Current Use Of Family Planning Research Articles

Sexual and reproductive health problems among women with mental illness attending tertiary care psychiatric outpatient clinic in India: A cross-sectional study.

Sexual and reproductive health (SRH) is a vital concern among women with mental illness (WMI) due to the increased risk for unplanned pregnancy, sexually transmitted infections (STIs), and poor obstetric outcomes. Objective of the study was to explore the current use of family planning (FP) methods, symptoms of STIs and sexual dysfunction among WMI. This descriptive study involved 404 WMI of reproductive age (18-49 years) attending tertiary care psychiatric outpatient clinics in India. During face-to-face interviews, centers for disease control and prevention (CDC)-reproductive health assessment toolkit-FP questionnaire, STI questionnaire and Female sexual function index (FSFI) were used to collect the data. Of 404 WMI, 261(64.6%) were users, and 137 (33.9%) were non-users of FP methods. About 6(1.5%) WMI did not respond FP methods question. Female sterilization was the highest among the users, 244(93%). Among non-users, 100 (73%) were unaware of choosing the effective method of FP. Most of the WMI, 377(93.3%), were unaware of STIs. The symptoms of STI reported include unusual genital discharge 62(15.3%) and genital ulcers/ sores 58(14.4 %). Most of them, 76(63.3%), were not on any treatment. The most common reason for not taking treatment was feeling ashamed 70(92.1%). Female sexual dysfunction was reported in 176(43.6%). Most of the WMI had difficulties in the arousal domain 288(71.3%), followed by low desire 233(57.7%) and dissatisfaction 186(46%). Most WMI underwent sterilization. Non-users of FP methods were not aware of choosing the effective method. Awareness about STIs was poor, and feeling ashamed was the primary reason for not availing of medical help. Nearly half of the WMI reported sexual dysfunction, among which arousal difficulties, low desire and dissatisfaction were common. Health professionals need to increase awareness about FP methods and symptoms of STIs among WMIs. Women require appropriate counselling regarding SRH and treatment for sexual dysfunction.

Knowledge, Perception, and Practice of DMPA-SC/Self-Injectable Contraceptive among Women: Findings from Mixed-Method Study in South-West and North-Central, Nigeria

Depot-Medroxyl-Progesterone-Acetate-Subcutaneous/Self Injection (DMPA-SC/SI) is an intentional approach used by the Nigerian government to improve the coverage rate of contraceptives method-mix. In this study, the knowledge, practice, and determinants of use of DMPA-SC/SI among women in North-Central and South-West, Nigeria, was assessed. A cross-sectional health facility study was conducted across four Nigerian states. Structured pretested questionnaires were used to elicit information from 844 women within reproductive age. Twenty focused group discussions and 40 In-depth interviews (IDIs). Descriptive statistics were used to analyze the characteristics of the women. Multivariate logistic regression was used to examine the determinants of the current use of DMPA-SC /SI. Statistical analyses were set at 5%. Recorded voices were transcribed in full and analyzed using literary methods. About 89.5% of respondents reported ever heard family planning; 97.6% reported heard DMPA-SC; 83.2% reported ever use family planning; 95.7% reported current use of family planning; 94.3% reported ever use DMPA-SC, and 46.5% reported ever use DMPA-SC/SI. The reason for the use of DMPA-SC/SI was because it was easy to use, effective and self-administered. The factors that discourage women from using DMPA-SC/SI were mainly fears associated with side effects, for and fear of SI-self-injury. The logistic regression results showed that those residing in a rural part of the country were less likely to use DMPA-SC/SI. The government should scale up this model nationally, including rural and hard-to-reach communities with public awareness programmes, public sensitization, and refresher training to improve on Provider’s counselling skills. Keywords: Knowledge, Practice, Self-injectable contraceptive.

Individual-level and community-level factors associated with the family planning use among pastoralist community of Ethiopia: a community-based cross-sectional study.

ObjectiveThe study aimed to identify the effects of the individual-level and community-level factors on the use of family planning (FP) among married women in the pastoralist community of Ethiopia.DesignA community-based cross-sectional study was conducted in September 2018. Data were analysed using R software. To determine the fixed effect of individual-level and community-level factors of FP use, a two-level mixed-effects logistic regression was used. The result was described using the Adjusted OR (AOR), and the variance partition coefficient.Setting and participantsAfar, Ethiopia (2018; n=891) married women of reproductive age (15–49) years.Primary outcome measuresFP use or non-use.ResultsThe current use of FP was 18.7% (16.31%–21.43%). Women who need to walk 1 hour and more to the nearest health facility (AOR 0.14, 95% CI 0.05 to 0.3), have ANC visit of 4 and above (AOR 6.02, 95% CI 1.74 to 20.8), had their last birth at a health facility (AOR 2.71 95% CI 1.27 to 5.81), have five and more children (AOR 4.71, 95% CI 1.86 to 11.9), have high knowledge on FP (AOR 2.74, 95% CI 1.11 to 6.74) and had high intentions to use FP (AOR 10.3, 95% CI 3.85 to 27.6) were more likely to report FP use. The magnitude of the effect of for FP use was smaller than that of 9 of the 13 individual factors. Apart from this 19.4% of the total variance in the odds of using FP attributed to between community difference (intraclass correlation coefficient=0.194). Regarding the community-level characteristics, clusters of having higher electronic media possession (AOR 2.84, 95% CI 1.2 to 6.72) and higher women decision making on FP (AOR 8.35, 95% CI 2.7 to 27.1) were significantly associated with increased FP use compared with clusters with lower reports of these aspects.ConclusionFP use among the pastoralist community is influenced by both individual cluster/community-level characteristics or factors. Even though the effect of clustering in FP use was large in comparison with the unexplained between-cluster variation, it was lower than the individual-level factors.Trail registrtion numberNCT03450564

Married very young adolescent girls in Niger at greatest risk of lifetime male partner reproductive coercion and sexual violence.

ObjectiveThe purpose of this analysis was to compare and contrast reproductive health (RH), gender equity attitudes, and intimate partner violence (IPV) among married very young adolescent (VYA) girls with married older adolescent girls and young women (AGYW) in rural Niger given limited literature on the topic.MethodsWe conducted an exploratory analysis of baseline data from the Reaching Married Adolescents Trial in Dosso region, Niger. We report counts and percents, by age group (13–14 years (VYA), 15–16 years, 17–19 years), of AGYW’s self-efficacy to use family planning (FP), accurate knowledge of FP, current use of modern FP, and unintended last pregnancy (UIP); lifetime reproductive coercion (RC), physical IPV, and sexual IPV; and gender equity attitudes. We also assess whether percents differ between VYA and older groups using Pearson’s Chi-Square and Fisher’s exact p-values. Results are stratified by parity. Finally, we use logistic regression to consider associations.ResultsThere were 49 VYA, 248 girls aged 15–16, and 775 AGYW aged 17–19 in our sample (n = 1072). Accurate knowledge of FP, self-efficacy to use FP, current use of modern FP, and UIP increased with age; all percents between VYA and AGYW 17–19 were marginally or statistically significantly different. We also saw VYA report higher lifetime RC and sexual IPV versus older groups, with sexual IPV statistically different between VYA and girls 17–19. Parous VYA reported a significantly higher percent of lifetime RC versus older AGYW. Among 17–19 year-olds, odds of current use of FP were higher among AGYW who reported physical IPV, and odds of UIP were higher among those reporting more gender equitable attitudes, both adjusted for parity.ConclusionsWe observed differences in RH, RC, and sexual IPV among married VYA and older AGYW in rural Niger. VYA should be prioritized in research to confirm and further understand their RH needs.

Socio-demographic Factors Associated with Knowledge and Uptake of Family Planning Among Women of Reproductive Age in a Rural Community of Abuja, Nigeria

Nigeria has a population of about 180 million, estimated to double in 22 years due to low uptake of family planning services. Low utilization of family planning is the major factor associated with high fertility pattern in Nigeria. This trend is higher among rural women in Northern Nigeria. Without a thorough understanding of, and due attention to the local context, utilization of family planning may continue to be low. Identification of correlates of family planning would be invaluable in designing strategies for ultimately improving uptake of family planning services. This study became relevant as no previous study on family planning has been carried out in Ushafa Community. The study was conducted at Ushafa community, a rural community, located in Bwari Area Council on the northern axis of the Federal Capital Territory (FCT) of Nigeria. The study was a descriptive cross-sectional study, conducted among women of reproductive age (15-49 years) who were permanent resident of Ushafa Community. Using proportion of contraceptive usage of 16% from a previous study, 240 women were recruited into the study by systematic sampling technique. Data was collected by means of a structured interviewer administered questionnaire, data was entered and analysed using statistical package for social sciences (SPSS) version 20. All tests were conducted using 2 tails while level of significance was set at 0.05. About a quarter of respondents (26.3%) knew that amenorrhoea could be a side effect of oral contraceptive pills, 51.1% knew that oral contraceptive pills must be taken daily, 58% were not using any form of family planning. Age (χ2 = 8.382, p = 0.01) and marital status (χ2 = 8.915, p = 0.01) were significantly associated with family planning knowledge. Level of education was significantly associated with current use of family planning (χ2 = 10.78, p = 0.03). Educational status was significantly associated with likelihood of using family planning in the future (χ2 = 8.64, p = 0.04). Although the respondents had fairly good knowledge of family planning, the study observed some misconceptions especially with respect to side effects and methodology of use of the commodities. Low uptake of family planning was observed among the respondents. Age and marital status were significantly associated with family planning knowledge; level of education was significantly associated with current use of family planning. There is need for incorporation of facts on usage and side effects of family planning in message disseminated by health workers in health facilities in Ushafa Community so as to correct misconceptions. DOI : http://dx.doi.org./10.17576/JSKM-2018-1601-09

Socio-Demographic Determinants of Family Planning Service Utilization among Women of Reproductive Age in Urban Communities of Imo State, Nigeria

Introduction: Many developing countries are characterized by rapid population growth, which is partly attributed to high fertility rates, high birth rates, accompanied by steady declines in death rates, low contraceptive use and high but declining mortality rate. AIM: To determine the factors influencing family planning method use among women of reproductive age in urban communities of Imo state, Nigeria. Methodology: The study was a community based descriptive cross-sectional study involving 560 women of reproductive age who met the inclusion criteria and were selected using the multistage sampling technique. The data were collected using a pretested, semi-structured and interviewer administered questionnaire and were analyzed using EPI-INFO version 3.2.1. A p-value ≤ 0.05 was considered significant. Results: The mean age of the respondents was 32.7 ± 7.7 years with most of the women (99.1%) being aware of family planning. The common methods known were; pills (65.2%), injections (62.5%), condoms (61.3%) and natural family planning methods (49.5%). The prevalence of ever use and current use of family planning was 54.1% and 35.1% respectively and the commonest method ever (36%) and currently (26%) used was the condom. The factors found to significantly influence family planning method use in the study were: age of women, religion, family size, number of male children, monthly income, being able to access and pay for family planning services without partners financial support, contraceptive knowledge, prior discussion of family planning with partner, partner being in support of modern family planning methods use and previous use of any form of contraception. Conclusion: Most of the factors found to influence use can be modified by appropriate intervention programs.? Thus there is need to institute these intervention programs by authorities concerned so as to increase utilization of services and reduce consequent problems.

Ugandan Women's View of the IUD: Generally Favorable but Many Have Misperceptions About Health Risks.

Between 2001 and 2006, IUD use in Uganda stagnated at 0.2% among women of reproductive age (WRA) ages 15-49. By 2011, IUD use had increased slightly to 0.4%. Recent studies report a significant increase in IUD use to 3.8%, but it is still low. Because the IUD is a little-used method in Uganda, we assessed the acceptability of the IUD by surveying women about their perceptions, attitudes, and beliefs. In August and September 2014, we conducted a cross-sectional survey among 1,505 WRA exiting public and private health facilities in Uganda. We collected information on women's attitudes, knowledge, and beliefs about the IUD, as well as their perceptions about its availability. We classified women's responses according to a behavior change framework with 3 summary constructs: opportunity (structural factors that influence behavior), ability (skills to perform the behavior), and motivation (self-interest in adopting the behavior). As these 3 types of factors are more favorable to the desired behavior (in this case, use of the IUD), individuals are more likely to perform the behavior. Cross-tabulations compared the percentage results of perceptions and knowledge by key background characteristics. Most (87.8%) of the surveyed women had heard of the IUD, and nearly two-thirds had a positive attitude toward the method. But a lower percentage (38.6%) had accurate information about the IUD and more than half (51.6%) did not think the method was available in a nearby facility. More than half of the women believed incorrectly that the IUD can damage the womb (57%), that it reduces sexual pleasure (54%), and that it can cause cancer (58%). Current use of family planning or of a modern method specifically was positively associated with awareness and accurate knowledge and beliefs about the IUD. Married women had significantly higher awareness of the IUD than single women, and they had better knowledge and belief scores. The type of facility used for health care services (public, private franchise, or private non-franchise) may also influence acceptance of the IUD. Interventions to increase the use of IUDs in Uganda should address low availability of the method in facilities, as well as misperceptions and misinformation, especially about the safety of the IUD. Demand promotion should address provider misperceptions in addition to client misperceptions and should include interpersonal communication and the mass media.

Designing Evidence-Based Family Planning Programs for the Marginalized Community: An Example of Muslim Community in Nepal.

Family planning (FP), considered as an encouraging trend for development, is thought to be positively correlated with family health and well-being and negatively correlated with poverty levels. Despite being a priority goal of government and development agencies, in a heterogeneous society like Nepal, FP can be an issue that needs to be dealt with consideration for religious and cultural beliefs of different sections of society. Despite steady progress in achieving FP goals, minority populations have lagged behind the rest of the country in achieving improved family health outcomes; Muslim community being one such example. This study aims to explore the existing situation of FP use in Muslim communities and to identify key policy-related issues affecting the access to and utilization of FP services. Mixed approach was used in Kapilbastu district, which accommodated the larger proportion of Muslims in Nepal. Interview was conducted among 160 married women using semi-structured questionnaire. Focus group discussion, key informant interviews, and consultative meeting were the qualitative techniques employed in this study. Quantitative data were analyzed using descriptive and inferential statistics (Chi-square test), while qualitative data by thematic approach. More than half of women (56.0%) expressed their interest in FP use, while reported users were just below the quarter (24.0%). Husband approval and secrecy of their personal identity affect use of any method of contraception. Future plan for children and prior information regarding FP found to affect current use of FP, significantly. FP word itself was found to be stigmatizing, so women prefer replacing the word FP with culturally appropriate one. Furthermore, incorporating it into comprehensive package for improving women's health will definitely contribute to improve access and uptake of services. Discrepancy exists between current use and desire for use of FP among Muslim women in future. This highlights the inadequacy of implementing the current blanket policy and programs related to FP and offer ways to move forward with the national FP agenda ensuring the cultural rights and non-discrimination of women.

Maternal Health Care Service Utilization and Its Role in Postpartum Family Planning Use in Nepal

Family planning and maternal health care programme has been initiated in an integrated approach for a long time in Nepal. However, the use status of family planning method could not be presented at good instance. The International Conference on Population and Development (ICPD), 1994 and later millennium development goal 2002, both paved the way out for the situation mostly in the developing countries. Nepal also has made some changes in its services aiming to reduce high maternal mortality and promote to use family planning method. Use of family planning method within 12 months after childbirth could be a right solution for many developing countries like Nepal having high unintended birth. Therefore, this paper aims to analyse the role of maternal health care service utilization in initiating use of family planning method after post-partum period. Women’s data file from Nepal Demographic Health Survey, 2011 has been used for the analysis. Bivariate and multivariate analysis result have revealed that the role of delivery care, controlling other variables seems to be much appreciable in getting family planning use within 12 months of delivery. Effects of some study variables besides delivery care remains unchanged in different models. Therefore, embracing family planning programme along with maternity care components would have implications towards - increasing current use of family planning, reducing the chances of unwanted/unintended birth, providing opportunities to control over female own body, contribution in achieving replacement level fertility and maintaining good health for both mother and the baby.

Contraceptive Practices and Fertility Desires Among HIV-Infected and Uninfected Women in Kenya

Prevention of unplanned pregnancies is a critical element in the prevention of mother-to-child transmission of HIV infection, but its potential has not been fully realized. We assessed the utilization of family planning (FP) and fertility desires among women of reproductive age by HIV status. We selected a nationally representative sample of households using a stratified 2-stage cluster design and surveyed women aged 15-49 years. We administered questionnaires and examined predictors of current use of FP and desire for children among sexually active women with known HIV infection and women who were HIV uninfected. Of 3583 respondents, 68.2% were currently using FP, and 57.7% did not desire children in the future. Among women who did not desire children in the future, 70.9% reported that they were using FP, including 68.7% of women with known HIV infection and 71.0% of women who were HIV uninfected. Women with known HIV infection had similar odds of using FP as women with no HIV infection (odds ratio, 1.12; 95% confidence interval: 0.81 to 1.54). Women with no HIV infection had significantly higher adjusted odds of desiring future children (adjusted OR, 2.27; 95% confidence interval: 1.31 to 3.93) than women with known HIV infection. There is unmet need for FP for HIV-infected women, underscoring a gap in the national prevention of mother-to-child transmission of HIV strategy. Efforts to empower HIV-infected women to prevent unintended pregnancies should lead to expanded access to contraceptive methods and take into account women's reproductive intentions.

The Status of Desired Maternal and Child Health Practices and Service Utilizations of Model Families of the Health Extension Program in SNNPR, Ethiopia

Background: Maternal and Child Health (MCH) is one of the main focus areas of the Health Extension Program (HEP). Therefore, assessing the status of MCH service utilization of families benefiting from the HEP is critical to inform progress of the program and future directions. Objective: The purpose of this study is to assess the status of desired MCH practices and service utilization of families benefiting from the HEP in SNNPR state of Ethiopia. Method: A cross-sectional comparative study was conducted from December 2010 to June 2011 in Wolayta and Kembata Tembaro Zones of Southern Nations, Nationalities and Peoples Regional State of Ethiopia. Comparison of selected variables that show MCH service utilization was made between a randomly selected 690 model families and 686 non-model families. Qualitative data were collected from the two selected zones to complement the findings of the quantitative data. The qualitative data was collected from a purposively selected group of women and men among model families. Descriptive and analytics statistics were used to analyse the quantitative data using STATA version 10 while the qualitative data were analysed using Open Code version 3.6.2.0. Results: The study showed that ITN ownership and utilization by model families was 66.9% and 58.4% as compared to 53.3% and 42.6% by non-model families respectively (p<0.01). Similarly, ever and current use of family planning was 45.4% and 32.3% as compared to 33.6% and 18.6% among model and non-model families respectively (p<0.001). Nearly half (47.3%) of the women in model families had ever tested for HIV while 35.2% of the women in non-model families did the same (P<0.01). Forty two point three Percent (42.3%) of husbands in model families also tested for HIV while only 35.8% of their counterparts in non-model families did the same (p<0.01). There was no significant difference in the proportion of households with child immunization and feeding practices between model and non-model families. Conclusion: Generally, model families performed better than non-model families. The government’s decision of making all households models through the implementation of the health development army is a timely decision. Regular follow up of model families after graduation help further improve outcome and sustain the gains.

Uptake of family planning methods and unplanned pregnancies among HIV‐infected individuals: a cross‐sectional survey among clients at HIV clinics in Uganda

BackgroundPrevention of unplanned pregnancies among HIV-infected individuals is critical to the prevention of mother to child HIV transmission (PMTCT), but its potential has not been fully utilized by PMTCT programmes. The uptake of family planning methods among women in Uganda is low, with current use of family planning methods estimated at 24%, but available data has not been disaggregated by HIV status. The aim of this study was to assess the utilization of family planning and unintended pregnancies among HIV-infected people in Uganda.MethodsWe conducted exit interviews with 1100 HIV-infected individuals, including 441 men and 659 women, from 12 HIV clinics in three districts in Uganda to assess the uptake of family planning services, and unplanned pregnancies, among HIV-infected people. We conducted multivariate analysis for predictors of current use of family planning among women who were married or in consensual union and were not pregnant at the time of the interview.ResultsOne-third (33%, 216) of the women reported being pregnant since their HIV diagnoses and 28% (123) of the men reported their partner being pregnant since their HIV diagnoses. Of these, 43% (105) said these pregnancies were not planned: 53% (80) among women compared with 26% (25) among men. Most respondents (58%; 640) reported that they were currently using family planning methods. Among women who were married or in consensual union and not pregnant, 80% (242) were currently using any family planning method and 68% were currently using modern family planning methods (excluding withdrawal, lactational amenorrhoea and rhythm). At multivariate analysis, women who did not discuss the number of children they wanted with their partners and those who did not disclose their HIV status to sexual partners were less likely to use modern family planning methods (adjusted OR 0.40, range 0.20-0.81, and 0.30, range 0.10-0.85, respectively).ConclusionsThe uptake of family planning among HIV-infected individuals is fairly high. However, there are a large number of unplanned pregnancies. These findings highlight the need for strengthening of family planning services for HIV-infected people.

MEN’S APPROVAL OF FAMILY PLANNING IN BANGLADESH

This article attempts to evaluate men's approval of family planning in Bangladesh using the couple data set from the recent Bangladesh Demographic and Health Survey (BDHS), 1999-2000. Family planning approval is addressed both from individual and couple perspectives. Analysis of BDHS data shows that about 85% of the wives report that their husbands approve of family planning, which is lower than the wives' own approval rate (95%). Using the couple data set, husbands' characteristics were matched to the wives' responses on family planning approval. Regression analyses show that age, education, access to TV, inter-spousal communication, current use of family planning and the number of living children significantly determine family planning approval among both men as well as couples. Family planning approval was found to be much lower in Sylhet than in the other administrative divisions. Multilevel modelling analysis suggests almost negligible variation at the community level. The findings indicate the need for careful evaluation of the DHS questions in order to measure appropriately men's family planning attitudes.

Family Planning Prevalence, Acceptance and Use in Chitungwiza

iis study utilises data collected in the Chitungiuiza socio-demograpliic suiivy (1990) to determine the levels of knoivledge, ever-use and current use of family planning among Chitungwiza women. Also examined is the ideal number of children and the channels used to distribute family planning information in Chitungwiza. The study has shown that zuhilst the level ofknoiuledge is quite high among Chitungzoiza women, levels of use particularly current use are not substantial. Discussion of the ideal family size is a common phenomenon among Chitungwiza spouses.

Determinants of marital fertility in Pakistan: the impact of education, work and family planning.

The relative impact of the indirect and direct determinants of fertility of Pakistani women was assessed using the 1990/91 Pakistan Demographic and Health Survey (PDHS). A total of 7926 households was selected and 5713 women of reproductive age (15-49 years old) who had at least one birth were interviewed. Several social, economic, and demographic variables were employed to assess the number of children ever born. Ordinary least squares regression was used to estimate four multivariate models of children ever born. The direct and indirect determinants and the control variable of current age were simultaneously entered for each of four models that differed by age: 15-49, 15-24, 25-34, and 35-49 years. There was a 0.5 child difference between children ever born (4.64) and living children (4.11) for the 15-49 age group. This indicates infant and child mortality: 26% of the women experienced at least one child death before the age of 2 years. The oldest group had the lowest percentage ever attending school: 19% vs. 25% and 26% (15-24 and 25-34 age groups, respectively). Education was nonsignificant for the youngest and middle-aged cohorts, but it was negative and significant for the older cohorts. For employment, only the 25-34 age group was negative and significant. Age at marriage and breast feeding were strong and negative for all models. Current use of family planning was positive and significant for the oldest age group and the total. The younger cohorts did not have a negative and significant relationship between education and fertility; and the 15-24 age group living in a major city had significantly higher fertility than their town and village counterparts. The variables that showed differential impact were education, employment, residence, and contraceptive use. Education did not significantly lower fertility for the younger groups, but it did for the older group. Employment significantly lowered fertility for the 25-34 age group. Contraceptive prevalence steadily increased from 7% in the 15-19 age group to nearly 21% in the 35-39 age group.

Australian family planning surveys: some problems of comparability.

SummaryThis paper assesses the Australian data on the current use of family planning during the 1970s. The problems of comparing the results of various surveys, and of reconciling these results with Department of Health statistics, are discussed. In spite of an unfortunate lack of comparability between the various sources, the switch from oral contraceptives to sterilization is well-marked. Whereas the IUD has maintained its popularity, natural methods are shown to be of declining importance.