Immediate Postpartum Modern Family Planning Utilization and Associated factors among women gave birth public Health facilities, Addis Ababa, Ethiopia

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Predictors and Barriers to Post Abortion Family Planning Uptake in Hai District, Northern Tanzania: A Mixed Methods Study

Introduction: Post Abortion Care (PAC) encompassing family planning counselling and contraception provision is a key strategy to reducing maternal morbidity and mortality especially in countries with restrictive abortion laws. Various factors affect the uptake of PAC modern family Planning (FP) in different settings. This study aimed at determining the prevalence, assessment of factors and barriers to PAC modern FP uptake in Hai district, Northern Tanzania Methods: A mixed-methods study was conducted using an explanatory sequential design. Exit interviews using questionnaires was conducted among 189 women. In-depth interviews were conducted with 26 healthcare providers (HCPs) and 28 women who received PAC in Hai district hospital, Machame hospital and Moshi Specialists health centre in Hai district. Quantitative data was analysed using a Statistical Package for Social Science (IMB SPSS Statistics for Windows version 20.0 (SPSS Inc., Chicago, Ill., USA)). Bivariate and multivariable analyses were applied to estimate the predictors of uptake of PAC modern FP. Thematic content analysis was employed to explore barriers to uptake of post-abortion modern family planning. Results: The prevalence of uptake of modern family planning following PAC was 59/189(31.2%). 56% of the 189 women who received PAC did not receive counselling services on family planning. Marital status and partner’s support were predictors of PAC modern family planning uptake (p=.007 vs. p= <.05, respectively). Misinformation and misconception about modern contraceptives, lack of knowledge and fear of side effects were reported to be the major barriers to uptake of post-abortion family planning. Most women reported to have not received comprehensive family planning information from the HCPs. On the other hand, HCPs perceived their poor counselling skills as the barrier to post-abortion family planning uptake. This study observed poor coordination of PAC services within each visited facility and this was linked to women leaving the facility without family planning counselling and/or contraceptives provision. Conclusion: Suboptimal modern family planning counselling during PAC contributes to the low uptake of contraceptives methods in this setting. Strategies are needed to improve PAC modern family planning services uptake. Strategies such as; provision of counselling skills to HCPs with comprehensive information targeting local contextual misconception and promoting PAC provision as a one-stop service.

Effect of pregnancy tests on demand for family planning: evidence from a randomized controlled trial in Uganda

Background Unmet need for family planning and unintended pregnancies are high in developing countries. Home pregnancy tests help women determine their pregnancy status earlier and the confirmation of a negative pregnancy status can facilitate the adoption of family planning. This study provides the first experimental evidence of the effect of access to pregnancy tests on women’s demand for modern family planning. Methods A randomized controlled trial was conducted among 810 women of reproductive age in northern Uganda. During a baseline survey, women were randomly allocated to either: (1) an offer to take a hCG urine pregnancy test during the survey (on-the-spot pregnancy test) (N = 170), (2) an offer of a home pregnancy test kit to be used at any time in the future (future-use pregnancy test) (N = 163), (3) offers of both on-the-spot and future-use pregnancy tests (N = 153), or (4) a control group (N = 324). Future-use pregnancy tests were offered either for free, or randomly assigned prices. Approximately 4 weeks after the baseline survey, a follow-up survey was conducted; modern contraception methods were made available at no charge at local community outreach centers. Results When offered a free, on-the-spot pregnancy test, 62 percent of women accepted (N = 200). Almost all, 97 percent (N = 69), of women offered a free future-use pregnancy test strip, accepted it. Purchases of future-use pregnancy tests declined with price. The offer of either on-the-spot, future-use tests, or both, have no overall large or statistically significant effects on the take-up of modern family planning. Conclusion Demand for pregnancy tests is high and access to pregnancy tests has the potential to facilitate the demand for family planning. At the same time, more research is needed to understand underlying beliefs about pregnancy status and risk that guide behaviors ultimately important for maternal and neonatal health. Trial registration The study was pre-registered in July 2018 for AEA RCT registry (AEARCTR-0003187) and clinicaltrials.gov (NCT03975933). Registered 05 June 2019, https://clinicaltrials.gov/ct2/show/record/NCT03975933

Factors Associated with Non-Use of modern Contraceptives among sexually active women in Ethiopia: A multi-level mixed effect analysis

Background: Appropriate contraceptive use prevents unintended pregnancy, protects the health of mother and child, and promotes women's well-being. Use of modern Family planning in Ethiopia was still very low. The purpose of this study was to assess the factors that are associated with non-use of modern family planning services among women of reproductive age. Method: A nationally representative 2016 EDHS women data were used for analysis. Descriptive and multilevel multivariable binary logistic regression models were used to summarize descriptive data and measure statistical association between the dependent and the individual and community level variable, respectively. Adjusted odds ratio and confidence interval were respectively used to measure association and its statistical significance. Result: Among women in the reproductive age group 79.49% did not use a modern contraceptive method. Of this, 65.9 %, were from rural areas. Women age between 25-34 years (AOR=0.54, 95% CI: 0.5-0.61) and age between 34-49 year (AOR=0.62, 95% CI: 0.55-0.71), Women with a primary level of education (AOR=0.8, 95% CI: 0.68-0.87), husband’s education level was secondary and above were 0.83(AOR = 0.83, 95% CI: 0.72-0.96), middle income women (AOR=0.66, 95% CI: 0.58-0.76) , rich women (AOR=0.74,95%CI:0.65-0.85), women delivered at the health facility were lower by 0.84 (AOR = 0.84, 95%CI: 0.73-0.0.98), watched family planning related information from TV (AOR=0.74, 95% CI: 0.65-0.85) had 1-2 and 3 or more children in the previous five years (AOR = 0.21, 95% CI: 0.19-0.23) and (AOR = 0.4, 95% CI: 0.28-0.56), respectively, are individual-level factors that are less likely to not use contraception were identified. Furthermore, Muslim women (AOR=1.4, 95% CI: 1.23-1.62), women living in rural area (AOR=3.43; 95% CI: 2.72-4.32), and ANC visit 1.3(1.07-1.5) were more likely to not use contraception. Further, Women in Afar, Somali, Gambela, Harari, and Dire Dawa were less likely to use modern contraception methods than women in Tigray, but Amhara region had a lower rate of non-use. Conclusion: Family planning interventions should target younger women, women living in rural areas, the poor, and Muslim women. Moreover, initiatives to empower women associated to family planning programs would be beneficial in increasing contraceptive uptake among sexually active women in Ethiopia.

Adoption and Utilization of Family Planning Services among Couples in Rural-Urban Communities in Oyo State, Nigeria

Modern Contraceptive Use Among Couples Has Been Documented To Be A Highly Effective Means Of Improving Maternal Health By Preventing Unintended Pregnancies And Maternal Morbidity. Nigeria Has A High Fertility Rate And Poor Contraceptive Usage, Marred By Social And Economic Dimensions With Other Cultural Norms, Including Gender Disparity. This Paper Presents The Findings Of A Cross-Sectional Quantitative Study Exploring The Adoption And Utilization Of Family Planning Services Among Couples In Rural-Urban Communities In Oyo State, Nigeria. Systematic Sampling Technique Was Used To Select 570 Women And Men Of Reproductive Age In Rural-Urban Communities Of The Oyo State, Using A 54 Semi-Structured Questionnaire Which Included Questions On Socio-Demographic Characteristics, Perception, Socio-Cultural Factors, Adoption, And Utilization Of Modern Contraceptive Services. Of The 570 Respondents, The Mean Age Of The Respondents Was 30.3 ±7.8 Years. Most (63.3%) Of Respondents Were Females, While 36.7% Were Males. The Most Common Family Planning Methods Respondents And Their Spouses Had Heard Injectable (21.2%), The Male Condom (18.6%), And Implants (15.1%), IUD (13.4%), And Pills (13.2%). Spousal Support Is 0.438 Times More Likely To Influence Utilization Of Modern Family Planning Method And Was Statistically Significant (Β=-0.826, Odd Ratio [OR]=0.438, P<0.05). Similarly, Stigmatization Is 1.298 Times More Likely To Influence The Level Of Utilization Of Modern Family Planning Methods (Β=0.261, Odd Ratio [OR]=1.298, P<0.05). It Is Important For Government And Family Planning Programmers To Focus On Programs That Address Stigmatization And Effective Spousal Communication For Improved Modern Contraceptive Uptake.

Quality of Family Planning Care as Enabling Factor for Modern Contraceptive Use in Indonesia: Evidence from PMA2020 Survey

BackgroundThe utilization of modern family planning methods is a key pointer that mirrors universal access to reproductive health cares. Fulfilling unmet needs for modern contraceptives may decrease the level of maternal mortality by almost a third. This research employed the 2016 PMA2020 survey to assess multilevel variables related to modern family planning method use among women of reproductive age in Indonesia. MethodData from interviews of female and Service Delivery Point (SDP) of the 2016 Performance Monitoring and Accountability 2020 (PMA2020) survey were linked to generate a merged dataset comprising women’s individual, cluster and SDP factors (N=10,210). Multilevel analysis was done to assess the influence of contextual factors including a summary index of SDP quality FP care on woman’s modern family planning practice. Adjusted odds ratios and 95% CIs were analysed and interpreted.ResultsModern contraceptive prevalence among women of childbearing age was 42.3% in 2016. There was a considerable variation in the likelihood of modern method use across the 372 clusters/EAs. Age, education, marital status, parity, residency, region, woman’s FP decision autonomy, cluster’s average ideal number of children, percentage of females dissatisfied with FP, and percent of females visited by CHVs were significant factors for modern FP use after adjusting for multilevel characteristics. Quality of FP care was revealed to be a significant enabling factor for modern contraceptive use in Indonesia. ConclusionsModern contraceptive prevalence among females aged 15-49 years was relatively low in 2016. The findings indicate that an advancement in modern method use can be gained by improving quality of family planning care. Likewise, an enhancement in women’s FP decision autonomy and their level of education, decline in women’s ideal number of children and diminution of the dissatisfaction with family planning are all major concerns to be addressed. Family planning policies must tackle adverse cultural norms and inequities in quality of family planning care and women’s education that would produce welfares to women, children, and communities.

Immediate Postpartum Modern Family Planning Utilization and Associated factors among women gave birth public Health facilities, Addis Ababa, Ethiopia

Introduction: The first 48 hours after a woman has given birth is a crucial period for taking the immediate postpartum contraceptive to prevent unintended pregnancy. However many women do not realize that the time to initiate contraceptive. The postpartum period is a critical period for addressing widespread unmet needs in family planning and for reducing the risks of closely spaced pregnancies.Objective: The aim of this study was to determine immediate postpartum modern family planning utilization and associated factors among women attending delivery at Public Health Facilities in Addis Ababa.Methods: A facility based cross-sectional study design was conducted from November to December, 2019. A systematic random sampling technique was used to select the study participants. Data were entered into Epi-data version 4.6.0.0 and analyzed with STATA version 14. Data were mainly analyzed using descriptive statistic and binary logistic regression. For the qualitative study purposive sampling technique was employed, and 7 participants were interviewed. Open coded thematic content analysis was used.Result: Of the total of 586 participants, 12.97 % with 95% CI: (10.1, 15.5) mothers were used immediate postpartum contraceptive methods, of which implant was the most frequently used method. Current knowledge of IPPFP (AOR=1.79, 95% CI: (1.02, 3.24)), Attitude towards IPPFP (AOR=1.73, 95% CI: (1.05, 2.85)) and counseled at delivery room (AOR=5.85, 95% CI: (2.57, 13.14)) were associated factors for utilizing contraceptive in the immediate postpartum period.Conclusion: Utilization of immediate postpartum modern family planning was low as compared to previous study done. This study identified that factors associated with utilization of immediate postpartum modern family planning were:- mothers’ knowledge, attitude towards postpartum modern family planning and had been counseled at delivery room were identified factors may increases likelihood of immediate postpartum family planning utilization. Therefore, these factors should be emphatically considered during antenatal care and post-partum care program development and training to improve contraceptive utilize during immediate postpartum period.