scholarly journals Access, Quality of Family Planning Service, and Unmet Need: A Systematic Review

Author(s):  
Helmi Safitri ◽  
◽  
Kemal Nazarudin Siregar ◽  
2019 ◽  
Author(s):  
Olugbenga Oguntunde ◽  
Jabulani Nyenwa ◽  
Sikiratu Kilani-Ahmadu ◽  
Abdulsamad Salihu ◽  
Issa Yusuf

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


Author(s):  
Tamirat Tesfaye Dasa ◽  
Teshager Worku Kassie ◽  
Aklilu Abrham Roba ◽  
Elias Bekele Wakwoya ◽  
Henna Umer Kelel

Abstract Background Even though the modern contraceptive use was improved in Ethiopia, the utilization of long-acting family planning services is still low because of numerous factors. The aim of this systematic review was to synthesize logical evidence about factors associated with long acting family planning service utilization in Ethiopia. Methods The participants of the study were married women of reproductive age in Ethiopia. This search included all published and unpublished observational studies written in the English language conducted before April 30, 2018, in Ethiopia. Electronic and non-electronic sources were used. PubMed, MEDLINE (EBSCO), CINHAL (EBSCO), Embase (EBSCO), POPLINE and the search engines like Google, Google Scholar Mednar and world cat log were used. The overall selected search results were 15 studies. Each study was evaluated using the Joanna Briggs Institute Quality Assessment Tool for Observational Studies. Data synthesis and statistical analysis were conducted using ReviewManagerVersion5.3.5. Results Women’s inadequate knowledge level [OR, 0.29; 95% CI: 0.10, 0.83, P = 0.02], women’s age between 15 and 34 [OR, 0.82; 95% CI: 0.53, 0.93, P = 0.01], not having electronic media [OR, 0.65; 95% CI: 0.53, 0.79, P < 0.0001] and women from rural area [OR = 0.65;95% CI:0.50, 0.81, P = 0.0009] were less likely associated in the use of long-acting family planning services. The odds of utilizing long acting family planning methods were high among non-government- employed women and husband [OR, 1.77; 95% CI: 1.29, 2.43, P = 0.0004], [OR, 1.69; 95% CI: 1.33, 2.15, P < 0.0001] respectively. Having no previous exposure to any modern family planning method [OR = 2.29; 95%CI: 1.83, 2.86, P < 0.00001] and women having no discussion with husband [OR = 1.92 (95%CI: 1.50, 2.45) P < 0.00001] were more likely associated in the utilization of long-acting family planning services. Conclusion Lack of information and knowledge, having discussion with husband, being women of younger age, having less than five living children, being government-employed women and husband, not having electronic media, and being residents in rural area were significant barriers for underutilization of long acting family planning methods in Ethiopia. Hence, the investigators suggest that key stakeholders should design interventions strategies to avert attitudinal, cultural and informational barriers towards long-acting family planning methods. Systematic review registration PROSPERO: 2018: CRD42018096373.


2001 ◽  
Vol 33 (2) ◽  
pp. 161-172 ◽  
Author(s):  
MOHAMED M. ALI

Indicators of family planning service access and quality were generated using the Egypt DHS-I (1988) and the Egypt Service Availability Survey (1989), and linked to episodes of contraceptive pill use. Multilevel analysis was used to ascertain whether or not these access and quality indicators influence the continuation of pill use, net of women’s socioeconomic, demographic and motivational characteristics. A model with random components at the cluster and women levels was fitted for all reasons of discontinuation, except desire for pregnancy, at 24 months of use. Net of women’s background characteristics, the results show that facilities with smaller numbers of health personnel trained in family planning, a lack of access to facilities with female doctors and a lack of range of available methods are associated with a high risk of discontinuation of pill use for all reasons except desire for pregnancy.


2021 ◽  
pp. 1-33
Author(s):  
Srinivas Goli ◽  
K. S. James ◽  
Devender Singh ◽  
Venkatesh Srinivasan ◽  
Rakesh Mishra ◽  
...  

Abstract Investment in family planning (FP) provides returns through a lifetime. Global evidence shows that FP is the second-best buy in terms of return on investment after liberalizing trade. In this study, we estimate the cumulative benefits of FP investments for India from 1991 to 2016 and project them up to 2061 with four scenarios of fertility levels. The findings suggest that India will have greater elasticity of FP investments to lifetime economic returns compared to the world average (cost–revenue ratio of 1:120). We have taken four scenarios for the goalpost, viz., 2.1, 1.8, 1.6, and 1.4. Although different scenarios of total fertility rate (TFR) levels at the goalpost (i.e., the year 2061) offer varied lifetime returns from FP, scenario TFR < 1.8 will be counterproductive and will reduce the potential benefits. With a comprehensive approach, if the country focuses more on improving the quality of FP services and on reducing the unmet need for FP to enhance reproductive health care and expand maximum opportunities for education and employment for both women and men, it can improve its potential to reap more benefits.


Author(s):  
Ann K. Blanc ◽  
Katharine J. McCarthy ◽  
Charlotte Warren ◽  
Ashish Bajracharya ◽  
Benjamin Bellows

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

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


2015 ◽  
Vol 2015 ◽  
pp. 1-17 ◽  
Author(s):  
Jembere Gizachew Balew ◽  
Yongtae Cho ◽  
Clara Tammy Kim ◽  
Woorim Ko

Family planning coverage has improved in Ethiopia in the last decade, though fertility is still about 5.8 in the rural setup. In this paper, the major structural determinants of family planning service were analyzed using a multilevel model from 8906 individual women observation in the 2011 EDHS data. The results show that there is a big variation in family planning use both at the individual and between group levels. More than 39% of the variation in FP use is explained by contextual cluster level differences. Most of the socioeconomic predictors; respondent’s education, ethnicity, and partners’ education as well as employment status and urbanization were found to be significant factors that affect FP use. Similarly health extension visit and media access were found to be strong factors that affect FP service at both individual and cluster levels. This evidence concludes that addressing these contextual factors is very crucial to strengthen FP use and fertility reduction in the nation, beyond individual behavioral changes.


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