Barriers and determinants of postpartum family planning uptake among postpartum women in Western Ethiopia: a facility-based cross-sectional study

Background Despite Ethiopia’s efforts to avail postpartum family planning (PPFP) services, the unmet need for family planning among postpartum women remains high. Therefore, this study is aimed to assess barriers and determinants of postpartum family-planning uptake among women visiting Maternal, Neonatal, and Child Health (MNCH) services in public health facilities of western Ethiopia. Methods A facility-based cross-sectional study design with a quantitative method was conducted on 989 postpartum women in Western Ethiopia from September 1 to October 30, 2020. Data were collected through face-to-face interviews using pretested structured questionnaires, entered using EPI-INFO version 7.0, and analyzed by SPSS version 25. Descriptive analysis and logistic regressions were performed. The adjusted odds ratio with a 95% confidence interval was used and statistical significance was declared at P-value < 0.05. Result In this study, 56.1% of participants had used PPFP in the last year. The most commonly used method was injectable (51.7%). Family planning use before the index pregnancy (AOR = 2.09;95%CI:1.29,3,41),counselling on PPFP during antenatal care and delivery (AOR = 4.89;95%CI:2.31,10.37),health facility delivery (AOR = 7.61;95%CI:4.36,13.28), skilled birth attendance (AOR = 4.99;95%CI:2.88,8.64),COVID-19 restrictions (AOR = 0.59;95%CI:0.39,0.90) were factors associated with PPFP utilization. Being breastfeeding and amenorrhea were major reasons for not using postpartum family planning. Conclusion Post-partum family planning utilization among study participants was low. Given the associated factors, it is recommended that health facilities should make postpartum family planning one of their top priorities and focus on these factors to improve its utilization.

Individual and facility-level factors associated with women’s receipt of immediate postpartum family planning counseling in Ethiopia: results from national surveys of women and health facilities

Background Immediate postpartum family planning (IPPFP) helps prevent unintended and closely spaced pregnancies. Despite Ethiopia’s rising facility-based delivery rate and supportive IPPFP policies, the prevalence of postpartum contraceptive use remains low, with little known about disparities in access to IPPFP counseling. We sought to understand if women’s receipt of IPPFP counseling varied by individual and facility characteristics. Methods We used weighted linked household and facility data from the national Performance Monitoring for Action Ethiopia (PMA-Ethiopia) study. Altogether, 936 women 5–9 weeks postpartum who delivered at a government facility were matched to the nearest facility offering labor and delivery care, corresponding to the facility type in which each woman reported delivering (n = 224 facilities). We explored women’s receipt of IPPFP counseling and individual and facility-level characteristics utilizing descriptive statistics. The relationship between women’s receipt of IPPFP counseling and individual and facility factors were assessed through multivariate, multilevel models. Results Approximately one-quarter of postpartum women received IPPFP counseling (27%) and most women delivered government health centers (59%). Nearly all facilities provided IPPFP services (94%); most had short- and long-acting methods available (71 and 87%, respectively) and no recent stockouts (60%). Multivariate analyses revealed significant disparities in IPPFP counseling with lower odds of counseling among primiparous women, those who delivered vaginally, and women who did not receive delivery care from a doctor or health officer (all p < 0.05). Having never used contraception was marginally associated with lower odds of receiving IPPFP counseling (p < 0.10). IPPFP counseling did not differ by age, residence, method availability, or facility type, after adjusting for other individual and facility factors. Conclusion Despite relatively widespread availability of IPPFP services in Ethiopia, receipt of IPPFP counseling remains low. Our results highlight important gaps in IPPFP care, particularly among first-time mothers, women who have never used contraception, women who delivered vaginally, and those who did not receive delivery care from a doctor or health officer. As facility births continue to rise in Ethiopia, health systems and providers must ensure that equitable, high-quality IPPFP services are offered to all women.

Postpartum contraceptive practices among urban and peri-urban women in North India: a mixed-methods cohort study protocol

Background Postpartum family planning (PPFP) helps women space childbirths, increase exclusive breastfeeding and prevent unintended pregnancies, leading to reduction in maternal, infant and child morbidities and mortality. Unmet need of family planning is highest among women in the postpartum period due to lack of knowledge, cultural and religious barriers, access barriers and low antenatal care service utilization. However, in spite of low prevalence of postpartum family planning practices, birth-to-birth interval is reportedly high in Delhi, India. This study explores the postpartum contraception practices and the relationship between use of postpartum contraception and subsequent child linear growth. Methods This is a mixed method cohort study on PPFP and is nested within an ongoing “Women and Infants Integrated Interventions for Growth Study” (WINGS). Married women aged 18–30 years who have delivered a live baby are recruited for quantitative interviews at 6 weeks, 6, 12, and 24 months postpartum. In-depth interviews are conducted with a randomly selected sub-sample of women at each of the four time points, 35 husbands and 20 local service providers to understand their perspectives on PPFP practices. Discussion The findings from the study will provide useful insights into couples’ contraception preferences and choice of contraception, modern and traditional, initiation time and the effect of birth spacing and contraception use on subsequent linear growth of the child. This knowledge will be of significant public health relevance and will help in designing appropriate interventions for appropriate postpartum contraception use and delivery strategies. The study aims to work address the Sexual and Reproductive Health and Rights goal of promoting reproductive health, voluntary and safe sexual and reproductive choices for women. Trial registration Trial registration number: CTRI/2020/03/023954.

Use of Postpartum Family Planning among Women Undergoing Deliveries in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

Introduction: The postpartum period is a high-risk time for unintended pregnancies. A short inter-pregnancy interval leads to a series of complications for both the mother and the fetus. Postpartum contraceptive knowledge helps women decide the time frame for future pregnancy and prepare. The study aimed to find out the prevalence of postpartum family planning among women undergoing deliveries in a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted from hospital records of all postpartum women delivering in a tertiary care hospital from Jan 2017 to Jan 2019. Ethical approval was taken from the Institutional Review Committee (IRC) of Kathmandu University School of Medical Sciences/Dhulikhel Hospital (reference number: 62/19). Convenience sampling was done. Data was entered and analyzed using Statistical Package of the Social Sciences version 26. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 4205 deliveries, 1211 (28.7%) (27.33-30.06 at 95% Confidence Interval) women utilized postpartum family planning. Depot-medroxyprogesterone acetate was adopted by a majority of the participants 802 (19.1%). Conclusions: The use of postpartum contraception in this study was similar to the findings from studies done in national data and studies.

Utilization of Immediate Postpartum Long Acting Reversible Contraceptives among Women Who Gave Birth in Public Health Facilities in Eastern Ethiopia: A Cross-Sectional Study

Objective. Although importance of postpartum family planning is essential and immediate postpartum insertion of long acting and reversible contraceptives (LARC) is recommended, evidence on its uptake and associated factors is limited in Ethiopia. This study was conducted to assess utilization of immediate postpartum LARC among women who gave birth in selected public health facilities in eastern Ethiopia. Method. An institution-based cross-sectional study was conducted among randomly selected women who gave birth in selected public health facilities in eastern Ethiopia from 10 March to 09 April 2020. At discharge, all eligible women who gave birth in the facilities were interviewed using a pretested structured questionnaire. Data were entered using EpiData 3.1 and analyzed using SPSS 24. Bivariable and multivariable logistic regression analyses were conducted to identify factors associated with utilization of immediate postpartum LARC. Adjusted odds ratio (aOR) with 95% confidence interval was used to report association, and significance was declared at p value < 0.05. Results. From a total of 546 women invited to the study, 530 (97.1%) participated in the study and 98 (18.5%; 95% CI: 15.1%, 22.0%) reported starting long acting reversible contraceptives. Women who reported discussing about contraceptives with partners ( aOR = 6.69 , 95% CI: 3.54, 12.61) and receiving postpartum counselling on contraceptives ( aOR = 5.37 , 95% CI: 3.00, 9.63) were more likely to using contraception. However, women who live >30-minute walking distance from the nearest health facility ( aOR = 0.47 , 95% CI: 0.26, 0.85) and reported disrespect and abuse during childbirth ( aOR = 0.22 , 95% CI: 0.12, 0.40) were less likely to start LARC. Conclusions. Almost one in five women delivering in public health facilities in eastern Ethiopia started using LARC. Provision of respectful maternity care including counselling on the importance of immediate postpartum family planning is essential for increasing its uptake.

Prediksi Pencapaian Target Peserta Keluarga Berencana Pasca Persalinan Menggunakan Algoritma Backpropagation

Population growth in Indonesia continues to increase, so the government makes a program to control the rate of growth of the population, namely the Family Planning Program (KB). The implementation of family planning also has another objective, namely to reduce the risk of maternal death after childbirth. To measure the level of increasing target achievement of postpartum family planning participants. So that it can be a reference for the DPPKBP3A in carrying out the postpartum family planning program. Data from the Population Control, Family Planning, Women Empowerment and Child Protection (DPPKBP3A) District Lima Puluh Kota data processed in this study is data on the achievement of postpartum family planning participants from 2018 to 2020. Data processing uses the Backpropagation algorithm through several stages, namely the stage initialization, activation stage, weight training (weight change) and iteration stage. One of the results obtained from the calculation is the comparison of the target with the output gradient error in Suliki District in 2018, namely the target of 0.11311 and the result of the error gradient output is -0.1171. The prediction results obtained from this process become a reference for the Population Control, Family Planning and Women Empowerment and Child Protection Agency (DPPKBP3A) of District Lima Puluh Kota to implement the implementation of postpartum family planning programs to the community the following year.

Long-acting reversible contraception utilization and associated factors among women in extended postpartum period in southern Ethiopia

Background Postpartum long-acting reversible contraceptive is important to prevent unintended and closed spaced pregnancy following the first 12 months of childbirth. Few data were available on postpartum long-acting reversible contraceptive use in Ethiopia. So, this study aimed to assess the long-acting reversible contraception use and associated factors among women who gave birth in the last 12 months. Methods A community-based cross-sectional study was conducted from October 1st to November 2019. Systematic random sampling was applied to recruit a total of 416 study participants. Data were collected using a structured questionnaire. Data were entered using Epidata 4.6 and exported to SPSS version 25 for analysis. P-value < 0.05 with 95% confidence interval (CI) used to declare statistical significance. Result In this study, long acting contraceptive utilization among women in the extended postpartum period was 22.6%. Maternal age ≤ 24 years (AOR = 3.7, 95% CI: 1.5, 8.9), being married (AOR =3.5 95% CI: (1.17–10.28)), menses resumption (AOR = 4.9 95% CI: (2.92, 8.20)), sexual intercourse resumption (AOR = 7.1 95% CI: (4.03, 12.56)) and received postpartum family planning counseling (AOR = 3.2 95% (1.95, 5.28)) were the factors associated with Long-acting reversible contraception use. Conclusion This finding showed postpartum women’s long-acting reversible contraceptive use during the extended postpartum period was low. The factors significantly associated with extended postpartum modern contraceptive use were women’s age, being married, menses resumption, sexual intercourse resumption, and got postnatal family planning counseling. Strengthening Antenatal and postnatal counseling of postpartum family planning would improve long-acting reversible contraception use.

IDENTIFYING FACTORS ASSOCIATED WITH THE USE OF A SCALED-UP POSTPARTUM FAMILY PLANNING PROJECT IMPLEMENTED IN PUNJAB, PAKISTAN

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.

Prediksi Pencapaian Target Peserta Keluarga Berencana Pasca Persalinan menggunakan Algoritma Backpropagation

Population growth in Indonesia continues to increase, so the government makes a program to control the rate of growth of the population, namely the Family Planning Program (KB). The implementation of family planning also has another objective, namely to reduce the risk of maternal death after childbirth. To measure the level of increasing target achievement of postpartum family planning participants. So that it can be a reference for the DPPKBP3A in carrying out the postpartum family planning program. Data from the Population Control, Family Planning, Women Empowerment and Child Protection (DPPKBP3A) District Lima Puluh Kota data processed in this study is data on the achievement of postpartum family planning participants from 2018 to 2020. Data processing uses the Backpropagation algorithm through several stages, namely the stage initialization, activation stage, weight training (weight change) and iteration stage. One of the results obtained from the calculation is the comparison of the target with the output gradient error in Suliki District in 2018, namely the target of 0.11311 and the result of the error gradient output is -0.1171. The prediction results obtained from this process become a reference for the Population Control, Family Planning and Women Empowerment and Child Protection Agency (DPPKBP3A) of District Lima Puluh Kota to implement the implementation of postpartum family planning programs to the community the following year.

Uptakes and associated factors of postpartum family planning in southern Ethiopia: A cross-sectional study

Post-partum family planning aims to prevent unintended pregnancy within the first year postpartum. Closely spaced pregnancy within the first year of post-partum (PP) is associated with higher risk of preterm birth, low birth weight or small for gestational age. However, the perceived uptakes of postpartum contraceptives is very low. The intention of this study was determine uptakes and associated factors of postpartum family planning in southern Ethiopia. The study was conducted in Hawassa city administration which is the capital of SNNPR. Community based cross-sectional study was employed women who gave birth in the last 12 months before survey. Data was collected using structured questionnaire proceeding informed verbal consent. Logistic regression model was used to identify associations between variables and findings were presented by tables and figures. The prevalence of current post-partum contraceptive use was 85.1%. After adjusting for covariates; the odds of using postpartum contraceptive were 1.31 times, 12.13 times, 5.17 times, 10.77 time and 4.69 times higher among women with, knowledge about advantages and side effects of contraceptives, partner support for contraceptive use, previously contraceptive use and not returned period respectively with (P &#60;0. 05).uptakesofpostpartum contraceptives in Hawassa city administration was promising. Detailed counseling about postpartum contraceptive use, could assist equipping women with knowledge of family planning methods; empowering them to be decisive in the health and positivity of male partners are very crucial to promote postpartum use of contraceptives.