Pendidikan Kontrasepsi Pada Wanita Pasangan Usia Subur Sebagai Upaya Antisipasi Baby Bomming Di Masa Adaptasi Kebiasaan Baru Pasca Pandemi Covid-19 Di Wilayah Kecamatan Kuta Utara

The results of family planning services during the COVID-19 pandemic in national scale has decreasedin the number of contraceptive uses reaching 40% in almost all regions in Indonesia (BKKBN, 2020). This couldbe caused by various problems, including an increase in the number of unwanted pregnancies and baby booms orincrease of birth rate. This is due to the obstruction of access to services, delaying access to health facilities dueto fears of contracting COVID-19 and increasing of husband and wife sexual intercourse without usingcontraceptives that inducing pregnancy. Based on the results of Widiastuti's research in 2020, where a survey wasconducted to find out the description of family planning use during the pandemic in the North Kuta District, it wasfound that half of them (53.2%) of respondents were using contraceptives and almost half of them (46.8%) ofrespondents did not use contraception. One of the efforts to suppress the surge in baby births is through the FamilyPlanning program for couples of childbearing age. The aim of this community service is to provide knowledgeabout contraceptive tools and methods in suppressing the surge in baby births. The targets are women ofchildbearing age aged 15-45 years who have not used contraception or who use and do not make repeat visits asmany as 30 people. The implementation of the activity was carried out by assessing the level of understanding ofthe respondents by pre-testing through google forms, implementing counseling, family planning counseling andintroduction of contraceptives and evaluating the material by post-testing via google forms. The results of theactivity show that there is an increase in mother's knowledge about family planning tools and methods, which isexpected to influence the behavior of woman in using contraceptives so that they are expected to anticipate theoccurrence of baby boom.

Factors Associated with Uptake of Contraceptives Among HIV Positive Women on Dolutegravir Based Anti-Retroviral Treatment - A Crossectional Survey in Urban Uganda.

Background In May 2018, following the preliminary results of a study in Botswana that reported congenital anomalies in babies born to HIV-positive women taking dolutegravir drug, the WHO issued a teratogenicity alert. However, there are scarce data on the impact of this guidance on contraceptive uptake among women taking dolutegravir. We assessed the uptake of contraceptives in HIV-positive women of reproductive age on dolutegravir regimens. Methods We conducted a cross-sectional survey from April 2019 to July 2019 in five government health facilities in central Uganda, where dolutegravir-based regimens were offered as the preferred first-line antiretroviral treatment. We randomly selected 359 non-pregnant women aged 15-49 years taking dolutegravir-based regimens and interviewed them using semi-structured interviewer-administered questionnaires. We collected data on demographics, contraceptive use, individual, social, and health system factors. We described patients’ characteristics using descriptive statistics and assessed factors associated with contraceptive uptake using a modified Poisson regression model. Results A total of 359 women were included in the study. The mean age was 37 years (standard deviation=6.8) and overall contraceptive uptake was 38.4%. The most utilized method was injectable method at 58.4% followed by condoms (15%), intrauterine device (10.7%), pills (6.4%), implants (5.4%), and sterilization (0.7%) Predictors for contraceptive uptake were parity of 3-4 children (Adjusted Prevalence Ratio (APR) =1.48, 95% confidence interval (CI): 1.14, 1.92). There was reduced uptake in the age range of 40-49 years (APR=0.45, CI: 0.21-0.94), unemployed (APR: 0.6, CI: 0.42- 0.94), women not discussing family planning with their partner (APR=0.39, CI: 0.29-0.52) and not receiving family planning counseling (APR= 0.56, CI: 0.34-0.92). Conclusion We observed a low-level uptake of contraceptives, with injectables as the most used method. Family planning counseling and partner discussion on family planning were associated with contraceptive uptake among the women who used dolutegravir based regimens. There is a need for more strategies to integrate FP services and increase male involvement in HIV care programs.

Cross-sectional assessment of government health center needs to implement long-acting reversible contraception services in rural Rwanda

Background There is unmet need for family planning in Rwanda. We previously developed an evidence-based couples’ family planning counseling (C)FPC program in the capital city that combines: (1) fertility goal-based family planning counseling with a focus on long-acting reversible contraceptive (LARC) for couples wishing to delay pregnancy; (2) health center capacity building for provision of LARC methods, and (3) LARC promotion by community health workers (CHW) trained in community-based provision of oral and injectable contraception. From 2015 to 2016, this service was integrated into eight government health centers in Kigali, reaching 6072 clients and resulting in 5743 LARC insertions. Methods From May to July 2016, we conducted cross-sectional health center needs assessments in 30 rural health centers using surveys, key informant interviews, logbook extraction, and structured observations. The assessment focused on the infrastructure, materials, and human resources needed for LARC demand creation and provision. Results Few nurses had received training in LARC insertion [41% implant, 27% intrauterine device (IUD)]. All health centers reported working with CHW, but none trained in LARC promotion. Health centers had limited numbers of IUDs (median 10), implants (median 39), functional gynecological exam tables (median 2), and lamps for viewing the cervix (median 0). Many did not have backup power supplies (40%). Most health centers reported no funding partners for family planning assistance (60%). Per national guidelines, couples’ voluntary HIV counseling and testing (CVCT) was provided at the first antenatal visit at all clinics, reaching over 80% of pregnant women and their partners. However, only 10% of health centers had integrated family planning and HIV services. Conclusions To successfully implement (C)FPC and LARC services in rural health centers across Rwanda, material and human resource capacity for LARC provision will need to be greatly strengthened through equipment (gynecological exam tables, sterilization capacity, lamps, and backup power supplies), provider trainings and follow-up supervision, and new funding partnerships. Simultaneously, awareness of LARC methods will need to be increased among couples through education and promotion to ensure that demand and supply scale up together. The potential for integrating (C)FPC with ongoing CVCT in antenatal clinics is unique in Africa and should be pursued.

Assessing quality of family planning counseling and its determinants in Kenya: Analysis of health facility exit interviews

Background Available evidence suggests that provision of quality of care in family planning services is crucial to increasing uptake and continuation of use of contraception. Kenya achieved a modern contraceptive prevalence rate of 60% in 2018, surpassing its 2020 target of 58%. With the high prevalence, focus is geared towards improved quality of family planning services. The objective of this study is to examine the quality of family planning counseling and its associated factors in health facilities in Kenya. Methods We conducted a secondary analysis of the 2019 Kenya Performance Monitoring and Action, client exit data of women who had received family planning services. Quality of counseling was assessed using the Method Information Index Plus. We conducted a multivariable ordinal logistic regression analysis of data from 3,731 women to establish determinants of receiving quality family planning services. Results The Method Information Index Plus score for higher-quality counseling was 56.7%, lower-quality counseling 32.4%, and no counseling 10.9%. Women aged 15–24 years (aOR = 0.69, 95% CI = 0.56–0.86, p = 0.001) had lower odds of receiving better counseling compared to women aged 35 years and above. Those with no education (aOR = 0.52, 95% CI = 0.33–0.82, p = 0.005), primary (aOR = 0.56, 95% CI = 0.44–0.71, p<0.001) and secondary (aOR = 0.79, 95% CI = 0.65–0.98, p = 0.028) were less likely to receive better counseling compared to those with tertiary education. Women who received long acting and reversible contraception methods (aOR = 1.75, 95% CI = 1.42–2.17, p<0.001), and those who were method switchers (aOR = 1.24, 95% CI = 1.03–1.50, p = 0.027), had a higher likelihood of receiving better quality of counseling as compared to those on short-term methods and those who were continuers, respectively. Conclusion The quality of family planning counseling in Kenya is still sub-optimal considering that some women receive no form of counseling at service delivery point. There is need to review the existing FP guidelines and training packages to increase focus on the quality of counseling services offered by health providers. Social accountability strategies that empower women to demand quality services should be included in community-level family planning interventions.

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.

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

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.

Health facility capacity to provide postabortion care in Afghanistan: a cross-sectional study

Background Afghanistan has one of the highest burdens of maternal mortality in the world, estimated at 638 deaths per 100,000 live births in 2017. Infections, obstetric hemorrhage, and unsafe abortion are the three leading causes of maternal death. Contraceptive prevalence rate has fluctuated between 10 and 20% since 2006. The 2016 Afghanistan National Maternal and Newborn Health Quality of Care Assessment evaluated facility readiness to provide quality routine and emergency obstetric and newborn care, including postabortion care services. Methods Accessible public health facilities with at least five births per day (n = 77), a nationally representative sample of public health facilities with fewer than five births per day (n = 149), and 20 purposively selected private health facilities were assessed. Assessment components examining postabortion care included a facility inventory and record review tool to verify drug, supply, equipment, and facility record availability, and an interview tool to collect information on skilled birth attendants’ knowledge and perceptions. Results Most facilities had supplies, equipment, and drugs to manage postabortion care, including family planning counseling and services provision. At public facilities, 36% of skilled birth attendants asked to name essential actions to address abortion complications mentioned manual vacuum aspiration (23% at private facilities); fewer than one-quarter mentioned counseling. When asked what information should be given to postabortion clients, 73% described family planning counseling need (70% at private facilities). Nearly all high-volume public health facilities with an average of five or more births per day and less than 5% of low volume public health facilities with an average of 0–4 deliveries per day reported removal of retained products of conception in the past 3 months. Among the 77 high volume facilities assessed, 58 (75%) reported using misoprostol for removal of retained products of conception, 59 (77%) reported using manual vacuum aspiration, and 67 (87%) reported using dilation and curettage. Conclusions This study provides evidence that there is room for improvement in postabortion care services provision in Afghanistan health facilities including post abortion family planning. Access to high-quality postabortion care needs additional investments to improve providers’ knowledge and practice, availability of supplies and equipment.

Free Family Planning Counseling and Services in Labuh Baru Barat Pekanbaru

Indonesia is a country with a relatively high growth rate. The essence of the task of the Family Planning (KB) program is to reduce fertility in order to reduce the burden of development for the realization of happiness and prosperity for the people and nation of Indonesia. As a problem There are people who do not know about contraceptives and have not become family planning acceptors. This activity aims to provide knowledge about contraceptives and provide contraceptives for free. This activity aims to provide knowledge about contraceptives and provide contraceptives for free. The method of service is counseling and coaching residents of West Labuh Baru Village. The service was carried out in Labuh Baru Barat Village, Pekanbaru with 98 participants/samples in the activity. This activity is also in collaboration with midwives in the working area of the Payung Sekaki Health Center, Labuh Baru Barat Village. The tools and materials used in the activity are in the form of contraception as a free family planning service and counseling using the lecture method. The results of community service in Labuh Baru Barat Village are willing to become family planning acceptors according to their needs, and will repeat family planning if the family planning period has ended.

KNOWLEDGE ATTITUDE AAND PRACTICE OF MALE PARTNER REGARDING FAMILY PLANNING, EASTERN PROVINCE, SAUDI ARABIA

BACKGROUND: Family planning is the act of controlling birth numbers and intervals by using contraception or voluntary sterilization, the availability of a variety of female contraceptive methods led to an increase in family planning programs and researches that targets women. It is important to identify the perception of Saudi men, regarding the use of contraception methods and the effect of socio-demographic characteristics on this perception and to identify their requirements to encourage them to be involved in family planning. this study is aimed to address the knowledge, practice and attitude of Saudi men toward family planning. METHOD: A descriptive cross-sectional study in 2020 on 1610 respondents using a structured questionnaire distributed online. RESULT: Most of the respondents heard about the term of family planning (69.1%), and were able to recognize the most commonly used contraceptives however, the majority of our sample are not using contraception (56.3%). their attitude toward family planning was positive. Conclusion: Our sample population has a positive attitude toward family planning and they were willing to participate in family planning counseling and health care visit.

Method-specific beliefs and subsequent contraceptive method choice: Results from a longitudinal study in urban and rural Kenya

Introduction Evidence from sub-Saharan Africa, including Kenya, shows that negative beliefs about contraceptive methods are associated with non-use. However, little is known about the relationship between contraceptive beliefs and subsequent method choice. Methodology We used data from a two-year longitudinal survey of married women aged 15–39 years at enrollment from one urban site (Nairobi) and one rural site (Homa Bay) in Kenya. Analysis entails descriptive statistics and estimation of a conditional logit analysis to examine associations between method-specific beliefs and choice of injectables, implants or pills among women who were not using any method or were pregnant at baseline (round 1) but adopted these methods at 12-month follow-up (Nairobi, n = 221; Homa Bay n = 197). Results Beliefs about pills, injectables and implants among non-users were generally negative. With the partial exception of the pill in Nairobi, the majority thought that each method was likely to cause serious health problems, unpleasant side effects, menstrual disruption, and would be unsafe for long-term use. In both sites, satisfied past use of a method and the perception that a method is easy to use had a major influence on method choice. Concerns about menstrual disruption and safety for long-term use were unimportant in both sites. There were some marked differences between the two sites. Beliefs about long-term fertility impairment and perceived husband approval had strong influences on choice of injectables, implants or pills in the urban site but not in the rural site. Conclusion The relative importance of beliefs, some erroneous, in predisposing women to choose one method over another appears to be conditioned by the social context. There is need for family planning counseling programmes to pay attention to erroneous beliefs and misconceptions about contraceptives.