilitate analysis. Transcripts were read and re-read separately to identify emerging themes. Thematic analysis technique was used. Results This study revealed that the side effect of the long-acting family planning methods were the main reason for early removal. Furthermore, heavy and irregular menses were mentioned as the most frequently occurred side effects. Delayed fertility after removal of long-acting contraceptive was one of frequently stated fear by the clients. It was also stated that counseling provided by health professionals was not adequate. Conclusion The majority of study participants taught that the side effects of long-acting family planning methods outweigh the benefits. Besides, the counseling services provided by health care providers were not adequate. Therefore, proper counseling services should be given to mothers who are taking long-acting family planning methods.

scholarly journals Evaluation of a pilot program for task sharing short and long-acting contraceptive methods in Burkina Faso

2019 ◽  
Vol 3 ◽  
pp. 1499 ◽  
Author(s):  
Dawn S. Chin-Quee ◽  
Kathleen Ridgeway ◽  
Yentéma Onadja ◽  
Georges Guiella ◽  
Guy Martial Bai ◽  
...  
Keyword(s):  
Family Planning ◽  
Burkina Faso ◽  
Health Workers ◽  
Scale Up ◽  
Family Health ◽  
Pilot Project ◽  
Steady Increase ◽  
Task Sharing ◽  
Planning Methods ◽  
Long Acting

Background: The Family Health Directorate of the Ministry of Health (MoH/FHD) and Marie Stopes Burkina Faso (MS BF), with implementing partners, Association Burkinabé pour le Bien-être Familial (ABBEF) and Equilibres & Populations (Equipop) collaborated to conduct a pilot project in Burkina Faso focused on “increasing access to family planning (FP) services through task-sharing short- and long-acting family planning methods to primary care cadres.” Four cadres of providers were trained to provide intrauterine devices (IUDs) and implants, while community health workers (CHWs) were trained to provide pills and subcutaneous injectables. FHI 360 and the Institut Supérieur des Sciences de la Population (ISSP) evaluated the project’s impact on method uptake, client satisfaction, safety, acceptability and the feasibility of task sharing. Methods: The evaluation employed service statistics, client exit interviews (quantitative) and in-depth interviews (qualitative). New FP clients, community representatives, MoH officials, and pilot project-trained FP providers from Dandé and Tougan districts participated in these interviews. Results: Providers, community representatives and government officials all spoke favorably of the pilot project and considered it a boon to women and the communities in which they lived. FP clients were satisfied with their methods and the services they received from their respective providers, and they reported no safety concerns. However, service statistics did not show a clear and steady increase in method uptake for the four methods beyond spikes coinciding with pre-existing free contraceptive weeks. Conclusions: Results of the evaluation were largely positive. These evaluation findings are being used to guide decisions about scale-up.

Lived experience of women who underwent early removal of long-acting Contraceptive Methods: A phenomenological study

2020 ◽  
Author(s):  
Mohammed Suleiman Obsa1* ◽  
Kassahun Tekle Takiso ◽  
Tamiru Tilahun Ayele ◽  
Melkamu Worku kercho ◽  
Hailu Chare Koyra ◽  
...  
Keyword(s):  
Family Planning ◽  
Side Effects ◽  
Phenomenological Study ◽  
Counseling Services ◽  
Care Providers ◽  
Contraceptive Methods ◽  
Early Removal ◽  
Planning Methods ◽  
Long Acting ◽  
Family Planning Methods

Abstract Background: Long-acting contraceptive methods can play a pivotal role in reducing maternal mortality. In Etiopia, the total fertility rate per woman is 4.6. However, this rapid population growth is not in line with the weak economic growth of the country. Therefore, this study was performed to explore the lived experiences of women who underwent early removal of long-acting contraceptive methods in Bedesa town, Southern Ethiopia.Methods: A phenomenological study design was employed to include a total of 10 in-depth interviews of sampled women. Participants were recruited through the criterion sampling method. Open code version 4.03 was used to code and facilitate analysis. Transcripts were read and re-read separately to identify emerging themes. A thematic analysis technique was used.Results: This study revealed that the side effects of long-acting family planning methods were the main reason for early removal. Furthermore, heavy and irregular menses were mentioned as the most frequently occurring side effects. Delayed fertility after removal of long-acting contraceptives was one of the most frequently stated fears by clients. It was also stated that counseling provided by health professionals was not adequate.Conclusion: The majority of study participants taught that the side effects of long-acting family planning methods outweigh the benefits. In addition, the counseling services provided by health care providers were not adequate. Therefore, proper counseling services should be given to mothers who are taking long-acting family planning methods.

scholarly journals Disparities in Long-Acting Reversible Contraceptive Utilization among Married Women in Ethiopia: Findings of the Ethiopian Demographic and Health Survey

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Biniyam Tadesse Haile ◽  
Yohannes Ejigu Tsehay
Keyword(s):  
Family Planning ◽  
Health Survey ◽  
Associated Factors ◽  
Married Women ◽  
Demographic And Health Survey ◽  
Contraceptive Methods ◽  
Contraceptive Utilization ◽  
Planning Methods ◽  
Long Acting ◽  
Family Planning Methods

Background. Long-acting contraceptive methods, subdermal implants, and intrauterine devices are reliable, safe, and cost-effective family planning methods. However, these methods are not widely used in Ethiopia despite government effort to increase access. The study is aimed at assessing the rate of utilization of long-acting contraceptive methods among married women and associated factors. Method. We analyzed the 2016 Ethiopian Demographic and Health Survey dataset. A total of 2045 married women of reproductive age group, who were using any modern contraceptive method at the time of the survey, were included in the study. Descriptive statistics were computed to characterize the study participants. Bivariate and multivariable logistic regression analyses were performed to identify associated factors, reporting odds ratios (ORs) and 95% confidence intervals (95% CIs). Result. The multivariable analyses showed that women educational status, parity, religion, previous history of abortion, desire for more child, and region where the respondents reside were significantly the factors that determine the utilization of long-acting contraceptive. There is a significant regional disparity in long-acting contraceptive utilization. Compared to women residing in Tigray region, those who live in other regions (Afar-Somali, Oromia, Amhara, Benishangul Gumz-Gambela, and Southern Nations Nationalities and People) have low likelihood of using long-acting contraceptive methods. Conclusion. Utilization of long-acting family planning method is low in Ethiopia. There is a significant regional disparity in utilizing these methods. Policy makers should promote culture-sensitive and tailored interventions to improve the utilization of long-acting family planning methods.

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