scholarly journals Women Do Not Utilise Family Planning According to Their Needs in Southern Malawi: A Cross-Sectional Survey

Author(s):  
Maria Lisa Odland ◽  
Oda Vallner ◽  
Marlen Toch-Marquardt ◽  
Elisabeth Darj

Malawi is a low-income country with a high maternal mortality rate. This study aimed to investigate the use of contraception and factors associated with unmet need of family planning among fertile women in selected health facilities in southern Malawi. A cross-sectional study design was employed using a validated questionnaire to investigate the unmet need. A total of 419 pregnant women, who attended antenatal clinics at a central hospital and two district hospitals, voluntarily participated in the study. Logistic regression analysis was used to identify possible factors associated with unmet needs. Amongst the participants, 15.1% reported unmet need, 27.0% had never used a contraceptive method, and 27.2% had an unwanted pregnancy. Being married, 20–24 years of age, living in a rural area, and high parity were protective factors against having unmet need regarding family planning. Malawi, a country with a young population and a high fertility rate, has a high level of unmet family planning need. Barriers and facilitators need to be identified and addressed at different levels by the health care system, society, and the government of Malawi.

2021 ◽  
Vol 21 (2) ◽  
pp. 466-474
Author(s):  
Aniza Ismail ◽  
Mariam Ashraf ◽  
Idayu Badilla Idris ◽  
Inayat Thaver ◽  
Ahsan Maqbool Ahmad ◽  
...  

Pakistan has one of the highest unmet needs for family planning among low and middle-income countries. Postpartum family planning (PPFP) is considered to have the potential of significantly improving the contraceptive prevalence rate and reducing the unmet need for family planning. Jhpiego (John Hopkins Affiliate) implemented a PPFP pilot project in the district headquarter hospital of Mandi Bahauddin.  The key interventions of the Jhpiego pilot were to improve services pertinent to PPFP. Based on the successes of the pilot, the interventions were scaled up to other health facilities. The present study aims to identify the factors associated with the utilization of the postpartum family planning health project implemented in the health facilities once the scale-up activities ended and comparing it with the pilot facility. A cross-sectional survey with a sample of 410 women using postpartum care services in the facilities was conducted using a structured questionnaire. The findings indicated that the complete set of interventions were not present in the facilities.  Postpartum family planning method uptake was low (26%) along with the shortage of contraceptives supplies. Multivariate logistic regression was conducted to identify the predictors for the current use of postpartum family planning. The predictors identified that women with the age of 25 years and above with 3 or more children, who attended antenatal care visits and were counselled on PPFP were more likely to adopt/use PPFP in the postpartum period. The findings indicated scale-up was limited and the interventions were not sustained once the donor support ended. 


2018 ◽  
Vol 51 (4) ◽  
pp. 505-519
Author(s):  
Aparna Jain ◽  
Hussein Ismail ◽  
Elizabeth Tobey ◽  
Annabel Erulkar

AbstractNearly 33 million female youths have an unmet need for voluntary family planning (FP), meaning they are sexually active and do not want to become pregnant. In Ethiopia, age at marriage remains low: 40% and 14% of young women aged 20–24 were married by the ages of 18 and 15, respectively. Despite increases in FP use by married 15- to 24-year-olds from 5% in 2000 to 37% in 2016, unmet need remains high at 19%. Supply-and-demand factors have been shown to limit FP use, yet little is known about how stigma influences FP use among youth. This study validates an anticipated stigma (expectation of discrimination from others) index and explores its effect on unmet need. A cross-sectional survey was implemented with 15- to 24-year-old female youth in Ethiopia in 2016. The analytic sample included married respondents with a demand (met and unmet need) for FP (n=371). A five-item anticipated stigma index (Cronbach’sα=0.66) was developed using principal component factor analysis. These items related to fear, worry and embarrassment when accessing FP. The findings showed that 30% agreed with at least one anticipated stigma question; 44% had an unmet need; 58% were married before age 18; and 100% could name an FP method and knew where to obtain FP. In multivariate regression models, youth who experienced anticipated stigma were significantly more likely to have an unmet need, and those who lived close to a youth-friendly service (YFS) site were significantly less likely to have an unmet need. Interventions should address anticipated stigma while focusing on social norms that restrict married youth from accessing FP; unmet need may be mitigated in the presence of a YFS; and the anticipated stigma index appears valid and reliable but should be tested in other countries and among different adolescent groups.


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Abebe Tadesse G/Meskel ◽  
Habtamu Oljira Desta ◽  
Elias Teferi Bala

Background. It is estimated that more than 142 million married women in developing countries have an unmet need for family planning. This study is aimed at identifying factors associated with the unmet need of family planning among married women of reproductive age in Toke Kutaye district, Ethiopia in 2019. Methods. A community-based cross-sectional study was conducted in Toke Kutaye district from March 1–30, 2019. A systematic random sampling technique was used to select 494 reproductive-age women who were married during data collection. Data were collected using a pretested structured questionnaire. Bivariate and multivariate logistic regression analyses were used to assess factors associated with the unmet need of family planning at 95% CI with a p value of ≤ 0.05. Result. The prevalence of unmet need for family planning in the Toke Kutaye district was 23.1% [95% CI (19.2-26.7)], with 15.2% for spacing and 7.9% for limiting. Women’s education [AOR, 3.64, 95% CI: 1.43-9.25], number of living children [AOR, 2.63, 95% CI: 1.37-5.05], husband disapproval of family planning [AOR, 3.68, 95% CI: 2.20-6.16], and discussion with healthcare providers on family planning [AOR, 0.20, 95% CI: 0.13-0.37] were significantly associated with unmet need for family planning. Conclusion. The prevalence of unmet need for family planning was high. Therefore, program managers, partners, and health workers should work to address the gaps in maternal education, the number of living children, partner disapproval of family planning, and discussion on family planning issues through enhancing female education, awareness on family planning, and male involvement in family planning services.


2014 ◽  
Vol 9 (4) ◽  
pp. 307-316 ◽  
Author(s):  
Melonie M. Walcott ◽  
John Ehiri ◽  
Mirjam C. Kempf ◽  
Ellen Funkhouser ◽  
Marion Bakhoya ◽  
...  

The objective of this study was to identify the association between gender norms and family planning practices among men in Western Jamaica. A cross-sectional survey of 549 men aged 19 to 54 years attending or visiting four government-operated hospitals was conducted in 2011. Logistic regression models were used to identify factors associated with taking steps to prevent unwanted pregnancy, intention to have a large family size (three or more children), and fathering children with multiple women. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were calculated from the models. Reduced odds for taking steps to prevent unwanted pregnancy among men with moderate (AOR = 0.5; 95% CI = 0.3-0.8) and high (AOR = 0.3; 95% CI = 0.1-0.6) support for inequitable gender norms was observed. Desiring large family size was associated with moderate (AOR = 2.0; 95% CI = 1.3-2.5) and high (AOR = 2.6; 95% CI = 1.5-4.3) support for macho scores. For men with two or more children (41%), there were increased odds of fathering children with multiple women among those who had moderate (AOR = 2.1; 95% CI = 1.0-4.4) and high (AOR = 2.4; 95% CI = 1.1-5.6) support for masculinity norms. Support for inequitable gender norms was associated with reduced odds of taking steps to prevent unwanted pregnancy, while support for masculinity norms was associated with desiring a large family size and fathering children with multiple women. These findings highlight the importance of including men and gender norms in family planning programs in Jamaica.


2020 ◽  
Author(s):  
Joseph Batholomeo Massenga ◽  
Ritha Norohna ◽  
Bayoum Awadhi ◽  
Dunstan Bishanga ◽  
Oliva Safari ◽  
...  

Abstract BackgroundIn Tanzania, 27.1% of all women of reproductive age are currently using modern contraception, and 16.8% have an unmet need for family planning. We therefore examined factors associated with family planning uptake after giving birth in two regions of Tanzania.MethodsSub-analysis of a cross-sectional household survey conducted in April 2016 in Mara and Kagera regions in Tanzania. A total of 1184 women aged 15-49 years, who had given birth less than two years prior to the survey were included. Logistic regression mixed effect modelling was used to examine factors associated with family planning uptake. Univariate analysis was used to present crude effects of covariates, followed by stepwise forward selection to build a multiple logistic regression model. A p-value ≥ 0.20 was applied as the criterion to retain a variable into the model.ResultsAmong 1184 women within two years after giving birth, 393 (33.2%) used family planning methods. After adjusting for (1) age, (2) level of education, (3) living in union, (4) being accompanied to ANC by a partner and (5) being able to mention at least one method, factors independently associated with family planning uptake included: (1) having discussed family planning with the partner (aOR 2.90; 95% CI 1.88-4.49), (2) having been counselled on family planning during ANC (aOR 2.15; 95% CI 1.48-3.13), (3) having discussed family planning with a community health worker (aOR 3.32; 95% CI 1.91-5.77), (4) having discussed family planning with a facility health care worker (aOR 1.79; 95% CI 1.22-2.62), (5) having primary or higher educational level (aOR 1.66; 95% CI 1.01-2.273) and (6) being in union (aOR 1.86; 95% CI 1.02-3.42).ConclusionSupportive constitutes including educational interaction with facility and community health workers, as well as having a supportive partner are facilitators to increased uptake of family planning among women in Tanzania


2017 ◽  
Vol 4 (2) ◽  
pp. 30-42
Author(s):  
Ghanshyam K Bhatta ◽  
Josue Orellana ◽  
Bidya Mahat ◽  
Ishwar Nath Mishra ◽  
Chandeshwari Tamrakar ◽  
...  

Background: Family Planning (FP) is a key developmental focus for the government of Nepal. Use of modern contraceptives has stagnated at 43.2% since 2011. Unmet need for family planning (FP) in Nepal remains high at 27%. A factor contributing to this levelling of contraceptive use despite relatively high unmet need is the limited range of methods available to most clients at most sites. To address the FP need among married women of reproductive age (WRA), we tested integration of FP into agricultural programs.   Aim: To assess the effectiveness of a FP program integrated into an agriculture (e.g. non-health) sector program. Methods: A cross-sectional interventional study conducted November 2015 to February 2016 among 525 WRA who were participants in an agriculture program. Results: The contraceptives commonly used by women in the study location were Depo Provera and Minilap.  After Technical Integration Coverage and Access (TICA) interventions, almost all of the respondents (99.6%) had heard about FP of which 67.8% correctly understood FP as a method to prevent unwanted pregnancy. About 50% of the respondents were found currently using FP.  The percentage of WRA aware of long-acting and permanent FP methods increased from 49.0% to 62.0% and 39.0% to 52.0% respectively. Decisions on using a FP method were predominantly made by the husband (68.0%). However, 68.4% women reported that they were motivated by their husband. The proportion of men willing to use FP increased from 5.2% to 15.5% after TICA activities implementation. The main reason identified for not currently using FP devices was that the husband and wife were not living together (88.8%). Most of the women (98.0%) reported that FP utilization improved their quality of life. Conclusion: TICA activities were very successful in both increasing FP knowledge level as well as utilization of FP services among the targeted beneficiaries. The use of FP increased among agriculture program beneficiaries after the integration of TICA activities with a gradual shift from short-acting FP methods to long-acting and permanent FP methods. For easy integration, FP projects should also utilize existing community structures such as cooperatives, women’s groups, men’s groups, and youth clubs.


Author(s):  
Sudha V. ◽  
Vrushabhendra H. N. ◽  
Srikanth S. ◽  
Suganya E.

Background: Providing universal family planning services is an important strategy to reduce maternal morbidity and to control population growth. Worldwide, when contraception is used properly and effectively to avoid unwanted pregnancy it can reduce 25–35% of maternal deaths. The present study aimed at measuring the proportion of married women with unmet need for family planning in an urban area of Puducherry.Methods: A cross sectional study was conducted among 235 married women in the urban field practice area of Sri Venkateshwara Medical College Hospital & Research Centre, Puducherry. Participants were selected based on predetermined eligibility criteria using systematic random sampling method. SPSS version 23.0 was used for statistical analysis. Proportion, Mean, Standard deviation and Logistic regression were applied to interpret the results.Results: Mean age of the participants was 33.3 ±6 years, Nearly 77 %( 181) of the participants reported having used any method of contraceptive at least once and 34.5 %( 81) were found to have unmet need for family planning. The most common reason for unmet need for contraception was fear of side effects (39.5%) and others were infrequent sex (12.3%),insisted by family members (12.3%) and religious reasons (12.3%).Conclusions: Unmet need for family planning was found to be fairly high in our study population. Health care personnel, preferably field staff should be trained to give an informed choice of contraception to the eligible couples to reduce the unmet need for contraception.


2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Atem Bethel Ajong ◽  
Philip Nana Njotang ◽  
Martin Ndinakie Yakum ◽  
Marie José Essi ◽  
Felix Essiben ◽  
...  

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anthony Wemakor ◽  
Humphrey Garti ◽  
Nawaf Saeed ◽  
Obed Asumadu ◽  
Bede Anyoka

Abstract Background Unmet need for contraception contributes to the burden of unwanted pregnancies, which are correlated with a host of adverse maternal and child outcomes. The aim of this study was to determine the prevalence and identify the determinants of unmet need for contraception in North Gonja District, Ghana. Methods A cross-sectional survey involving 386 randomly selected women of childbearing age was conducted in North Gonja district, Ghana, with the use of a questionnaire in household interviews. Women were classified as having unmet need for contraception if they were fecund, sexually active and wished to postpone the next birth or halt childbearing completely but were not using any form of contraception. Chi-square/Fisher’s exact test and logistic regression analysis were used to identify the determinants of unmet need. Results The mean age of the study population was 26.1 (±8.4) years and awareness on contraception was almost universal in the district (95.9%). The overall prevalence of unmet need for contraception was 38.9%, with 27.5% having unmet need for limiting and 12.2% unmet need for spacing. In multivariate analysis, compared to women aged 25–29 years, those aged 20–24 years [Adjusted Odds Ratio (AOR) 0.26; 95% Confidence Interval (CI) 0.11–0.58] and 30 years and above (AOR 0.25; 95% CI 0.09–0.73) were less likely to have unmet need for contraception. However, uneducated women (AOR 5.06; 95% CI 1.07–24.01) compared with those educated to tertiary level; those unaware of family planning (AOR 3.93; 95% CI 1.12–13.80) compared to those aware; and those who had not previously practised contraception (AOR 1.81; 95% CI 1.09–3.00) compared to those who did were more likely to have unmet need. Conclusions The present study found high prevalence of both awareness on and unmet need for contraception among the study population. Unmet need for contraception is associated with age, educational status, awareness on family planning and previous contraception practice. Educational campaigns to promote contraception should prioritize women of middle age and low educational status. Further studies are needed to understand the low correlation between awareness on and unmet need for contraception.


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