Access To Contraception Research Articles

Family planning service availability and readiness assessment of primary health care facilities in Delta State, Nigeria: a mixed methods survey

BackgroundThe availability of contraceptives, family planning guidelines, and Information, Education, and Communication (IEC) materials can increase access to family planning services. This study assessed the availability of commodities and readiness of primary health care (PHC) facilities in Delta State to offer family planning services.MethodsA cross-sectional design with an explanatory mixed-method approach was used i.e., the authors first collected the quantitative data, and after preliminary analysis of quantitative information, the qualitative approach was utilised to gather data on the perspectives of 32 PHC facility managers and 6 reproductive health supervisors on factors affecting family planning service availability and readiness.ResultsTwenty-one (65.6%) of the PHC facilities surveyed offered at least five modern methods of family planning. Stock-outs of emergency contraceptives, implants, intra-uterine contraceptive device (IUCD), oral contraceptive pills (OCP), condoms, and injectables were observed in 31 (96.9%), 17 (53.1%), 13 (40.6%), 4 (12.5%), 2 (6.3%), and 1 (3.1%) of the facilities respectively. Eleven (34.4%) and 8 (25.0%) of the facilities had IEC materials and family planning guidelines, and contraceptive commodity checklists respectively. Seventeen (53.1%) of the facilities did not have complete records of family planning activities.ConclusionThis study shows that a significant proportion of PHC facilities had stock-outs of contraceptive commodities, no complete records of contraceptive activities, no IEC materials and no family planning checklists. Continuous training of health providers and increased government commitment can help to improve contraceptive services.

Shortcomings and disparities in contraception counseling and use by hypertensive individuals at risk for unintended pregnancy: a comparative analysis of the National Survey of Family Growth

BackgroundHypertension is a leading cause of adverse pregnancy outcomes. These outcomes disproportionately affect Black individuals. Reproductive life planning that includes patient-centered contraception counseling could mitigate the impact of unintended pregnancy. ObjectiveThe primary objective of the study is to compare contraception counseling and use among hypertensive and non-hypertensive individuals at risk for unintended pregnancy. Our secondary objectives are 1) to evaluate the effect of race on the probability of counseling and the use of contraception and 2) to evaluate the methods used by individuals with hypertension. MethodsData from the 2015-2017 and 2017-2019 National Survey of Family Growth Female Respondent Files were used to analyze whether individuals who reported being informed of having high blood pressure within the prior 12 months received counseling about contraception or received a contraceptive method. Covariates considered in the analysis included age, race, parity, educational attainment, body mass index, smoking, diabetes, and experience with social determinants of health (SDH). The SDH covariate was based on reported experiences within five SDH domains: food security, housing stability, financial security, transportation access, and childcare needs. Linear probability models were employed to estimate the adjusted probability of receiving counseling and the use of a contraceptive. Using difference in difference analyses, we compared the change in counseling and use between hypertensive and non-hypertensive respondents by race, relative to White respondents. ResultsOf the 8,625 subjects analyzed, 771 (9%) were hypertensive. Contraception counseling was received by 26.2% (95%CI 20.4-31.9) of hypertensive individuals and 20.7% (95%CI 19.3-22.2) of non-hypertensive individuals. Contraception use was reported by 39.8% (95% CI 33.2-46.5) of hypertensive and 35.3% (95%CI 33.3-37.2) of non-hypertensive individuals. The linear probability model adjusting for age, parity, education attainment, body mass index, smoking, diabetes and SDH indicated that hypertensive individuals were 8 percentage points (95%CI 3, 18 percentage points). more likely to receive counseling and 9 percentage points (95%CI 3, 16 percentage points) more likely to receive contraception. Hypertensive Black individuals did not receive more counseling or use more contraceptives compared to non-hypertensive Black women. The lack of difference in counseling when hypertension is present is 13 percent less than the change we observed for White respondents when hypertension was present (p=0.01). The most frequently used contraceptive method among hypertensive individuals was combined oral contraceptive pills (COCs) [54.0% (95%CI 44.3-63.5%)]. ConclusionsDespite a higher likelihood of receiving contraception counseling and using contraception among hypertensive individuals at risk for unintended pregnancy, two-thirds of this population did not receive contraception counseling, and less than 40% used any contraceptive method. Furthermore, unlike for White individuals, Black individuals with hypertension did not receive more contraception care than non-hypertensive Black individuals. Of all those who used contraception, half relied on a method classified as Center for Disease Control Medical Eligibility Criteria Category 3. These findings highlight a substantial unmet need for safe and accessible contraception options for hypertensive individuals at risk for unintended pregnancy, emphasizing the importance of targeted interventions to improve contraceptive care and counseling in this population.

Building an implementation framework to address unmet contraceptive care needs in a carceral setting: a systematic review

BackgroundThe provision of contraceptive care for incarcerated individuals has been largely inconsistent and has contributed to, at best, inadequate care, and at worst reproductive abuses, violence, and coercion. While previous research has identified strategies to remedy known issues, to date, very few recommendations have been implemented across the carceral system. To address this, we conducted a systematic review of policy and practice recommendations to improve contraceptive care to reproductive-aged, incarcerated individuals in the United States.MethodsWe conducted this systematic review utilizing the Joanna Briggs Institute methodology and framed it within the National Implementation Research Network’s (NIRN) Exploration stage. We searched PubMed, PSYCInfo, SCOPUS, ProQuest, Web of Science, MedLine, Social Science Citation Index and reference sections of included materials. Basic study information, explicitly stated policy and practice recommendations, and discussions and conclusions that subtly provide recommendations were extracted in full text. We utilized a thematic analysis approach to analyze the extracted text.ResultsA total of 45 materials met the inclusion criteria. Seven overarching themes were identified: 1) policy changes needed to implement care; 2) need for contraceptive care in carceral systems; 3) justice agency barriers regarding contraceptive care provision; 4) policy barriers to contraceptive access; 5) funding strategies to improve care; 6) patient preferences for contraceptive care delivery; and 7) healthcare provider knowledge regarding contraceptive care. The seven themes identified shed light on the need for, gaps, barriers, and facilitators of current contraceptive care provision to incarcerated individuals.ConclusionThis systematic review accomplished two goals of NIRN’s Exploration stage. First, the compiled evidence identified a clear need for change regarding policies and practices pertaining to contraceptive care provision to incarcerated individuals in the United States. Second, our findings identified several evidence-based solutions supported both by research and professional healthcare organizations to address the identified need for change. This study provides an initial blueprint for correctional agencies to implement the necessary changes for improving contraceptive care provision to incarcerated populations. The correctional system is in a unique position to deliver much-needed care, which would result in many potential benefits to the individuals, correctional system, and community at large.

Access to on-campus contraception on college and university campuses in North Carolina

Background and ObjectiveUnintended pregnancies occur more frequently in college students and negatively affect health outcomes and educational attainment. This study examined access to on-campus contraceptives at all 4-year colleges and universities in North Carolina (NC). MethodsThis institutional review board-exempt study evaluated availability of on-campus contraceptives including condoms; hormonal contraceptives including pills, patches, and vaginal rings; medroxyprogesterone injections; implants; intrauterine devices; and emergency contraception via website review. Institutions were stratified by characteristics including size, location, type (e.g., public, private, religious affiliation, historically black colleges and universities, women’s colleges), and presence of a student health pharmacy. Comparisons were made using chi-square test or Fisher’s exact test. ResultsFifty-four 4-year colleges and universities were identified. A plurality or the majority of schools were considered small (41%) and urban (48%) and had a religious affiliation (61%). Thirty-three percent of colleges and universities had an on-campus pharmacy. The most frequent contraceptives offered were condoms (43%), oral contraceptives (33%), and medroxyprogesterone injections (22%). Emergency contraception was available at approximately one-third of colleges and universities. Six percent of institutions provided a full range of contraceptive methods. Contraceptives were offered more frequently at large, public, urban institutions, whereas religious institutions and smaller institutions were less likely to offer contraceptives. ConclusionAccess to on-campus contraception for college students in NC is lacking, and the vast majority of institutions did not provide a full range of contraceptives. Policy measures, such as enhancing reproductive health services at student health centers or increasing contraception availability directly through pharmacies, are needed to improve access for college students.

A stakeholder-developed logic model to improve utilization of pharmacy-prescribed contraception in Utah

BackgroundCurrently, 20 states in the USA have passed policies allowing pharmacists to prescribe short-acting hormonal contraception, including pills, patches, and vaginal rings. Yet, utilization of these services remains limited. The purpose of this study was to (a) assess barriers and facilitators of pharmacy contraceptive dispensing among contraceptive users, pharmacists, and healthcare providers in Utah and (b) adapt and propose an evidence-based contraceptive intervention in the pharmacy environment.MethodsWe conducted 6 focus groups among contraceptive users, pharmacists, and healthcare providers assessing current barriers and facilitators to pharmacy prescribing. We coded transcripts of these focus groups to the Consolidated Framework for Implementation Research, Version 2.0 (CFIR) and characterized the findings based on the Expert Recommendations for Implementing Change (ERIC) Barrier-Busting tool. Based on the CFIR findings and ERIC strategies output, we adapted an existing evidence-based intervention (a contraceptive access initiative) to the Utah pharmacy environment. We then convened a pharmacy stakeholder meeting and presented elements of an Implementation Research Logic Model and obtained feedback. We coded this feedback to the CFIR framework to finalize an Implementation Research Logic Model for a proposed implementation approach to improving contraceptive prescribing.ResultsInitial focus group responses clustered around specific implementation barriers including financial barriers (cost for patients, as well as lack of reimbursement for pharmacist’s time); lack of awareness of the service (on the part of patients, pharmacists, and health care providers); need for updated tools for contraceptive counseling and scheduling; and need for increased pharmacists education to conduct contraceptive counseling. Proposed adaptations to the existing contraceptive access intervention included development of a technology-based patient/pharmacist screener tool and a healthcare provider/pharmacist contraceptive referral network. Stakeholders identified pharmacist reimbursement as the top priority for improving utilization.ConclusionsElements of contraceptive access initiatives mapped well as proposed implementation strategies to improving utilization of contraceptive prescribing in pharmacies.

Reproductive care in community health centers: Multi-method evaluation of the Illinois Contraceptive Access Now (ICAN!) demonstration program

ObjectivesNearly one-third of low-income women of reproductive age in the U.S. receive care in federally qualified community health centers, but comprehensive reproductive care is not consistently provided. Illinois Contraceptive Access Now (ICAN!) is an initiative addressing the access gap to high-quality contraceptive care with a focus on normalizing reproductive health screening for patients in federally qualified community health centers (FQHCs). Study designThis multi-method program evaluation used the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework, with retrospective and prospective data collection from three Illinois FQHCs who participated as Quality Hubs, and from a Community Advisory Board. We conducted descriptive analysis of patient surveys using the Person-Centered Contraceptive Counseling (PCCC) measure (n = 142); clinician and staff pre-and post-training surveys (n = 210); and Community Advisory Board surveys (n = 8) collecting quantitative and qualitative feedback. We ran logistic regression on claims data from 15- to 49-year-old patients identified as female at birth (n = 103,756). ResultsReach assessment showed patients receiving contraceptive or preconception care increased from 1063 per month in 2020 to 1236 per month in 2021 (16% increase), while general volume increased 2%. Effectiveness showed most patients (78%) described the quality of contraceptive counseling as “excellent” on the PCCC. Adoption assessment showed knowledge increases after clinical training on Modern Contraception (85% pre-training, 95% post-training) and Reproductive Justice (RJ) (58% pre-training, 70% post-training). Implementation assessment found that most Community Advisory Board members felt ICAN! was responsive to community needs. ConclusionsThe ICAN! demonstration year increased provider knowledge and volume of reproductive care at three Illinois FQHCs. ImplicationsContraceptive access initiatives that operationalize same day access to birth control methods while training FQHC providers on RJ and modern contraception, show promise on several measures. Early evidence from ICAN! indicates increased reproductive health service provision, as well as increases in provider knowledge of RJ and modern contraceptive care.

Popular contraception videos on TikTok: An assessment of content topics

ObjectivesThis study aimed to explore the contraception content topics on the highly popular social media platform TikTok to understand this influential information source patients may bring into birth control counseling visits. Study designUtilizing a snapshot method, we collected the 100 most popular TikTok English-language videos for each of the eight contraception-specific search terms. We abstracted video content topics addressed and creator attributes. Two independent abstractors coded each video with high agreement, with a third coder adjudicating discrepancies. ResultsThe final data set included 700 unique videos, with a total of 1.18 billion views, 131 million likes, 1.5 million comments, and 4.1 million shares. In these videos, the most common topics addressed were patient experience (n = 365, 52.1%) and logistics of use (n = 351, 50.1%). Health care professionals created only 19.3% of videos (n = 135), but these videos accounted for a larger portion of the total video views (41.3%). Health care professionals largely made educational videos (92.6%) compared to 22.5% of videos coded as educational videos when made by perceived non–health care professionals. A small number of prolific video creators developed the majority of videos made by health care professionals, with 91 (67.4%) made by six TikTok creators. ConclusionsTikTok contains highly accessible contraception content, which garners high viewership, especially when created by health care providers. Clinicians should be aware of TikTok’s potential to influence patients prior to contraceptive counseling visits and recognize this platform as a public health instrument to disseminate contraceptive information to a key demographic. ImplicationsFew previous studies have examined the presence and popularity of contraception content topics on TikTok; little is known about the health content on this highly popular platform. Providers should be aware of the contraceptive topics on TikTok for understanding both patient perceptions and the potential for health education through this media.

3.18 An Opportunity to Access Contraception Care: Interest, Barriers, and Influential Factors among Psychiatrically Hospitalized Female Adolescents

3.18 An Opportunity to Access Contraception Care: Interest, Barriers, and Influential Factors among Psychiatrically Hospitalized Female Adolescents

Socio- demographic characteristics and women attitude as determinants to practice modern contraceptives uptake as correlated among women of child bearing age in Jigawa State, Nigeria

Background: Universal contraceptive access is one of the key strategies for achieving sustainable developments in any country. Yet, uptake has remained low in most developing nations like Nigeria. The reasons for low use must be contextually understood to aid effective contraceptive programming (Ajibola et al., n.d.). This study assessed socio- demographic characteristics and women attitude as determinants to practice modern contraceptives uptake as correlated among women of child bearing age in Jigawa state, Nigeria. Aim: This study assessed socio- demographic characteristics and women attitude as determinants to practice modern contraceptives uptake as correlated among women of child bearing age in Jigawa state, Nigeria. Methodology: A cross-sectional descriptive research was conducted on the respondents. The study population comprised all the eligible women of child bearing age within the study area, who were selected and agreed to participate in the study. Sample sizes of Four Hundred and four (404), respondents were recruited using a multistage sampling technique. Data was collected using Questionnaire Data collected was coded, entered, and analyzed using the Statistical Package for the Social Sciences (SPSS) version 22. Result: The relationship between socio-demographic characteristics and respondents’ attitude to contraceptive uptake, statistically significant association was found between respondents’ attitude to contraceptive uptake and marital status (χ2=9.1, p=0.036), age (χ2=3.9, p=0.041), religion (χ2=6.3, p=0.023), and level of educational (χ2=8.3, p=0.048) Respondents with no formal education were significantly less likely to have used contraception compared to their educated counterparts (AOR=0.414, 95%CI=0.173-0.861). Also, those with less than 29 years of age were significantly less likely to have used contraception than those with 30 years and above age (AOR=0.563, 95%CI=0.331–1.018). Likewise, those with poor knowledge and negative attitude had significantly lesser odds of modern contraceptive use (OR=0.411, 95%CI=1.131-1.857 and OR=0.147, 95%CI=0.151-0.763). Conclusions: The study revealed that significant number of women had poor knowledge and attitude towards FP. Multiple socio-demographic factors contributed to knowledge and attitude of FP. Therefore, the health sectors of the regions and other stakeholders should strengthen the health extension program to disseminate messages related to FP to improve the knowledge and attitude of women.

Qualitative insights into the need for a contraception protocol from obstetricians’ and gynecologists’ perspectives

BackgroundStudies on the use of contraception in the Saudi community highlight the need for improving community knowledge about contraception, implementing guidelines, and restricting contraception dispensing. However, there is a lack of studies assessing the need for contraception protocols from obstetricians’ and gynecologists’ (Ob/Gyn) perspectives. This study aimed to assess the need for a contraception protocol from the perspectives of Ob/Gyn physicians.MethodsQualitative in depth, semi-structured interviews were conducted with a convenience sample that comprised physicians from the Department of Obstetrics and Gynecology in a tertiary teaching hospital. Interviews were audio recorded and transcribed verbatim and then analyzed using NVivo (QSR International) software.ResultsA total of 12 interviews were conducted and analyzed. Participants indicated a lack of prescribing restrictions and highlighted issues of low contraception literacy in Saudi communities, self-prescribing behaviors, health system organization, and physicians’ knowledge. Participants perceived the need for a contraception protocol guiding the prescribing process and patient counseling without restricting prescribing. Moreover, participants highlighted a number of factors affecting the development and implementation of such a protocol, including the availability of contraception, the need for research by physicians, patient factors, and the expected increased load on the hospital.ConclusionsThis research described current practices, showed the need for a contraception protocol, and highlighted the factors affecting the development and implementation of such a protocol.

Contraception After Abortion.

After a spontaneous or induced abortion, people may desire to delay or prevent a future pregnancy and many desire to use contraceptive methods to do so. Contraception counseling and provision at the time of abortion care are important components to improve contraceptive access and convenience for people undergoing abortion care. The majority of hormonal and barrier contraceptive methods may be safely initiated at the time of medication or procedural abortion or shortly thereafter, although delayed initiation may be necessary in certain circumstances. A patient-centered approach to contraceptive counseling can identify patients' priorities and mitigate provider coercion or pressure.

Community pharmacists and improving contraception access: Relationships between contraceptive counseling and dispensing contraceptives

BackgroundExperiences of contraceptive counseling and obtaining contraceptives vary for women of childbearing age based on education level, race, ethnicity, and health insurance. Community pharmacists are an important resource for improving access to contraceptive care in states with over-the-counter access to and pharmacist prescribing of contraceptives. ObjectivesWe first aimed to determine how patient education level, race, ethnicity, insurance, and patient-provider race concordance influenced the likelihood of receiving contraceptive counseling. The second aim was to determine how receiving contraceptive counseling influenced the likelihood of being dispensed contraceptives by a pharmacist. MethodsPearson chi-square tests and logistic regression were used to address study aims. ResultsOlder women and those with Medicaid were less likely to receive contraceptive counseling. Race concordance had no influence on counseling. Counseling and education level were strong predictors of being dispensed contraceptives. Race, ethnicity, Medicaid, and marital status were negatively associated with being dispensed contraceptives. ConclusionsInequities exist in access to contraceptive care for women of diverse backgrounds as well as those insured through Medicaid. State-level policy advancements and over the counter access to oral contraceptives may provide pharmacists a unique opportunity to provide contraceptive care for women without access to a primary care provider.

Scientists’ Warning: Remove the Barriers to Contraception Access, for Health of Women and the Planet

The human population reached 8 billion in 2022 and is still growing, and will possibly peak at 10.4 billion in 2086. Environmental science mandates that continued growth of the human enterprise on a finite planet is unsustainable and already in overshoot. Indeed, 3 billion is an evidence-based target number, for our species in competition with all non-human life-forms. We must achieve zero population growth and, ultimately, a massive decrease. Commonly, even among environmentalists who are not “population-deniers”, human numbers are seen as a given, to be adapted to rather than influenced or managed. Yet, just and appropriate interventions exist. The fundamental requirement is the empowerment of women, removing the barriers in many settings to their education (including environmental education, and the reproductive ethics of smaller families) and to realistic, voluntary access to contraception. Wherever “reproductive health” includes access to rights-based family planning, this not only promotes the health of the planet but also women’s health through, inter alia, their choice to have fewer and better-spaced children. This is ethical, pragmatic, and cost-effective—a prime example of preventive medicine. Politicians (mostly men) everywhere must embrace this long-term thinking and significantly increase the currently inadequate funding of contraceptive care. Herein is another Scientists’ Warning: there is just one planet for all life.

The Factors That Influence Women's Desire in using Intrauterine Devices: A Cross-Sectional Observational Study

Background: In family planning for welfare, the number of children becomes an important factor. This relates to the use of contraceptives, including intrauterine devices (IUDs). The determinants of the use of this type of contraceptive are still unclear. The purpose of this study is to look into the various aspects of the use of IUDs. Materials and Methods: A cross-sectional observational study was done on the couples of reproductive age who were classified as IUD users or nonusers. Age, education level, knowledge level, income level, as well as social support, husband’s support, health support, and tool availability were all examined. The Chi-square test is used for the statistical analysis. Results: Age, education level, knowledge level, income level, as well as social support, husband’s support, and health support, as well as the availability of contraceptives with the use of IUDs, all had a significant association (P < 0.05). Conclusions: In conclusion, age, education level, knowledge level, income level, as well as social support, husband’s support, and health support, as well as the availability of tools, were found to be predictors in becoming an acceptor of contraceptives in family planning. As a result, it is advised that government efforts in family health be focused on strengthening these factors.

Impact of the Choose Well Initiative on Contraceptive Access at Federally Qualified Health Centers in South Carolina: A Midline Evaluation.

Choose Well (CW) is a statewide contraceptive access initiative to reduce unintended pregnancy among patients utilizing federally funded family planning services. We examined CW's impact on contraceptive access at South Carolina federally qualified health centers from 2016 to 2019, which reported significantly higher increases in providing the full range of contraceptive methods and training onsite. CW prioritized ensuring change sustainability through obtaining funding and institutionalizing changes. (Am J Public Health. 2023;113(11):1167-1172. https://doi.org/10.2105/AJPH.2023.307384).

Strengthening systems to provide long-acting reversible contraceptives (LARCs) in public sector health facilities in Uganda and Zambia: Program results and learnings.

In Uganda and Zambia, both supply- and demand-side factors hamper availability of long-acting reversible contraceptives (LARCs), including implants and intrauterine devices (IUDs), at public sector facilities. This paper discusses results of a program aimed at increasing access to and uptake of LARC services in public sector facilities through capacity building of government health workers, strengthening government supply chains, and client mobilization. From 2018-2021, the Ministries of Health (MOHs) in Uganda and Zambia and Clinton Health Access Initiative (CHAI) worked to increase readiness to provide LARC services within 51 focal facilities in Uganda and 85 focal facilities in Zambia. Annual facility assessments of LARC-related resources were conducted and routine service delivery data were monitored. At baseline, few focal facilities had supplies and skilled staff to provide LARC services. At endline, over 90% of focal facilities in both countries had a provider trained to provide both implants and IUDs and 55% had the commodities and equipment needed for implant provision. In Uganda and Zambia, respectively, 65% and 38% of focal facilities had commodities and equipment for IUD provision at endline. Both programs observed significant increases in the number of implants provided at focal facilities; in Uganda implant volumes increased five-fold from 4,560 at baseline to 23,463 at endline, and in Zambia implant volumes increased nearly four-fold from 1,884 at baseline to 7,394 at endline. Uganda did not observe growth in IUD volumes, whereas Zambia observed significantly increased IUD service volumes from 251 at baseline to 3,866 at endline. Public sector facilities can be rapidly and sustainably capacitated to provide LARCs when both catalytic and systems strengthening interventions are deployed for health worker capacity building, supply chain management, and community mobilization to ensure client flow. Investments should be intentionally sequenced and coordinated to generate a virtuous cycle that enables continued LARC service provision.

Explaining sex discrepancies in sterilization rates in the United States: An evidence-informed commentary.

With abortion no longer deemed a constitutional right in the United States (US), the importance of effective contraceptive methods cannot be overstated. Both male sterilization (vasectomy) and female sterilization (tubal ligation) have the lowest failure rates of available means of contraception. Despite the less invasive and reversible nature of vasectomy compared to tubal ligation procedures and even though some healthcare professionals dissuade certain women, especially those who are white and/or economically advantaged, from undergoing a sterilization procedure, female sterilization is approximately three times more prevalent than male sterilization in the US. We suggest that the discrepancy in sterilization rates is attributable to the burdens of pregnancy and birth experienced by women, beliefs that pregnancy prevention is a woman's responsibility, a dearth of sex education that results in lack of knowledge and poor understanding of contraception, perceptions of masculinity in which contraception is viewed as feminizing, and the increase in long-term singlehood that shapes the desire of individuals to avoid unwanted pregnancy that may result in single parenting. Recent reports suggest that court rulings restricting abortion access and looming threats to contraceptive legality and accessibility may be prompting a national increase in male sterilization.

IMPLEMENTASI KEBIJAKAN PROGRAM KELUARGA BERENCANA DI PUSKESMAS KEDUNGDORO KECAMATAN TEGALSARI KOTA SURABAYA

This study aims to determine the process of implementing the KB Village program. In this study, the focus will be on what factors determine the process of implementing the KB village program. Broadly speaking, the KB Village program is an attempt by the central government through the BKKBN to move people to live a more prosperous and quality life. This study aims to describe the implementation of the KB Village program in Tegalsari District. This research method is descriptive using a qualitative approach. The population in this study was taken from 3 locations in the KB Village in Tegalsari District, Surabaya City. For the purposes of this research related to the establishment of Family Planning Counseling in Tegalsari District, the research was focused on KB Village, Tegalsari Sub-District (Malang Village), Dr. Sutomo (Pandegiling), Wonorejo Village. The results showed that the implementation of the KB Village program in Tegalsari District had gone well in terms of planning, coordination with the Kedungdoro Health Center in Surabaya, availability of infrastructure, contraceptives, and supervision. In addition, obstacles that need to be addressed are funding and PLKB personnel in the field. Therefore the implementation of the KB village program in Tegalsari District needs to be improved in the future.
 Keywords: Implementation, family planning, health center

Modern Contraceptive Use and Associated Factors In USSA Local Government Area Of Taraba State, Nigeria

With the high rate of unintended pregnancy in the world, encouraging the use of contraceptives has become necessary. However, some factors may influence whether a woman agrees to utilize contraceptives or not. This paper examines the impact of individual factors, sociocultural factors, and health system factors on the utilization of contraceptives in Ussa Local Government Area of Taraba State, Nigeria. Through a literature-based analysis and the application of rational choice theory, the findings highlight the complex interplay of these factors in shaping contraceptive utilization patterns in Ussa Local Government Area. Individual hurdles to uptake were identified as a lack of information about contraception, socioeconomic status, misconceptions, and unfavorable attitudes. Individuals' decision-making processes are influenced by sociocultural variables such as religion and cultural traditions that oppose contraception. Furthermore, a lack of contraceptive availability, a shortage of skilled healthcare practitioners, and a weaker healthcare infrastructure all restrict access to and utilization of contraceptive therapies. The paper recommended that focused interventions should address these various challenges to boost contraceptive usage in Ussa LGA. Individuals, communities, and religious leaders should be targeted for education and awareness efforts to debunk misunderstandings, enhance knowledge, and encourage favorable attitudes regarding contraception. Engaging community leaders and religious organizations in family planning advocacy can assist transform sociocultural norms in favour of family planning. Improving the availability, price, and quality of contraception, as well as training healthcare practitioners, will be crucial for boosting the utilization of contraceptives.

Factors that Influence Reproductive Health Decisions Among Low-Income Males Enrolled in an Anti-poverty Government Initiative in an Urban Community: A Qualitative Study Based on Thematic Analyses of Focus Group Discussions in Pasig, Philippines

Poor family planning greatly impacts both maternal and child health outcomes. While legislation of the 2012 Responsible Parenthood and Reproductive Health Law increased the access and use of contraceptives, there is still an unmet need for family planning in terms of limiting and spacing of births especially in the lower economic quintiles within densely populated urban communities. Meanwhile, while other studies have shown that male involvement in family planning yields beneficial reproductive health outcomes, local reproductive health policies by the government targeting men have remained very minimal. Therefore, this qualitative study explored the factors that influence the reproductive health decisions among low-income males which may augment the local government in creating reproductive health policies that extend to these demographics. Using a modified qualitative knowledge, attitudes and practices framework, low-income 18-45 year-old males enrolled in an anti-poverty government initiative, the Pantawid Pamilyang Pilipino Program (4Ps), in Barangay, Pinagbuhatan Pasig City were included in this study. Four FGDs with 3-5 members recruited through purposive sampling were conducted between June 1-July 31, 2019. Thematic analysis was done using NVIVO software (ver. 11) and five themes emerged as the key factors that influence reproductive health decisions. Men enrolled in the 4Ps in Barangay Pinagbuhatan, Pasig City decide the contraceptives to use while their female partners use these contraceptives. (1) Safety issues and (2) compatibility on a contraceptive, (3) control over sex, (4) possible infidelity in marital dynamics, and (5) hegemonic masculinity are the five factors that influence their choice of family planning methods.