“Impact on Family Planning Services in Primary Healthcare Facilities in Rural Sindh – Secondary Data Analysis of Pre- and on-going COVID-19 Crisis Period”

The current COVID-19 pandemic has devastated the improvements in family planning services during the past years. This study assessed the impact of the global pandemic that compromised the provision of family planning services in primary healthcare facilities in Sindh – Pakistan. A retrospective data from District Health Information System (DHIS) before Covid-19 (January – February 2020) and during Covid-19 (March – June 2020) was extracted on the provision of family planning services in primary healthcare facilities in Sindh. The study was conducted to understand the impact of service provision through time-series trend analysis by comparing two health facilities i.e., BHUs and BHU plus facilities on monthly average visits (Jan-Feb average) and differences in percentage change over time on the uptake of short and long-acting family planning methods. The findings suggested that due to lockdown and restrictive mobility, the family planning services have fallen drastically in terms of clients visit the health facility from the onset of the COVID-19 outbreak in the month of March 2020 and remain stagnant till June 2020 as compare to before COVID-19 period. The overall analysis revealed the largest decay in the uptake of family planning methods specifically, pills with 31% and 26% during April 2020 in BHU and BHU plus facilities. On the contrary, uptake of Implants showed 25% and 23% decline in the month of June and May in BHU and BHU plus facilities respectively, compared to the average percentage of the pre-COVID Period. The COVID-19 pandemic has adversely affected the provision of family planning services and steeply decreased the uptake of Pills and Implants in primary healthcare facilities in Sindh. On the contrary, the disruption and decrease in services have provided an opportunity to undertake further research exploration to develop future strategies and policies to combat health challenging situations in such pandemics.

“Impact on Family Planning Services in Primary Healthcare Facilities in Rural Sindh – Secondary Data Analysis of Pre- and on-going COVID-19 Crisis Period”

The current COVID-19 pandemic has devastated the improvements in family planning services during the past years. This study assessed the impact of the global pandemic that compromised the provision of family planning services in primary healthcare facilities in Sindh – Pakistan. A retrospective data from District Health Information System (DHIS) before Covid-19 (January – February 2020) and during Covid-19 (March – June 2020) was extracted on the provision of family planning services in primary healthcare facilities in Sindh. The study was conducted to understand the impact of service provision through time-series trend analysis by comparing two health facilities i.e., BHUs and BHU plus facilities on monthly average visits (Jan-Feb average) and differences in percentage change over time on the uptake of short and long-acting family planning methods. The findings suggested that due to lockdown and restrictive mobility, the family planning services have fallen drastically in terms of clients visit the health facility from the onset of the COVID-19 outbreak in the month of March 2020 and remain stagnant till June 2020 as compare to before COVID-19 period. The overall analysis revealed the largest decay in the uptake of family planning methods specifically, pills with 31% and 26% during April 2020 in BHU and BHU plus facilities. On the contrary, uptake of Implants showed 25% and 23% decline in the month of June and May in BHU and BHU plus facilities respectively, compared to the average percentage of the pre-COVID Period. The COVID-19 pandemic has adversely affected the provision of family planning services and steeply decreased the uptake of Pills and Implants in primary healthcare facilities in Sindh. On the contrary, the disruption and decrease in services have provided an opportunity to undertake further research exploration to develop future strategies and policies to combat health challenging situations in such pandemics.

Knowledge, Attitude and Practice of Family Planning Among the Currently Married Women of Reproductive Age of Shivasatakshi Municipality Jhapa District, Nepal

This study examines the Knowledge, Attitude and Practice of Family Planning among the Currently Married Women of Reproductive Age (15-49 Years); a case study of Shivasatakshi Municipaity Jhapa district is based on primary data successfully collected from sample survey, covering 100 sample respondents` from 100 sample households. The main objective of the study is to fine out the knowledge, attitude and practice of family planning methods among currently married women of reproductive age group (15-49 years) and the specific objective of the study are to study the socio-economic and demographic determinants of currently use of family planning method and to identify the reason the reason for use and non-use of family planning. Out of 100 sample respondents 83 percent women are literate and 17 percent are illiterate. The major occupations of the respondents are agriculture and services. Among currently married women, 99 percent of respondents are found to be familiar with at least one family planning method. Out of total respondents, 91 percents are ever uses and 92 percent are currently using family planning methods. There is strongly positive relationship existed between use of family planning method and socio-economic and demographic variables like educational status of women and number pf living children. Easily accessible and no side effect are main reasons for using family planning method. Desire for and husband and family’s disagreement are most important reason for not using family planning method.

Missing men in family planning: understanding the socio-spatial differentials in male sterilization and male spacing methods of contraception in India

Male involvement in family planning results in improved reproductive health and gender outcomes for women. In India, the use of family planning methods remains largely female-dominated. Recent media reports have indicated a rapid decline in male sterilization use in the past few years. This study aimed to assess the trends in, patterns of and factors associated with the use of male sterilization and male spacing methods in India using data from four rounds of the National Family Health Survey, conducted from 1992 to 2016. Bivariate analysis was done to see the trends in, and patterns of, male sterilization and spacing methods, while multinomial logistic regression was used to understand the factors associated with male spacing methods and sterilization. The results show a marked decline in the prevalence of male sterilization from 1992–93 (3.5%) to 2015–16 (0.3%) in India. Of the 640 districts, only 21 had a more than 2% prevalence of male sterilization. Scheduled tribe couples were two times more likely to use male sterilization than other (upper/no caste) groups. Couples from the northern region were significantly more likely to use male sterilization (aOR: 1.68, 95% CI: 1.43–1.97) compared with those from the south. There was a regional disparity in male condom use, with a very small proportion of couples in the southern (1.1%), north-eastern (2.4%) and eastern (3.3%) regions using the method compared with couples from the northern region (9.7%). Couples from the northern (aOR: 8.89, 95% CI: 8.44–9.38), north-eastern (aOR: 11.37, 95% CI: 10.62–12.18), eastern (aOR: 6.96, 95% CI: 6.60–7.34), western (aOR: 4.65, 95% CI: 4.40–4.92) and central (aOR: 10.89, 95% CI: 10.35–11.46) regions were also significantly more likely to use male spacing methods than those from southern India. Therefore, a greater focus on increasing the use of male sterilization and condoms is required in India to reduce the gender disparity in the use of family planning methods.

Use and Acceptability of Birth Spacing Contraceptive Among Multiparae in Bangladesh

Background: Contraception is one of the critical components of reproductive health, enabling women to control their fertility according to their desires and circumstances. This study aimed to determine the prevalence and acceptability of contraceptives among sexually active multiparous women for birth spacing. Methods: This is a cross-sectional study among married women aged 15-40 years having at least one child from January to June 2013 in the Department of Obstetrics and Gynecology, ICMH (Institute of Child and Mother Health), Matuail, Dhaka. Findings: A total of 433 women participated in this study. A majority of the respondents were in the mid-thirty (73.9%) and housewives (94.7%). Almost half (49.0%) of the respondents had primary education. Surprisingly, close to half of the respondents married before 18 years (42.7%). Almost two-thirds (64.4%) of the respondents received oral contraceptive pills previously, followed by condoms (17.1%) and injectable contraception (14.5%). More than half (51.6%) of the participants were motivated by health workers to use a contraceptive method. In terms of reasons for using the family planning methods, convenience to use (38.1%), being safe (31.9%), and accessibility (23.1%) were the most common reasons. Whereas side effects (49.9%), shifting to other forms (43.9%), and wanting more children (6.2%) were the most common reason for changing family planning methods. The respondents mostly used the oral pill at any education level. However, injectable contraception was higher within higher education levels, and IUD was higher within the illiterate group.

Faktor Determinan Fertilitas Remaja di Provinsi Nusa Tenggara Timur

Introduction: Adolescent fertility caused various negative consequences starting from the occurrence of adolescent fertility include health, social and economic impacts. Purpose: to study the determinants of adolescent fertility in the Province of East Nusa Tenggara. Methods: This study uses secondary survey data in the 2017 IDHS. The sample was adolescents aged 15-19 years who were recorded as selected samples in East Nusa Tenggara Province as many as 401 adolescents. Analysis using multiple logistic regression with predictive factor model. Results: The highest aOR value is marital status 17.25 (95% CI 6.60-45.04). Education only finished elementary school aOR 4.94 (95%CI 1.08-22.45). Never accessed the internet aOR 3.37 (95%CI 0.85-13.37). For every 1 year increase in adolescent age, the odds increased by 3.32 (95% CI 1.71-6.46) or 19 years old had the highest odds. Didn’t work aOR 3.00 (95% CI 0.71-12.66). Living in rural areas aOR 2.55 (95%CI 0.53-12.13). Low knowledge of family planning methods has an AOR of 0.26 (0.05-1.22). Conclusion: The determinants of adolescent fertility in NTT Province are age, education, occupation, marital status, place of residence, internet use and knowledge of family planning methods.

FAMILY PLANNING KNOWLEDGE, ATTITUDE AND PRACTICE AMONG WOMEN OF REPRODUCTIVE AGE IN NIMULE PAYAM, SOUTH SUDAN

Purpose: The purpose of this study was to examine family planning Knowledge, Attitude and Practice (KAP) among women of reproductive age in Nimule Payam, South Sudan. Method: The study used a descriptive cross-sectional design and quantitative approach to explore family planning knowledge, attitude and practice among women of reproductive age in Nimule Payam. The study population consisted of 6,621 women of reproductive age in the Bomas of Anzara (1,930), Jalei(,1521), Olikwi (1,536) and Nimule Central (1,634). A sample size of 342 was determined from the population using the formulae of Leslie. Stratified simple random sampling was employed through a researcher administered structured questionnaire to collect data from the respondents. The data was cleaned, coded and analyzed using EPI-INFO version 7 to generate descriptive statistics and the results were presented in tables. Results: The study revealed that women of reproductive age in Nimule Payam had high 273 (79.82%) level of family planning knowledge, good 233 (68%) family planning practices and positive attitude towards family planning. The positive attitude towards family planning was because majority 270 (78.97%) believed family planning was safe to use, could not cause infertility 252 (73.82%), cancer 264 (76.93%) and future abortion 251 (73.36%). The respondents also generally agreed that 319 (93.07%) family planning could prevent unwanted pregnancy. However, the majority of the respondents acknowledged that the practice of family planning was against their God/Allah 268 (78.31%) and culture 229 (67.03%). Unique contribution to theory, practice and policy: The study found that women of reproductive age in Nimule Payam had a high level of family planning knowledge, a fairly positive attitude with a moderate number practicing family planning methods. Increased sensitization of the respondents and their partners on family planning is required to improve their attitude and practice. Future studies should focus on the factors influencing the Knowledge, Attitude and Practice of family planning methods among women of reproductive age in Nimule Payam.

To Evaluate Knowledge, Attitude, Practice of Natural Family Planning Method and Associated Factors among Reproductive Age Group of Women’s at Jimma Town, Jimma Zone, South West Ethiopia

Background: The high fertility rate leading to the rapid growth of country’s population is a major hindrance towards the development of a nation. Sub-Saharan Africa has the highest fertility rate in the world, which is further promoted by the low utilization of contraceptive methods. Yet, many communities claim to have natural methods of family planning that pre-date the introduction of modern contraceptives, implying that contraception is a culturally acceptable norm. Objective: To Evaluate the Knowledge, Attitude and Practice towards Natural family planning among reproductive age women of Jimma town, Oromia, Ethiopia. Methods: Across sectional community based quantitative study was done in Jimma town, among reproductive age group women from February to March; 2020. A total of3 99 sample size is calculated using single population proportion formula with a proportion (P) of 50 %.Systematic random sampling technique issued to draw the study participants among the target population. The data was collected using structured questionnaire adapted from similar and the tools modified to fit the local context. The collected data was tallied and analyzed by using scientific calculator. Results: From the total of 399 respondents who responded the questionnaire Majority, 90% of women in Jimma town had a good level of knowledge of natural family planning methods. A positive attitude towards natural family planning methods was seen in (68%) of the respondents. Conclusion: A fair level of knowledge of natural family planning methods is seen among reproductive women in Jimma town, yet differences in knowledge of specific natural family planning methods exist. Therefore, physicians and other health care providers‟ limited knowledge of and experience with Natural family planning methods inhibits broader use as reproductive age women reported getting information about NFFP methods from health providers and friends, therefore, their level of knowledge will depend largely on the information received.

DETERMINANTS OF UNMET NEED FOR FAMILY PLANNING METHODS AMONG MARRIED WOMEN OF REPRODUCTIVE AGE IN OMBADA LOCALITY, KHARTOUM STATE, SUDAN. 2019

Introduction:The unmet need for family planning reflects the gap between womens reproductive intentions and their contraceptive behavior. Its a useful indicator for tracking progress towards the target of achieving universal access to reproductive health. Aim:This study aimsat measuringthe level of unmet need for family planning in Ombada locality to identify the determinants that affectutilization of FP methodsand to assessthe readiness of the public health facilities to the provision of FP services. Methods:The study was a descriptive cross-sectional health facility and community-based studyusinga multistage sampling technique.The study collected data from married women of reproductive age (15-49 years)and from the public health facilities providingfamily planning services in the study area using structured questionnaire and checklist respectively. The data were analyzed using the Statistical Package for Social Sciences version20. Results:Currently users for family planning methods were (21.55%). The total unmet need for family planning was high and measured as (39.26%), while the total demand for family planning was (60.8%). Factors such as age, age at marriage, living children, knowledge about family planning methods and discussion with husband were found to be significantly related to the high total unmet need. Major reasons for the non-use of family planning methods were husband/family objection, fear of side effects and a lack of knowledge about family planning methods. Assessment of health facilities revealed poor infrastructure readiness. Conclusion: Women in the surveyed locality are still not empowered regarding their reproductive health choices, as they are still under the control of husbands and families concerning the use of contraceptive methods. In addition, the lack of counsellingcomponent, which was the weakest link in the provision of family planning services, lead to voluntary or un-voluntary avoid of using FP methods, or adopting unprofessional sources or methods as alternatives. Thus, policymakers and directorates managers have to carefully consider such findings when planning for FP interventions.

Utilization of Long Acting And Permanent Contraceptive Method and Associated Factor Among Women of Reproductive Age in West Guji Zone, Southern Ethiopia, 2018.

Background: Increasing access to family planning helps to ensure the reproductive right, decrease unintended pregnancy, improve the health and nutritional status of children, reduction of maternal mortality, and enhance longer birth spacing . There is continually low utilization of long-acting and permanent contraceptive methods among low and middle-income countries. The aim of this study was to assess the Utilization of Long-Acting and permanent Contraceptive methods and associated factors among Women of Reproductive Age in the West Guji Zone.Methods: Hospital-based cross-sectional design was conducted among women of reproductive age in the West Guji Zone. A systematic random sampling method was used to select study subjects for the survey with a sample size of 507. Descriptive analysis was utilized to summarize the data while logistic regression to assess factors influencing the utilization of Long-Acting and permanent Contraceptive methods use. Statistical significance was declared for variables outcomes of the P-value less than 0.05.Result: Current utilization of Long-Acting And permanent Contraceptive methods at West Guji zone among the reproductive-aged group was 51.1%. More than the median of participants had negative altitude (72.4%) and poor knowledge (57%) towards the long-acting and permanent contraceptive methods. Educational status of women, the number of alive children, acceptance of utilization of Long-Acting and permanent Contraceptive methods, how treated by other staff, and waiting time during service delivery are significant determinant factors of long-acting and permanent family planning methods. Conclusion: Educational status, number of alive children ( Parity) , acceptance of Long-Acting And permanent Contraceptive methods , how treated by other staff, and waiting time to get the service are statistically significant predictors of utilization of long-acting and permanent family planning methods. More than half of women had a negative attitude and poor knowledge of Long-Acting and permanent Contraceptive methods.