Abstract
BackgroundNorthern Uganda was severely affected by two decades of civil war that led to the displacement and encampment of an estimated 1.6 million inhabitants. The objective of this study was to assess community perspectives, attitude and factors that influence use of family planning (FP) services in post conflict Gulu district.MethodsWe conducted a cross sectional study using multistage sampling technique. All three counties in the district were purposely selected. Two sub-counties per county and four parishes per sub-county were randomly selected. A total of 24 parishes (clusters) and 21 adult heads of households per cluster were randomly selected and interviewed. In total, 500 adults 117 males (23.4 %) and 383 females (76.6 %) were interviewed. We conducted 8 focus group discussions and 6 key informant interviews with family planning managers and service providers. Quantitative data were entered in EPI data and analyzed using STATA version 12. Qualitative data were analyzed manually using thematic content analysis.ResultsContraceptive prevalence rate was 47.5 %. Communities perceive FP as acceptable, beneficial and geographically, temporally and financially accessible. Factors associated with FP use included age 26–35 years (AOR 1.92, 95 % CI 1.18-3.10, p = 0.008), and 36–45 years (AOR 2.27, 95 % CI 1.21-4.25, p = 0.010), rural residence (AOR = 0.41, 95 % CI 0.24-0.71, p = 0.001), cohabitation (AOR = 2.77, 95 % CI 1.15-6.65, p = 0.023), and being a farmer (AOR 0.59, 95 % CI 0.35-0.97, p = 0.037). The main reason for non-use of family planning was fear of side effects 88.2 %. The main source of FP services was government health facilities 94.2 %.ConclusionUse of family planning is relatively high and communities view FP services as acceptable, beneficial and accessible. Family planning use is mainly determined by age, residence, occupation and marital status. Fear of side effects is the main impediment to FP use. There is need to increase awareness and effectively manage side effects of family planning in the settings.
Highlights
Northern Uganda was severely affected by two decades of civil war that led to the displacement and encampment of an estimated 1.6 million inhabitants
The objective of the study was to examine community perceptions, attitude and factors associated with the utilization of family planning services in post conflict Gulu district, northern Uganda
Our finding revealed a higher use of family planning services than the national average of 42 % [16]
Summary
Northern Uganda was severely affected by two decades of civil war that led to the displacement and encampment of an estimated 1.6 million inhabitants. During 1986–2006, northern Uganda experienced an intractable civil war that led to the displacement of an estimated 1.6 million (90 %) of the inhabitants into Internally Displaced Persons (IDP) Camps [1]. The total unmet need for family planning in the northern region, among married women was 46 % compared with 41 % nationally. There was high rate of abortions and unwanted pregnancies. One in every five pregnant women in northern Uganda had had an abortion, while 50 % of pregnancies were unwanted [2]. The protracted civil war presented several challenges to the delivery of health services including family planning in the settings [5]
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