Family Planning Methods Research Articles

Fertility, family planning methods and autonomy among women in Delhi

Background: Women’s autonomy is defined as the ability to regulate one’s environment with the help of social and material resources. This autonomy is intricately linked to various reproductive health outcomes, including reduced fertility, increased contraceptive usage and access to prenatal care. It can be understood as the ability of women to oversee and manage their surroundings independently, allowing them to make decisions about their lifestyle, irrespective of societal opinions. Aims and Objectives: This study explored the association between fertility, family planning methods (FPMs) and autonomy amongst women in Delhi. Materials and Methods: The data for the present study were collected from 400 married women aged 15–45 years old residing in Delhi. A face to face interview was conducted using a semi structured schedule to collect quantitative and qualitative data. Results: The findings revealed that the autonomy level of women was found to be low (13.75%), medium (56.5%) and high (29.75%). Respondents with low autonomy status (47.27%) were illiterate or had a primary level of education. Women with low autonomy have a more significant number of conceptions than medium and high autonomy women, resulting in increased live births amongst low autonomy women. In addition, participants with low levels of autonomy were less aware of FPMs. The study underscored the influence of women’s social position, as reflected in factors such as education, occupation and the economic status of the family, on fertility and contraceptive usage. Conclusion: The findings of this study indicate that women exhibiting lower autonomy levels tend to possess lower educational attainment, experience a higher frequency of conceptions, demonstrate limited knowledge about contraception and show lower rates of employment.

THE AWARENESS AND PRACTICES OF POSTNATAL CARE IN MOTHERS DELIVERED AT A TERTIARY CARE CENTRE: A HOSPITAL-BASED STUDY Authors

Introduction: The postpartum period is the most crucial phase in a mother’s life. The unawareness of postpartum care can have disastrous consequences on both the mother and newborn. This study helps in the identification of gaps in postpartum care by studying awareness and practices in our postnatal women. Methods: This cross-sectional studywas conducted at a tertiary care hospital in Delhi, India between July 2022 to May 2023.Ethical clearance was obtained. About 200 postnatal women were enrolled in the postnatal clinic during their follow-up visit at six weeks of delivery. After informed consent,the details were collected as per the predesigned proforma. The awareness and practices on breastfeeding, family planning, and postpartum health were recorded. Results: Among 200 women, the majority were in the age group of 25 to 30 years. About 51% were multipara and 33.5% were graduates and most belonged to upper lower socioeconomicclass. About 86.5% were aware of exclusive breastfeeding practice and 81.5% had awareness of family planning methods. About 73% of our participants were aware of postnatal danger signs. The prevalence of anemia was 70.4% and 56.5% were noncompliant with iron and calcium supplements. Conclusion: Postnatal care constitutes an indispensable component of maternal health care. The high prevalence of postpartum anemia and non-compliance to iron and calcium intake among our postnatal mothers calls for an urgent need to emphasize counseling regarding the diet as well as iron and calcium prophylaxis during the discharge of postnatal women.

Relationship between reproductive health literacy and components of healthy fertility in women of the reproductive age.

One of the key factors affecting women's behavior with fertility issues is their health literacy, but this topic has been less addressed in the existing studies. We aimed to determine the relationship between reproductive health literacy and components of healthy fertility in women of reproductive age. This cross-sectional study was conducted from March 2019 to September 2014 on 230 married women who were referred to comprehensive health centers in Lordegan city. Data were collected using a reproductive health literacy questionnaire, demographic and fertility information checklist, and components of healthy fertility. Data analysis was done using SPSS software, version 20. Pearson, Spearman, and independent t-tests were used as appropriate. The mean ± SD reproductive health literacy score in the participants was 43.80 ± 18.99 depicting an average literacy level in more than half of the women. Also, the reproductive health literacy score had a statistically significant relationship with the use of low-failure contraceptive methods (P < 0.001) and planned pregnancy (P = 0.03). However, this relationship was not significant regarding pre-pregnancy care (P = 0.88) and observing the interval between pregnancies (P = 0.57). We found a relationship between the level of reproductive health literacy and the use of family planning methods with low failure and planned pregnancy. Hence, it seems that interventions to improve reproductive health literacy are effective in reducing the occurrence of high-risk pregnancies and unwanted and unplanned pregnancies. Therefore, it is suggested that the health system consider and provide education related to reproductive health literacy as a part of healthy reproductive services.

Knowledge, Attitude and Practice of Modern Family Planning Methods among Men in Ogbogu Community in Ogba-Egbema-Ndoni Local Government Area of Rivers State

This study examined the knowledge, attitude and practice of modern family planning methods among men in Ogbogu Community in Ogba/Egbema/Ndoni Local Government Area of Rivers State. Introduction: Family planning is the practice that helps individuals or couples to attain certain objectives such as avoiding unwanted pregnancies, bringing about wanted babies at the right time, regulating the interval between pregnancies, controlling the time at which birth occurs in relation to the ages of the parents. Methodology: The study used a descriptive survey research design. The study population comprised married men currently residing in Ogbogu Community in Ogba/Egbema/Ndoni Local Government Area of Rivers State. A sample size of 389 persons was selected using a simple random technique. A structured questionnaire was used for data collection and data were analyzed using Statistical Package for Social Sciences (SPSS) windows (version 20.0). Results: The study showed that there is high awareness of family planning of among the married couples used for the study. Majority of the participants had detailed knowledge of condom. Also, the study indicated that married couples had a favourable attitude toward modern family planning methods of 51%, out of the married couples that were aware of modern family planning methods. Again, the study revealed that high percentage of married couples practice modern family planning methods. Conclusion: Knowledge of modern contraceptives is high in the study population. Substantial proportion of married couples had positive attitude towards modern contraceptives and hence more room for increasing modern contraceptive use in the study population.

Knowledge Regarding Family Planning Methods Among Women Admitted at A Public Hospital Postnatal Ward Windhoek, Khomas Region Namibia.

Family planning is a strategy that empower couples and individual to plan and control the number, spacing and timing of their children through the use of contraceptives. A quantitative descriptive design was applied. Primary data was collected directly from the participants through structured validated questionnaire. A probability systematic sampling technique was employed, involving a sample of 255 postnatal women. Data was analysed using excel and presented in graphs and tables for easy interpretation. The findings indicated that the competence was based on a knowledge score of ≥50% because participants were not healthcare professionals and might not have medical background. Participants that obtained a knowledge score of &lt;50% were 72.2%. Only 27.8% out of 255 participants obtained a knowledge score of ≥50%. It can be concluded that a relatively low proportion, specifically 27.8% of postnatal women, possessed good knowledge of family planning methods. The study suggests advocate for healthcare providers to incorporate family planning counselling and education as an integral part of antenatal care services at each contact.

Family planning in the Eastern Democratic Republic of the Congo: personal beliefs, intimate partner negotiations and social pressure

The Democratic Republic of the Congo (DRC) has a low prevalence of family planning use. Recent studies have highlighted the significant role that socio-cultural factors play in the decision to use family planning or not. This qualitative study explored barriers to women’s use of family planning methods in an ongoing conflict region, South-Kivu, DRC. Focus group discussions and individual in-depth interviews were conducted to understand perceptions and habits regarding family planning. An inductive approach was used to analyse the data. Precariousness of life, religious beliefs and fear of side effects were limiting factors to the use of family planning. Power relations within the couple also played an important role in decision-making. Sole provider (‘breadwinner’) women were more likely to use family planning, including hormonal methods. Our findings highlight the continued importance of family planning programmes that respond to socio-cultural factors, personal beliefs, and fear of side effects in parallel with addressing availability and accessibility. This will require including the community in their design and implementation in order to meet unmet family planning needs. Health care providers’ capacity building and training to help women manage family planning side effects will also be beneficial.

Women decision making on use of modern family planning methods and associated factors, evidence from PMA Ethiopia.

Family planning decision making is defined as women´s ability to determine the family planning methods that she wanted to use through the process of informed decision making. Despite the availability and accessibility of family planning methods, the utilization rate is not more than 41% in Ethiopia. Evidence and experts have consistently show that women decisions making ability on family planning method they desired to use is one of the possible reasons for this slow rate of family planning use increment. In consideration of this and further motives family planning use decision making has become one of the top sexual and reproductive health related sustainable development agendas. Hence, this study aimed at determining the level, trend and spatial distribution of family planning use decision making among married women and identify factors affecting it. This study was based on Performance Monitoring for Action (PMA) 2020 cross sectional national survey data. Married women who are currently using or recently used family planning method were included in this study. Frequency was computed to describe the study participants while chi-square statistics was computed to examine the overall association of independent variable with family planning use decision making. To identify predictors of family planning use decision making multinomial logistics regression was employed. Results were presented in the form of percentage and relative risk ratio with 95% CI. Candidate variables were selected using p value of 0.25. Significance was declared at p value 0.05. This study revealed that one in two women (51.2%; 95% CI: 48.8%-53.6%) decide their family planning use by themselves while 37% (36.8%; 95% CI: 34.5%-39.2%) decide jointly with their husband and/or partner. Women alone family planning use decision making increased significantly 32.8% (95% CI: 29.4%, 36.4%) in 2014 to 51.2% (95% CI: 48.8%, 53.6%) in 2020. It also shows variation across regions from scanty in Afar and Somali to 63.6% in Amhara region and 61.5 Addis Ababa. Obtaining desired family planning method was found significantly to improve women alone and joint family planning use decision making. Women who have perceive control and feeling if they get pregnant now were found to be positively associated with women alone family planning use decision making. Discussion with husband, his feeling towards family planning were found positively to influence family planning use joint decision making. Moreover, women religion, was found reducing the likelihood of both women alone and joint family planning use decision making while experiencing side effect reduces the likelihood of joint family planning use decision making. Half of the women independently decide their family planning use which calls up on further improvement. Family planning use decision making ability is expected to be improved by efforts targeted on husbands' approval on wife's family planning use, discussion on family planning use with husband/partner, improving women psychosociological readiness and trust on her own to decide her desired family planning method; informing the possible side effects and what to do when they encountered during their family planning use visit. In addition, influencing women on the use of family planning via religious leader will help much in this regard. Monitoring and evaluating reproductive health policy 2021 to2025 and addressing bottlenecks which hinder women decision making health service use is hoped to improve women family planning use decision making. Further qualitative study to identify and address factors that contribute for the variation across regions also help much.

Effectiveness of Capacity-Building and Quality Improvement Interventions to Improve Day-of-Birth Care in Kinshasa, Democratic Republic of the Congo.

In sub-Saharan African settings like the Democratic Republic of the Congo, high-quality care during childbirth and the immediate postpartum period is lacking in public facilities, necessitating multipronged interventions to improve care. We used a pre-post design to examine the effectiveness of a low-dose, high-frequency capacity-building and quality improvement (QI) intervention to improve care for women and newborns around the day of birth in 16 health facilities in Kinshasa, Democratic Republic of the Congo. Effectiveness was assessed based on changes in provider skills, key health indicators, and beneficiary satisfaction. To assess changes in the competency of the 188 providers participating in the intervention, we conducted objective structured clinical examinations on care for mothers and newborns on the day of birth, immediate postpartum family planning (PPFP) counseling and method provision, and postabortion care before and after implementation of training and at 6 and 12 months after training. Interrupted time series (ITS) analysis techniques were used to analyze routine health service data for changes in select maternal, newborn, and postpartum outcomes before and after the intervention. To assess changes in clients' perceptions of care, 2 rounds of telephone surveys were administered. Before the intervention, less than 2% of participating providers demonstrated competency in skills. Immediately after training, more than 80% demonstrated competency, and 70% retained competency after 12 months. ITS analyses show the risk of early neonatal death declined significantly by 9% (95% confidence interval [CI]=4%, 13%, P<.001), and likelihood of immediate PPFP uptake increased significantly by 72% (95% CI=53%, 92%, P<.001). Client satisfaction improved by 58% over the life of the project. These findings build on previous studies documenting the effectiveness of clinical capacity-building and QI approaches. If implemented at scale, this approach has the potential to substantively contribute to improving maternal and perinatal health in similar settings.

Key drivers of hysterectomy among women of reproductive age in three states in India: comparative evidence from NFHS-4 and NFHS-5

PurposeAccording to the 4th and 5th rounds of National Family Health Survey (NFHS), there is high prevalence of hysterectomies in the three states of Andhra Pradesh Telangana and Bihar. The three said states have more than double the number of hysterectomies taking place than the national average. Our purpose is to analyse whether these rates are increasing, decreasing or have stabilized and their reasons thereof. Such an analyses will help the policy makers in recommending good clinical practices within their states.Material and methodsWe used data from NFHS-4 (2015-16) and NFHS-5 (2019-2021) rounds. We calculated the differences in predicted probabilities for various factors, performed a Fairlie Decomposition analyses to quantify the positive and negative contributors in the prevalence of hysterectomy across the three states over two time points, and assessed the association of various socio-demographic characteristics to hysterectomy through a multilevel logistic regression model.Results and conclusionThe results show that out of a total of 80,976 eligible respondents from the states under study, 5826 respondents self-reported that they had a hysterectomy done. It was found that older age, living in rural areas, belonging to other backward classes and higher wealth quintile, and higher parity positively contributed to the increased prevalence of hysterectomies in the three states. Higher educational attainment and previous use of family planning methods acted as protective factors. Characteristics at the household level had the highest intra-class correlation value in the prevalence of hysterectomy among women, followed by the Primary Sampling Unit and District levels, indicating high clustering in the prevalence of hysterectomy at the household level in all three states. Heavy menstrual bleeding/pain was the leading cause of hysterectomies in all three states, followed by fibroids/cysts in Andhra Pradesh and Telangana and Uterine disorder/ prolapse in Bihar. Over 80% of hysterectomies took place in the private hospitals.RecommendationsThe study recommends better, more efficient and accountable hysterectomy surveillance to ensure more sustainable woman’s reproductive health services in India. Government should adopt and implement standard regulatory guidelines to prevent provider-driven avoidable hysterectomies. Moreover, we recommend informing primary care professionals about the long-term health effects of hysterectomy and promoting alternate therapies for treating uterine fibroids and heavy bleeding.

Factors associated with inadequate dietary diversity among adolescent girls in Hurumu Woreda High School, Oromia Region, Southwest Ethiopia.

Inadequate diet among adolescent girls leads to anatomical and physiological disturbances which will contribute to the vicious intergenerational cycle of malnutrition. However, only a few studies are available in Ethiopia on dietary diversity among adolescent girls who are attending school. The objective of this study is to assess factors associated with inadequate dietary diversity among high school adolescent girls in Hurumu Woreda, Southwest Ethiopia, 2022. An institution-based cross-sectional study was conducted among 374 high school adolescent girls from 3 May 2022 to 12 June 2022 and selected by using simple random sampling techniques. Data were collected through face-to-face interviews using structured questionnaires. Epi-data version 4.6.0 was used to enter the data, which were then exported to SPSS version 26 for analysis. Simple binary and multivariable logistic regressions were performed to identify factors associated with inadequate dietary diversity. In this study, the magnitude of inadequate dietary diversity among adolescent girls was 62.6% [95% CI: 57.5-66.5]. Living with more than five family members (AOR = 1.8, 95% CI: 1.16-3.44), consumption of sweet foods/beverages (AOR = 2.2, 95% CI: 1.07-3.41), poor nutritional knowledge (AOR = 2.5, 95% CI: 1.48-3.89), and poor household wealth tercile (AOR = 2.8, 95% CI: 1.44-5.12) were significantly associated with inadequate dietary diversity. Living with more than five family members, poor household wealth status, consumption of sweet foods/beverages, family size, and poor nutritional knowledge were factors significantly associated with inadequate dietary diversity. Hence, nutrition education, the use of family planning methods, and securing income-generating activities should be implemented.

Intimate partner violence influences modern family planning use among married women in Tanzania: cross-sectional study

BackgroundMarried women who experience intimate partner violence (IPV) are less likely to negotiate with their partners on modern family planning (FP) use. This study aimed to determine the influence of intimate partner violence and sociodemographics on modern family planning use.MethodsA community-based cross-sectional study was conducted in the Mara region, Tanzania from April to July 2020. A total of 366 married women were interviewed. Data were collected using a structured interviewer-administered questionnaire. Analysis was done using SPSS version 25, and a binary logistic regression model was used to determine the predictors of modern FP use. The significance level was set at a p-value less than 0.05.ResultsThe overall prevalence of IPV was 73% with 54.1% physical, 36.3% psychological, and 25.4%, sexual violence. The prevalence of modern FP use was 62%, and the most (49.1%) common method practiced by married women was injection (Depo Provera). Physical violence (AOR = 0.32, p = 0.0056), and psychological violence (AOR = 0.22, p = 0.0022) had significantly reduced odds of modern FP use. Religion (AOR = 4.6, p = 0.0085), and availability of preferred modern FP methods (AOR = 9.27, p < 0.0001) had significantly increased odds of modern FP use.ConclusionIn this study, there is a positive association between the use of modern FP methods and IPV. To prevent IPV and its negative health consequences, it is crucial to involve community leaders and primary healthcare workers. They can help in identifying the best strategies to prevent IPV and promote the use of modern FP methods. It is equally important to involve male partners in reproductive health decisions, including the use of modern FP methods. This approach will help reduce reproductive coercion.

Maternal and Child Health Exhibition in the early days of the People's Republic of China

In the early days of the People's Republic of China, Maternal and Child Health Exhibitions were widely held in urban and rural areas across the country. The vivid image and wide coverage of the Exhibition have directly promoted the popularization of a new and more progressive delivery methods in urban and rural areas across the country. While effectively protecting the health of mothers and children, the people's political power is closely linked to "progress".The purpose, organizer and content of the Maternal and Child Health Exhibition are related to the policies of new methods of midwifery, painless delivery, and birth control in the early days of People's Republic of China.It also partly carried the mission of learning from the Soviet Union to "learn from the advanced medical experience", therefore the content in the first ten years was slightly different.

Evaluation of Short-Term Complications of PPIUCD

Background: Postpartum intrauterine contraceptives device (PPIUCD) offers an effective means of providing contraceptive services to women in countries with high rates of unmet needs for family planning services. Scientific literature estimating the long-term retention rates is scarce. The complications following PPIUCD insertion at the three follow-up visits. The PPIUCD can be placed immediately following delivery of the placenta, during cesarean section or within 48 hours following childbirth. Objectives: The aim of the study was to assess the evaluation of short-term complications of Post-Partum Intrauterine Contraceptive Device (PPIUCD). Methods: This is a prospective observational study was conducted at Department of Obstetrics and Gynecology, Dhaka Medical College Hospital (DMCH). 360 eligible postpartum women were counselled for PPIUCD insertion. These women were also interviewed for their reasons for accepting and rejecting PPIUCD. After consent, Cu-T 380A insertion was done. Follow-up was done at 6 weeks or when reported with any complaint. Results: PPIUCD implantation was performed on 48 (13.3%) of 360 eligible counseled postpartum patients. Acceptance of PPIUCD was higher in the age range of 25 - 30 years (43.75%), women from middle socioeconomic status (58.3%), those with family support (75%), those who had previously had PPIUCD health counselling (70.8%), and multipara (68.75%). Missing thread (8.3%), lower abdomen pain (6.25%), and irregular per vaginal bleeding (4.2%) were the most prevalent problems. There was 86% continuation of IUCD, 8% discontinuance, 6% expulsion, and no occurrence of unintended pregnancy. Conclusion: The awareness about availability of PPIUCD is quite low because it is recently introduced in the family planning methods. The most common reason for refusal is disagreement between the husband and his family. Acceptance can be increased further by disseminating information and providing proper counseling in antenatal clinics.

A Digital Sexual Health Intervention for Urban Adolescent and Young Adult Male Emergency Department Patients: User-Centered Design Approach.

Adolescents and young adults frequently present to the emergency department (ED) for medical care and continue to have many unmet sexual health needs. Digital interventions show promise to improve adolescent and young adult sexual health; yet, few interventions focus on male ED patients, despite their infrequent use of contraceptives and rising rates of sexually transmitted infections. This paper describes the design and development of Dr. Eric (Emergency Room Interventions to Improve Care), a digital app focused on promoting condom use among sexually active adolescent and young adult male ED patients. This study followed 4 phases of app development, which were based on user-centered design and the software development lifecycle. In phase 1, define, we explored our target population and target health problem (infrequent condom use among male ED patients) by collecting key stakeholder input and conducting in-depth interviews with male patients and urban ED medical providers. In phase 2, discover, we partnered with a digital product agency to explore user experience and digital strategy. In phase 3, design, we refined Dr. Eric's content, a 5-part sexual health educational module and a 10-week SMS text messaging program that focuses on condom use and partner communication about effective contraceptives. We conducted semistructured interviews with male adolescent and young adults to gather feedback on the app and perform usability testing, editing the app after each interview. We also interviewed informatics experts to assess the usability of a high-fidelity prototype. Interviews were recorded and analyzed via descriptive thematic analysis; informatic expert feedback was categorized by Nielsen's heuristic principles. In phase 4, develop, we created the technical architecture and built a responsive web app. These findings were gathered leading to the final version of the digital Dr. Eric program. Using data and key stakeholder input from phases 1 and 2, we iteratively created the Dr. Eric prototype for implementation in the ED setting. Interviews with 8 adolescent and young adult male ED patients suggested that users preferred (1) straightforward information, (2) a clear vision of the purpose of Dr. Eric, (3) open-ended opportunities to explore family planning goals, (4) detailed birth control method information, and (5) games presenting novel information with rewards. Five usability experts provided heuristic feedback aiming to improve the ease of use of the app. These findings led to the final version of Dr. Eric. Following these mobile health development phases, we created a digital sexual health mobile health intervention incorporating the principles of user experience and interface design. Dr. Eric needs further evaluation to assess its efficacy in increasing condom use among adolescent and young adult male ED patients. Researchers can use this framework to form future digital health ED-based digital interventions.

Awareness and Utilisation of Family Planning Among Postpartum Women in Ondo State, Nigeria

This study investigates the awareness and utilisation of family planning among postpartum women attending postnatal clinics in selected health centers in Ifedore Local Government, Ondo State. The objectives include determining sources of information, examining common methods used, and assessing knowledge, utilisation, and perceived attitudes of workers regarding family planning. A descriptive design was employed, and the target population comprised women aged 15 to 49, 1 week–12 months postpartum, accessing child health services from three selected health centers. The sample size of 234 was determined using Cochran’s formula, with data collected through a self-structured questionnaire. Validity and reliability were ensured through expert assessment and a pilot study. Analysis using SPSS 27.0 involved percentages, tables, and chi-square tests. The findings revealed commendable understanding of family planning services among women of reproductive age, although utilisation remained inadequate. Factors contributing to this included low socioeconomic status, religious beliefs, and limited education. Despite these challenges, the study highlights the potential for positive outcomes in the future, emphasizing the importance of comprehensive understanding of family planning services. Recommendations include enhancing community education on the benefits of smaller families and women empowerment, promoting gender balance, and emphasizing immediate initiation of family planning postpartum in healthcare settings. These initiatives aim to address barriers and promote the use of family planning methods among women in the study area.

Knowledge and practice of family planning among pregnant tribal women in Southern India: an observational study

BackgroundThere are over 700 Scheduled Tribes (ST) living in 30 Indian states. As with other indigenous groups across the world, Indian ST have some of the poorest infant and child health outcomes of any communities in India. A child born to an ST family is 19% more likely to die in the first month of life and has a 45 percent risk of dying in their first year compared with other Indian populations. Research suggests that early conception, high fertility, and low use of family planning methods are large contributors to these disparities.MethodsA cross sectional survey in Kannada was conducted among 303 pregnant tribal women in Mysore, India after obtaining informed consent. Univariate and multivariable analyses were carried out to determine the demographic and psychosocial factors associated with knowledge of contraceptive methods using Stata 14.0.ResultsThere was widespread knowledge about female sterilization, while only 39.3% of women reported hearing about one or more forms of temporary contraception, and 36.3% knew where to get them. The largest proportion of women had heard about copper-T (33.0%), followed by oral contraceptive pills (23.8%), condoms (11.9%), and injectables (4.6%). Only 2.7% of women reported ever using any form of temporary contraception. Results from the multivariable logistic regression indicated that knowledge of at least one form of temporary contraception was linked to higher age (adjusted odds ratio[AOR]: 1.09; 95% CI: 1.02, 1.17), greater number of years of marriage (AOR: 0.90; 95% CI: 0.85, 0.96), and last birth in a government facility (AOR: 3.67; 95% CI: 1.99, 6.82).ConclusionsThe study revealed poor knowledge and utilization of temporary contraceptive methods among a tribal population in rural Mysore, India. Interventions aiming to increase knowledge of contraceptive options are important for birth spacing in this population and should target younger women and those without contact with government health facilities.

Abortion in The United States – The Impact of Changing Legislation on Prescription Patterns in Pediatric and Maternal Populations

Background and Hypothesis: Changes in healthcare legislation may have unintended consequences for patient care at the individual level. Following the Supreme Court case Dobbs vs Jackson Women’s Health Organization in 2022 resulting in the reversal of Roe V. Wade, many states enacted new abortion legislation. Currently, there are many restrictions and barriers to abortion and reproductive care that may limit access across the country. Given the volatile political environment surrounding abortion legislation, there may be some confusion among clinicians about the legality of abortion and miscarriage care. Abortion legislation and restriction may have an impact on other areas of healthcare, including prescription patterns of Category X medications in women of childbearing age. Based on the current legislation, we hypothesize that prescription rates of Category X medications will decrease while prescription rates of birth control methods will increase.&#x0D; Project Methods: Real world data on prescribing patterns will be obtained from IUH Cerner database and the Cerner Learning Health Network. Demographic information including age, race and insurance status will be obtained. Data will be analyzed to assess trends in prescription patterns for women of childbearing age that correlate with dates of changing abortion legislation.&#x0D; Potential Impact: The findings from this study will help direct future research on medication prescription and administration in people of childbearing age. Results may also inform future policy changes surrounding women’s healthcare.

Family planning service disruptions in the first two years of the COVID-19 pandemic: Evidence from health facilities in seven low- and middle-income countries.

Many speculated that COVID-19 would severely restrict the delivery of essential health services, including family planning (FP), but evidence of this impact is limited, partly due to data limitations. We use cross-sectional data collected from regional and national samples of health facilities (n = 2,610) offering FP across seven low- and middle-income countries (LMICs) between 2019 and 2021, with longitudinal data from four geographies, to examine reported disruptions to the FP service environment during COVID-19, assess how these disruptions varied according to health system characteristics, and evaluate how disruptions evolved throughout the first two years of the pandemic, relative to a pre-pandemic period. Findings show significant variation in the impact of COVID-19 on facility-based FP services across LMICs, with the largest disruptions to services occurring in Rajasthan, India, where COVID-19 cases were highest among geographies sampled, while in most sub-Saharan African settings there were limited disruptions impacting FP service availability, method provision, and contraceptive supplies. Facility-reported disruptions to care were not reflected in observed changes to the number of FP clients or types of stockouts experienced in the first two years of the pandemic. Public and higher-level facilities were generally less likely to experience COVID-19-related disruptions to FP services, suggesting policy mitigation measures-particularly those implemented among government-operated health facilities-may have been critical to ensuring sustained delivery of reproductive healthcare during the pandemic.

Effective strategies for increasing the uptake of modern methods of family planning in South Asia: a systematic review and meta-analysis

BackgroundFamily planning (FP) interventions have improved the use of modern contraceptives, yet a high unmet need for contraception still exists in South Asia. This systematic review of existing research was conducted to identify effective FP interventions that led to an increase in the uptake of modern methods of contraception in South Asia.MethodsFive electronic databases were searched for relevant studies published between January 1st, 2000 and May 4, 2023. Experimental studies that reported data on the impact of FP interventions on modern contraceptive use among women of reproductive age (15–49 years) in the South Asian region were included. A random-effects Inverse Variance weighted model was employed to pool the adjusted odds ratio (OR) on modern contraceptive use and unmet need for contraception. In addition, we computed subgroup meta-estimates based on intervention type and the urban-rural divide.ResultsAmong 643 studies identified, 21 met the inclusion criteria. The overall pooled odds ratio for modern contraceptive use was significantly higher (OR 1.51; 95% CI 1.35–1.70; heterogeneity; I2 = 81%) for FP interventions with a significant reduction in unmet need for contraception (OR 0.86; 95% CI 0.78–0.94, I2 = 50%). The subgroup analysis revealed demand-generation (OR 1.61; 95% CI 1.32–1.96), health system integrated (OR 1.53; 95% CI 1.07–2.20), and franchised FP clinic interventions (OR 1.32; 95% CI 1.21–1.44) had promoted the modern contraceptive uptake. Further, FP interventions implemented in urban settings showed a higher increase in modern contraceptive use (OR 1.73; 95% CI 1.44–2.07) compared to rural settings (OR 1.46; 95% CI 1.28–1.66). Given the considerable heterogeneity observed across studies and the low degree of certainty indicated by the GRADE summary for the primary outcome, caution is advised when interpreting the results.ConclusionThe review collated experimentally evaluated FP interventions that increased modern contraception use and reduced the unmet need in South Asia. The demand generation interventions were the most effective in increasing the uptake of modern contraceptive methods. Furthermore, the urban environment provides a conducive environment for interventions to improve contraceptive usage. However, further studies should assess which aspects were most effective on attitudes towards contraception, selection of more effective methods, and contraceptive behaviors.

Changes in Family Planning Methods and Sexual Behaviors after Türkiye’s Earthquake and the Effect of on Quality of Sexual Life

This study aims to examine the changes in family planning methods and sexual behaviors after Türkiye’s earthquake and the effect of on quality of sexual life. The study involved a total of 272 women. The multiple regression analysis indicated that having a low educational level, starting to use traditional family planning methods, experiencing a decrease in sexual desire, and having sexual intercourse once a month or less after the earthquake, negatively affected the quality of sexual life in women. Health professionals are recommended to assess women’s needs for family planning methods after disasters like earthquakes.