The Effect of Education Provided Through Online Flashcards During the Postpartum Period on Women's Perceived Barriers and Attitudes Toward Family Planning: An Experimental Four Solomon Group Design.

Postpartum education on contraceptive use is a routine component of discharge planning in many different countries with a wide variety of health care systems. This education is based on assumptions concerning women's receptivity to contraceptive education during the postpartum period and their presumed lack of access to such education after that time. The objective of this review is to assess the effects of education about contraceptive use to postpartum mothers. We searched the Cochrane Controlled Trials Register, MEDLINE, EMBASE, CINAHL, Psychlit, Popline, citations indexes and reference lists of relevant articles. We contacted subject experts to locate additional research, in addition to the Group's Specialised Register of Controlled Trials. Date of the most recent search: April 1999. Trials using random or quasi-random methods of allocation which evaluated the effectiveness of postpartum education about contraceptive use. Two independent reviewers abstracted data on trial characteristics and results. Three trials were identified with 5438 women. These trials were conducted in Lebanon, Peru and Nepal. None of the trials examined all major prespecified endpoints. Postpartum education about contraceptive use influenced short-term use assessed between 40 days and three months post-partum. Women in the intervention groups were less likely to be non-users than women in the comparison groups (Odds Ratio (OR) = 0.47, 95% Confidence Interval (CI) 0.39 to 0.58). This benefit was not apparent following analysis of data from better quality studies (OR = 0.67, 95% CI 0.41 to 1.13). An apparent benefit on contraceptive use at six months post-partum (OR = 0.52, 95% CI 0.37 to 0.74) was not apparent following sensitivity analyses (OR = 0.59, 95% CI 0.33 to 1.06). Data are inadequate to assess the impact on cessation of breast feeding and non-attendance at family planning clinics. Unplanned pregnancies, knowledge about contraception and satisfaction with care were not assessed in any trial. The effectiveness of postpartum education about contraceptive use has not yet been established in randomised controlled trials. Such education may be effective in increasing the short-term use of contraception. However, there are only limited data examining a more-important longer-term effect on the prevention of unplanned pregnancies. Research needs to be undertaken to assess the effectiveness of the minimalist education provided in more developed countries and the variety of programs provided in less developed regions. Such research should examine the content, timing, range and organisation of postpartum education on contraceptive use, as well as its impact on breast feeding rates.

Data on 661 married couples obtained from the 1988 Ghana Demographic and Health Survey were analyzed by multiple logistic regression to examine the attitudes and preferences of couples towards family size family limitation and contraceptive use as well as the degree of communication and discussion between husbands and wives. Both the husband and wife in 77% of couples shared like attitudes toward family planning. 73% of these couples approved of family planning. Yet 39% of the wives either did not know or misreported their husbands attitude. Even though 76% agreed that they wanted no more children only 44% reported the same responses on ideal family size. Only 35% of wives and 39% of husbands who knew at least one contraceptive method had talked to their spouse about family planning in the last 12 months. Wifes approval of family planning had a significant positive effect on current contraceptive use (relative risk [RR] = 11.75; p < 0.01) when the researcher controlled for background factors. While husbands approval did not have a significant effect (RR = 1.81). Significant independent variables of current contraceptive use included urban residence (RR = 1.53; p < 0.01) wifes attitude toward family planning (RR = 8.85; p < 0.01) and discussion of family planning between spouses (RR = 2.15-2.17; p < 0.01). These findings suggest that due to the considerable discrepancies between responses of wives and husbands one needs to interview both men and women to improve understanding of family planning decision making. They also indicate that the attitudes and preferences of the wife carry more weight in determining whether to adopt contraceptive than do those of the husband.

This AIDS supplement brings to the forefront the latest advances in family planning/HIV integration research programs and policy. It also offers insights into strategic directions for future investments in this area. Topics include: biomedical and basic science research on the relationship between reproductive health and HIV transmission and disease behavioral research examining contraceptive practices and fertility choices among women and couples affected by HIV implementation science evaluating integrated service delivery innovations and evidence-based recommendations for programming.

Background: Family planning is a crucial aspect of reproductive health that allows individuals to determine the number and timing of their children. The main reasons include the very low use of contraceptives (approximately 7% among married women aged 15–49, with only 1–2% using modern methods) and limited access to family planning services. Unintended pregnancies are a major contributor to maternal mortality, resulting from delayed or inadequate antenatal care, unsafe abortions, high-parity births, and short birth intervals. In Somalia, the gap between high levels of awareness and low rates of utilization of family planning, as well as the uncertainties regarding attitudinal and sociocultural determinants, is particularly noteworthy. Somali society follows strict norms based on religious beliefs and cultural values, which influence family decision-making and often limit women’s ability to plan their fertility or use family planning methods. Additionally, due to health policies such as the illegality of elective pregnancy termination, the country’s high fertility rate poses a serious public health concern. Studies have shown that the use of family planning methods remains low across East African countries, including Somalia. Understanding women’s attitudes toward family planning is essential to addressing this issue. This study aimed to examine the attitudes of married women in Mogadishu toward family planning and to identify the sociodemographic and obstetric factors associated with contraceptive use. Methods: This descriptive cross-sectional study was conducted among 286 married women aged 18–49 years who attended gynecological outpatient clinics in Mogadishu, Somalia. Data were collected through structured face-to-face interviews using a validated Family Planning Attitude Scale (FPAS). Data were analyzed using means, standard deviations, medians, frequencies, and percentages using the Statistical Package for the Social Sciences (SPSS) version 21.0. Results: The mean age of participants was 28.7 ± 5.57 years. Although 30.8% of women were aware of family planning methods, 82.2% did not use any form of contraception. Oral contraceptive pills were the most widely recognized method (14.3%), while implants were the most commonly used (4.5%). Women with no formal education had significantly more traditional views toward childbirth (p &lt; 0.05). Conclusions: The findings indicated low contraceptive utilization despite high awareness, with cultural and religious beliefs strongly influencing attitudes. Active participation in decision-making and increased knowledge of family planning were significantly associated with enhanced contraceptive use. These results highlight the need for targeted educational programs and policies that promote reproductive autonomy to improve family planning adoption in Mogadishu, Somalia. Achieving desirable women’s health outcomes requires improvements in national health service provision, strengthened efforts by non-governmental organizations (NGO), and the integration of these efforts into development goals.

Little is known about the contraceptive behavior and beliefs of Navy personnel. Nevertheless, the Navy, in its role as primary medical provider for its personnel, needs to know whether sailors have access to effective birth control and are sufficiently informed about contraception to make wise choices. As part of the Women Aboard Navy Ships Comprehensive Health and Readiness Project conducted at the Naval Health Research Center in San Diego, California, contraceptive use and attitudes toward family planning were assessed through a survey administered to 714 enlisted women and 665 enlisted men on 15 ships. Contraceptive use was not related to gender, age, marital status, pay grade, race, or education. More favorable family planning attitudes were related to contraceptive use. Women and men differed in their attitudes toward family planning, with women's responses more positive than men's. The results highlight the need for research focusing on the effect of attitudes on contraceptive behavior.

Background Postpartum contraceptive use is defined as the avoidance of short spaced pregnancies and unintended pregnancy through the first 12 months after delivery. In Ethiopia, different studies have been conducted to assess the prevalence of postpartum contraceptive use and associated factors. The findings of these studies were inconsistent and characterized by great variability. Therefore, the aim of this systematic review and meta-analysis was to estimate the pooled prevalence of postpartum contraceptive use and determinants in Ethiopia using the accessible studies. Methods The articles were identified through electronic search of reputable databases (MEDLINE through PubMed, EMBASE, HINARI, Science Direct, and Cochrane Library) and the hand search of reference listed in previous prevalence studies to retrieve more. 18 articles are included based on a comprehensive list of inclusion and exclusion criteria. Two authors independently extracted all necessary data using a standardized data extraction format. STATA 14 statistical software was used to analyze the data. The Cochrane Q and I2 test were used to assess the heterogeneity between the studies. A random effects model was calculated to estimate the pooled prevalence of postpartum contraceptive use. Moreover, the determinants for family planning use were reviewed. Results The pooled prevalence of family planning use among mothers during the postpartum period in Ethiopia was 48.11% (95% CI: 36.96, 59.27). Besides, subgroup analysis revealed that the highest family planning use prevalence among postpartum mothers was observed in Addis Ababa, 65.41 (95% CI: 48.71, 82.11). Resumed sexual activity: 7.91 (95% CI: 4.62, 13.55), antenatal care: 4.98 (95% CI: 2.34, 10.21), secondary school and above level of maternal education: 3.53 (95% CI: 1.67, 7.45), postnatal care: 3.16 (95% CI: 1.7, 5.88), menses resumption: 3.12 (95% CI: 1.52, 6.39), and ≥6 months of postpartum period: 2.78 (95% CI: 1.97, 3.93) have shown a positive association with the use of family planning among mothers in the postpartum epoch. Conclusions In this study, family planning use among mothers of the postpartum period in Ethiopia was significantly low compared to the existing global commendation on postpartum contraceptive use. Resumed sexual activity, antenatal care, secondary and above level of maternal education, postnatal care, menses resumption, and postpartum period ≥ 6 months were found to be significantly associated with postpartum contraceptive use.

BackgroundPrevious literature suggests that men reporting more gender-equitable attitudes are more likely to use condoms, but there is a paucity of data evaluating whether these attitudes are associated with contraceptive communication and use. The objective of this study is to test the hypothesis that men reporting more gender-equitable attitudes will be more likely to (a) engage in contraceptive communication with their wives and (b) that they and/or their wives will be more likely to use all forms of family planning, compared to men with less equitable attitudes. MethodsUsing cross-sectional dyadic survey data from young married couples from rural Maharashtra, India (N = 989), we assessed the associations between men's gender role attitudes and a) spousal contraceptive communication and b) contraceptive use by type (none, traditional, condoms, pills, or IUD). The contraceptive use outcome is based on wives' report. We assessed these associations via bivariate t-test (communication outcome) or ANOVA test (contraceptive type outcome), as well as unadjusted and adjusted logistic (communication outcome) and multinomial logistic (contraceptive type outcome) regression models. Adjusted models included sociodemographic factors selected a priori based on established associations with gender-equitable attitudes and/or our assessed outcomes. FindingsMen with more gender-equitable attitudes were more likely to discuss family planning with their wives (AOR = 1·05, 95%CI 1·03-1·07, p < 0·001) and to use condoms (ARRR = 1·03, 95%CI 1·00-1·06, p = 0·07). There was no association between gender-equitable attitudes and use of other types of contraception. InterpretationWhile gender-equitable attitudes among men may facilitate condom use and family planning communication in marriage, they do not appear to be linked with greater likelihood of use of more effective types of contraceptive use. This suggests that males supportive of gender equity may take greater responsibility for family planning vis a vis a less effective contraceptive, condoms, in the absence of more effective short-acting contraceptives for men. FundingThe National Institutes of Health [Grant number 5R01HD084453-01A1] and the Bill & Melinda Gates Foundation, Seattle, WA [grant number INV-002967].

BackgroundGlobally 1 in 7 women aren’t using family planning as a result, larger numbers of women get pregnant within 7–9 months of childbirth. The aim of this study was to estimate the time to initiate postpartum modern contraceptive use and predictors among women of reproductive age group within the first 12 months of delivery in Della Town, Southern, Ethiopia.MethodsA retrospective cohort study from March 25, 2019, to March 25, 2020, was conducted in Dilla town. A Systematic sampling technique was used to select 594 study participants. A Cox proportional hazards model was used to determine factors associated with time to initiate postpartum modern contraceptive use at 95% CI with a P-value of < 0.05.ResultsA total of 576 postpartum women were participated making a response rate of 96.9%. The median time to initiate postpartum modern contraceptive use was 7 months (IQR: 6, 8). Education [AHR = 3.01 (95% CI = 1.32, 6.83)], knowledge on family planning [AHR = 1.56(95% CI = 1.20, 2.02)], and family planning counseling during postnatal care [AHR = 2.22 (95% CI = 1.46, 3.38)] were predictors positively associated with time to initiate postpartum modern contraceptive.ConclusionsThe time to initiate postpartum modern contraceptive use was delayed longer than compared to the World Health Organization recommendation. Education level of women, knowledge of family planning, and family planning counseling during postnatal care were some predictors positively associated with time to initiate postpartum modern contraceptive use.

Effective contraception benefits both mothers and children by decreasing morbidity and mortality, improving the social and economic status of women, and improving the relationship of the mother with all her children. The main aim of the study was to determine contraceptive choices and use among postnatal women in Mwense, Mwansabobwe and Nchelenge districts of Luapula province. The study population comprised 92 randomly selected women attending family planning clinics. Findings revealed that 51% of the respondents were aged between 25 and 34 years, 75% were married, 63% were multiparas and had attained primary level of education (43%). Most respondents (79.3%) were not in formal employment, 52% had been using a family planning method for a period between one to three years and their main source of information on family planning were health care providers (71%). Two thirds (62%) of the respondents were using injectable contraceptive methods. When asked to state the contraceptive method they knew other than the one they were using, 75% mentioned injectable contraceptive and were aware of the benefits of family planning (87%). The respondents mentioned the following as side effects of family planning methods in general heavy bleeding (13%), irregular bleeding (25%), abdominal cramps (60%) and infertility (2%). With regards to the benefits of family planning, 87% knew the benefits of family planning and 83% of the family planning providers were nurses. 82% of the women reported that they received adequate information from the family planning provider on the contraceptives they were using and 92% were satisfied with the services rendered by health care providers, 74% of the respondents reason for the choice of contraceptives was safety of the contraceptive method and their main source of influence were their husbands (34%). Most women (79%) were willing to switch to other methods of contraceptives if the one they were using was not available and were willing to continue using family planning method (87%). To improve service delivery and client satisfaction among postnatal women, there is need for continued sensitization and provision of method specific information on family planning methods to the women to enable them to make informed contraceptive choices. Health facilities should be equipped with all family planning methods and logistics. There is also need to undertake further research to determine why injectable method of contraceptive is the most preferred among women in the current study.

Background: The use of contraception is one of the benchmarks for the success of family planning programs. The COVID-19 pandemic has had an impact on people to limit activities outside the home. The appeal from the government also has an impact on the possibility of hampering access to family planning services. The delay in family planning services will lead to a decrease in the use of contraception will ultimately have an impact on the uncontrolled birth rate (Baby Boom). The purpose of this study was to see how the use of contraception in couples of childbearing age during the COVID-19 pandemic. Methods: This study is a literature review related to the use of EFA contraceptives during the COVID-19 pandemic through the Google Scholar database, PubMed, government publication data. Results: Contraceptive use among new family planning participants decreased in general as well as among MKJP participants in the NTB area. The prevalence of contraceptive use in Indonesia has increased but has not yet reached the national target of 61.8%. In the DIY region, there was a decrease in contraceptive use among active family planning participants, as well as a decrease in the use of pill and injectable contraception. The research conducted in the Kalimantan region found that most women of childbearing age used the contraceptive method with the highest dropout rate, namely the pill. The number of unmet need for family planning in the NTB area has decreased, but the drop out rate for family planning in the early days of the COVID-19 pandemi has increased. Conclusion: The use of contraception during the COVID-19 pandemi in several regions in Indonesia is still fluctuating, but has a tendency to decrease.

There is wide variation of family planning services use among ethnic groups in Nepal. Despite three decades of implementation the need for family planning services is substantially unmet (25%), and there have been no systematic studies evaluating the i

BackgroundContraception use remains low in Ethiopia, particularly within the first year after childbirth. While some women might have medical conditions that limit their contraceptive options, the primary obstacle to wider family planning adoption is not a specific health problem. Instead, it is the lack of equitable access to high-quality family planning services. This barrier significantly hinders women's ability to make informed decisions about their reproductive health. This study examines postpartum family planning utilization and its associated factors among postpartum mothers in the Bule Hora District.MethodsWe conducted a community-based cross-sectional study. A multistage sampling technique was employed to recruit a total of 630 women who had given birth. To collect the data, structured, standardized, and pretested questionnaires were used, and the collected data were coded and entered into Epi-data version 4.6. The data were analyzed using SPSS version 25. Both bivariable and multivariable logistic regressions were used to identify factors associated with postpartum family planning utilization.ResultsThe study found that 71.3% of women utilized postpartum family planning. Significant associations were found between postpartum family planning utilization and various factors, including counseling on family planning during pregnancy [adjusted odds ratio (AOR) = 1.79, 95% confidence interval (CI) 1.61–2.82], delivery (AOR = 2.62, 95% CI 1.56–4.38), and the postpartum period (AOR = 2.71, 95% CI 1.75–4.21). Women who resumed sexual activity after birth (AOR = 1.92, 95% CI 1.25–2.96), and who had at least four antenatal care visits (AOR = 3.09, 95% CI 1.61–5.92) were also more likely to use postpartum family planning. Women with grand multiparity were 69% less likely to use family planning methods than primiparous women (AOR = 0.31, 95% CI 0.13–0.73).ConclusionPostpartum family planning use in this study was higher than the national average. Factors such as parity; counseling during the pregnancy, delivery, and postpartum periods; and early resumption of sexual activity were linked to increased contraceptive use. These findings suggest that enhanced counseling during antenatal, delivery, and postnatal care could significantly increase contraceptive use.

ObjectivesThis study examines the relationship between integrated, person-centered maternity care (PCMC), the provision of postpartum family planning (PPFP) services, and postpartum contraceptive use among women delivering at health facilities in Ethiopia. Study designWe analyze 2019–2021 longitudinal data from a representative sample of pregnant and recently postpartum women in Ethiopia. This study examines baseline, 6-week, and 6-month survey data collected from women who delivered at a health facility. ResultsMaternity patients who reported more person-centered care were more likely to be counseled on postpartum contraceptive methods before discharge. Overall, 27.5% of women delivering in a health facility received family planning counseling before discharge, ranging from 15.2% in the lowest PCMC quintile to 36.3% in the highest PCMC quintile. The receipt of PPFP counseling was associated with increased odds of postpartum contraceptive use. ConclusionsFindings suggest dimensions of quality care are interlinked, and person-centered care is associated with greater integration of recommended PPFP services into predischarge procedures. However, even among women who report relatively high levels of person-centered care, our results highlight that family planning is not routinely discussed prior to discharge from delivery, and very few women receive a contraceptive method or referral prior to discharge. ImplicationsWhile most postpartum women report they wish to limit or space future pregnancies, the uptake of modern contraceptive methods in the postpartum period is low. As women increasingly opt to deliver in health facilities, further integration of family planning services into predischarge procedures within maternity care can improve contraceptive access. Data statementThe data used in these analyses were collected as part of the PMA Ethiopia study. Data are publicly available at https://www.pmadata.org/data/request-access-datasets.

BackgroundMaternal health (MH) services provide an invaluable opportunity to inform and educate women about family planning (FP). It is expected that this would enable women to choose an appropriate method...

BackgroundThough modern contraceptive use among married women in Nepal has increased from 26% in 1996 to 43% in 2016, it remains low among postpartum women. Integration of counselling on family planning (FP) at the time of antenatal care (ANC) and delivery has the potential to increase post-partum contraceptive use. This study investigates the quality of FP counselling services provided during ANC visits and women’s perceptions of its effectiveness in assisting them to make a post-partum family planning (PPFP) decision.MethodsIn-depth interviews (IDIs) were conducted with 24 pregnant women who had attended at least two ANC visits in one of the six public hospitals that had received an intervention that sought to integrate FP counselling in maternity care services and introduce postpartum intrauterine device insertion in the immediate postpartum period. IDIs data were collected as part of a process evaluation of this intervention. Women were selected using maximum variation sampling to represent different socio-demographic characteristics. IDIs were audio recorded, transcribed verbatim in Nepali, and translated into English. Data were organized using Bruce-Jain quality of care framework and analyzed thematically.ResultsOverall, the quality of FP counselling during ANC was unsatisfactory based on patient expectations and experience of interactions with providers, as well as FP methods offered. Despite their interest, most women reported that they did not receive thorough information about FP, and about a third of them said that they did not receive any counselling services on PPFP. Reasons for dissatisfaction with counselling services included very crowded environment, short time with the provider, non-availability of provider, long waiting times, limited number of days for ANC services, and lack of comprehensive FP-related information, education and counselling (IEC) materials. Women visiting hospitals with a dedicated FP counselor reported higher quality of FP counselling.ConclusionsThere is an urgent need to re-visit the format of counselling on PPFP during ANC visits, corresponding IEC materials, counselling setting, and to strengthen availability and interaction with providers in order to improve quality, experience and satisfaction with FP counselling during ANC visits. Improvements in infrastructure and human resources are also needed to adequately meet women’s needs.