Abstract
BackgroundAlthough the majority of postpartum women indicate a desire to delay a next birth, family planning (FP) methods are often not offered to, or taken up by, women in the first year postpartum. This study uses data from urban Senegal to examine exposure to FP information and services at the time of delivery and at child immunization appointments and to determine if these points of integration are associated with greater use of postpartum FP.MethodsA representative, household sample of women, ages 15–49, was surveyed from six cities in Senegal in 2011. This study focuses on women who were within two years postpartum (n = 1879). We also include women who were surveyed through exit interviews after a visit to a high volume health facility in the same six cities; clients included were visiting the health facility for delivery, post-abortion care, postnatal care, and child immunization services (n = 794). Descriptive analyses are presented to examine exposure to FP services among postpartum women and women visiting the health facility. Logistic regression models are used to estimate the effect of integrated services on postpartum FP use in the household sample of women. Analyses were conducted using Stata version 12.ResultsAmong exit interview clients, knowledge of integrated services is high but only a few reported receiving FP services. A majority of the women who did not receive FP services indicated an interest in receiving such information and services.Among the household sample of women up to two-years postpartum, those who received FP information at the time of delivery are more likely to be using modern FP postpartum than their counterparts who also delivered in a facility but did not receive such information. Exposure to FP services at an immunization visit was not significantly related to postpartum FP use. Another key finding is that women with greater self-efficacy are more likely to use a modern FP method.ConclusionThis study’s findings lend strong support for the need to improve integration of FP services into maternal, newborn, and child health services with the goal of increasing postpartum women’s use of FP methods in urban Senegal.
Highlights
The majority of postpartum women indicate a desire to delay a birth, family planning (FP) methods are often not offered to, or taken up by, women in the first year postpartum
This study aims to assess the role of integrated maternal and child health (MCH)/FP services on use of postpartum family planning by: 1) examining women’s exposure to FP information and services at the time of delivery and at child immunization appointments, and 2) determining if these points of integration are associated with greater use of postpartum FP
The women in union who have never had a child in urban Senegal are the least likely to use a modern method of FP (3.5%)
Summary
The majority of postpartum women indicate a desire to delay a birth, family planning (FP) methods are often not offered to, or taken up by, women in the first year postpartum. The high rate of unintended pregnancy is said to be driving population growth, especially in sub-Saharan Africa where approximately one-half of all pregnancies are reported to be unintended, that is they came too soon or were unwanted [1] These pregnancies can be prevented with increased access to effective family planning (FP) methods. Research and interventions focus on improving access to FP services especially in the developing world where it is estimated that 222 million women are sexually active, want to delay or avoid a birth, and are not using modern FP (i.e., they have an unmet need for FP) [2]. This period is critical for two reasons: a) postpartum women have a high need for FP, and b) these women have multiple contacts with the health facility either for postnatal or child immunization visits
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