Family Planning Programs Research Articles

Assessing Acceptability of Biodegradable Contraceptive Implants in Kenya and Senegal.

Contraceptive implants are popular in Africa, but barriers to removal exist. Biodegradable implants (BDIs) offer an alternative to the need for removal. This study explored potential user, provider, and other stakeholder perspectives on 2 BDI prototypes, revealing opportunities and challenges for introduction. We conducted focus group discussions (FGDs) and in-depth interviews (IDIs) with women, men, family planning (FP) providers, community influencers, and FP policymakers and program staff in Kenya and Senegal. Characteristics of the 2 BDI prototypes were shared, and participants held and interacted with placebo prototypes. Structural coding was used to analyze the data focused on key product attributes, including biodegradation, removal potential, size, material, insertion site, and duration of effectiveness. We conducted 16 FGDs and 35 IDIs with 106 participants in Kenya and 15 FGDs and 43 IDIs with 102 participants in Senegal. Overall, respondents liked the idea of a BDI, noting the avoidance of pain and scarring and reduced transport and costs as benefits of no removal requirement. Kenyan respondents expressed greater understanding of the biodegradation process than those in Senegal, though potential users in both countries expressed concerns about possible side effects associated with the process. In Senegal, mention of cholesterol in a BDI caused concern, while Kenyan participants responded positively to the same BDI being composed of organic materials. The second BDI product was viewed as more similar to existing implants, which providers preferred. Participants suggested increasing the pregnancy protection duration beyond 18 months. No clear preference between products emerged, and participants liked and disliked some characteristics of both. Kenyan and Senegalese participants expressed interest in the BDI concept but expressed some reservations related to biodegradation, material, and side effects. BDIs offer the opportunity to expand contraceptive choice. However, messaging around product characteristics will be required for successful introduction and uptake.

Income Diversification of Rural Households in Bangladesh (2022-23)

This study examines income diversification and inequality among rural households in Bangladesh in 2022- 23, focusing on agricultural and non-agricultural sources of income. The analysis includes three districts: Chadpur, Sirajganj and Rajshahi, with specific economic activities. Data were collected through household surveys that collect income from agriculture, livestock, fishing, services and industries, and demographic data. Rajshahi has the highest income, due to high income from cattle, while Chadpur has the lowest. The results show significant income disparities, high levels of animal activity and differences in economic activity between regions. Larger houses in Rajshahi reflect changes in family structure. The main challenges identified were land fragmentation, climate change and limited access to finance and infrastructure. Recommendations for policy interventions include targeting support to low-income areas, investing in livestock development, promoting income diversification, improving infrastructure, strengthening climate livelihoods, expanding access to finance, the adoption of technology and the implementation of family planning programs. These strategies aim to reduce income inequality, improve economic opportunities and promote sustainable development in rural Bangladesh.

Factors Associated with the Utilisation of Family Planning Services among Women of Reproductive Age (15-49 Years) Attending Hoima Regional Referral Hospital

Family planning is defined as the ability for individuals and couples to attain their desired number of children and plan the spacing and timing of their births through the use of contraceptive methods. Promoting family is one of the main targets to reach the SDGs, and timely achievement of family planning targets is expected to accelerate achievement across the 5 SDG themes of people, planet, prosperity, peace, and partnership. Despite the enormous benefits of family planning services, the uptake of the service remains low Uganda. This has resulted in high rates of unwanted pregnancies, unplanned deliveries, unsafe abortions, and maternal mortalities in Uganda. Several factors play an important role in the use of contraceptives among women of childbearing age. The identification of these factors is crucial to the planning and implementation of a suitable family planning programme. The study was designed to determine the factors associated with the utilisation of family planning among women of reproductive age (15–49) attending Hoima Regional Referral Hospital, Western Uganda. This was a hospital-based cross-sectional study. Quantitative and qualitative methods of data collection were utilised to collect data from 251 participants. From the results of the study majority, 182(72.5%) had never used family planning services and 68 (27.5%) had ever used family planning services. Therefore, the level of utilizing family planning services was found to be 27.5%. Thus, the level of utilisation of family planning services among women of reproductive age (15–49) attending Hoima Regional Referral Hospital, Western Uganda, was low, which is significantly associated with the education level and perceived skills of health workers. There is a need to promote and effectively implement policies in support of girls’ education to increase FP service utilisation. Keywords: Family Planning, Women, SDGs, Contraceptives, HIV/AIDS

Asymmetry in contraceptive information at two sites in Burkina Faso

BackgroundFamily planning programs are foundationally important to public health, but like any medical intervention, contraception has drawbacks in addition to its benefits. Knowledge of these drawbacks in addition to benefits is essential for informed choice. Despite a general consensus among family planning researchers and providers that contraceptive counseling should be unbiased, little quantitative research has assessed the extent of bias in contraceptive counseling, and in people's contraceptive knowledge more broadly. ObjectiveTo understand the extent to which women report being told more about the advantages of contraception than the disadvantages—a concept we call “asymmetry” in contraceptive counseling, at two research sites in Burkina Faso. MethodsWe use data from a cross-sectional population-based survey of 3,929 women residing in the catchment areas of the Ouagadougou (urban) and the Nouna (rural) Health and Demographic Surveillance Systems in Burkina Faso. We use descriptive statistics to explore asymmetry in knowledge of the benefits/advantages and risks/disadvantages of contraceptive use overall, as well as method-specific asymmetry among current method users regarding their counseling experience. FindingsResults show substantial asymmetry in knowledge of advantages/benefits of contraception compared to disadvantages/risks. 86% of respondents said they could name any advantage of family planning, while half of that proportion (43%) could name any disadvantage. We find a similarly stark asymmetry in method-specific results among contraceptive users, especially for hormonal/biomedical methods. We also find substantial variation between research sites, with urban respondents much less likely to self-report complete family planning knowledge than their rural counterparts. ConclusionOur results suggest that family planning messaging in Burkina Faso may place an emphasis on the advantages without a commensurate focus on disadvantages. Family planning programs worldwide must ensure that people can make informed choices based on balanced, accurate information about both the benefits and the disadvantages of contraception.

A qualitative exploration of how a community engagement approach influences community and health worker perceptions related to family planning service delivery in Togo.

There is a growing body of evidence that asserts community engagement approaches can improve the quality of reproductive health services. Family planning (FP) programs in Togo are implementing such approaches, which aim to mobilize both health workers and communities to improve FP service quality and FP uptake. However, there is not enough known about the enabling factors and challenges associated with implementation, or the extent to which the programs improve outcomes leading to contraceptive uptake. We qualitatively explored how a community engagement approach influenced health worker and community perceptions related to FP service delivery in and around the city of Lomé, Togo, within the context of the broader integration of social and behavior change and service delivery. We conducted 18 in-depth interviews with health workers and 9 focus group discussions with community members. We found the approach, which included community dialogues, site walkthrough visits and the development of community action plans, worked synergistically together to support collaborative action between communities and health workers to increase mutual understanding of their collective needs related to FP services. Community members cited improved reception at the health facilities by health workers and indicated that the site walkthrough visits created a greater sense of empathy towards the providers and the challenges faced in their work environment. Health workers acknowledged a greater understanding of barriers at the community level following community dialogues, particularly among community members that are not routinely encountered at the health facility for reproductive health services such as men and youth. We found limited implementation of health facility improvements included in community action plans because they were dependent on commitment from community leadership and the need to mobilize additional support or financial resources. Community engagement approaches are a promising mechanism to support collaboration and enhance mutual understanding between health workers and communities to achieve improved FP service quality. Future programs should consider incorporating additional mechanisms to monitor community action plans and provide support to address structural challenges at the facility level particularly those that require financial resources.

Scoping review of qualitative studies on family planning in Uganda.

Family planning (FP) is an essential component of public health programs and significantly impacts maternal and child health outcomes. In Uganda, there is a need for a comprehensive review of the existing literature on FP to inform future research and programmatic efforts. This scoping review aims to identify factors shaping the use of FP in Uganda. We conducted a systematic search of eight scholarly databases, for qualitative studies on FP in Uganda. We screened the titles and abstracts of identified articles published between 2002-2023 and assessed their eligibility based on predefined criteria. We extracted data from the 71 eligible studies and synthesized the findings using thematic analysis and the Ecological Systems Theory (EST) individual, interpersonal, community, institutional, and policy-level determinants. Findings reveal the interplay of factors at different socio-ecological levels influencing family planning decisions. At the individual level, the most common determinants related to the EST were knowledge and attitudes of FP. Interpersonal dynamics, including partner communication and social support networks, played pivotal roles. Community-level factors, such as cultural norms and accessibility of services, significantly influenced family planning practices. Institutional and policy-level factors, particularly a healthcare system's quality and policies, also shaped use. Other themes included the intersection of HIV/AIDS on FP practice and Ugandan views of comprehensive abortion care. This scoping review underscores the intricate socio-ecological fabric shaping FP in Uganda. The findings highlight the need for targeted interventions to increase knowledge and awareness of FP, improve access to services, and address social and cultural norms that discourage contraceptive use. Policymakers and program implementers should also consider gender dynamics and power imbalances in FP programs to ensure they are equitable and effective.

Relationship Between Age and Education of Women of Fertile Age with Participation in Long-Term Contraceptive Methods

Objective: The aim of this research is to determine the relationship between age and education and the decision of women of childbearing age (WUS) to become MKJP family planning acceptors in Mamuju District. Method: This research is quantitative research with a cross-sectional method. Data collection techniques include questionnaires. The data analysis used was univariate analysis and bivariate analysis with the chi square statistical test. Result: The results of research based on the Chi Square Test show that there is a relationship between age (p value = 0.050) and education (p value = 0.017) and MKJP family planning participation. Conclusion: The results of this study explain that there is a relationship between age, education, and WUS participation in family planning programs using long-term contraceptive methods.

Sosialisasi Booklet Persiapan Reproduksi Sehat Berkeluarga

Indonesian teenagers have relatively low knowledge about reproductive health (index value 52.4). On the one hand, sexual education plays an important role in forming positive attitudes so that teenagers can prepare for family life. Preparation for a family is a teenager's planning in determining the age of starting a family, determining the spacing of children's pregnancies, and participation in the Family Planning (KB) program. The aim of this community service activity is to socialize the booklet on preparing for healthy reproduction for a family to students of the Blora Midwifery Study Program, Diploma Three Program, Poltekkes Kemenkes Semarang in 2024. The method of this community service activity is by socializing lectures using booklet media. The target of the activity is 61 final year students who will soon graduate and face the world outside of education which can be applied by working, continuing their education, or even getting married. So this community service activity needs to be carried out to equip students to better prepare for a healthy family life.

PENYULUHAN TENTANG PENGGUNAAN METODE KONTRASEPSI JANGKA PANJANG (MKJP) PADA WANITA USIA SUBUR

Long Term Contraceptive Method (MKJP) is a contraceptive method that works for a long time and has high effectiveness in preventing pregnancy. The use of contraception is one of the effective efforts in the Family Planning Program to control fertility or suppress population growth. In its implementation, efforts are made to ensure that all contraceptive methods or devices provided or offered to the public provide optimal benefits. In choosing a method, a woman must consider various factors, including health factors, potential side effects of a method, and the consequences of unwanted pregnancy. However, contraceptive use among women at young and old ages (risk age) is much lower than for women aged 20-39 years (non-risk age). Family Planning (KB) participants are women of childbearing age (WUS), one of whom uses contraceptive methods/methods for the purpose of preventing pregnancy or better known as acceptors. This community service implementation was carried out in Kediri Village Gading Rejo Districtand followed by 25 women of childbearing age. The methods used in health education are lecture, discussion and question and answer methods using flip sheets. It can be concluded that the education day regarding the use of MKJP can increase awareness and interest among women of childbearing age to choose to use long-term contraceptive methods and understand the many benefits of using long-term contraceptive methods.

Knowledge, Attitude and Practices- A Concept

The current article deals with the concept of Knowledge, Attitude& Practices (KAP) that emerged from the family planning programs after independence of the nation. Further, the concept of KAPGap emerged regarding the improvement of quality of the family planning programs. Development of the concept of KAP gap helped improved the quality of the family planning program & the program name changed to Family Welfare program. Further, it also provided a cafetoria approach of family planning methods where the people had to choice to chose from the available basket of methods of family planning/welfare. The current article traverses the history of the KAP approach, thereafter it sees how it sailed through finally reaching the current status of the KAP approach through the indicator of unmet need of family planning through the National Family Health Surveys of 4th& 5th rounds.

FAMILY PLANNING COUNSELING BY VASECTOMY MOTIVATORS (CASE STUDY OF VASECTOMY COUNSELING COMMUNICATION BY MOTIVATORS IN SIATAS BARITA SUBDISTRICT, NORTH TAPANULI REGENCY)

This study aims to analyze counseling communication, obstacles faced, and efforts made by vasectomy motivators to prospective acceptors in Siatas Barita District, North Tapanuli Regency, Indonesia. The researcher used several data collection techniques to conduct this study, namely in-depth interviews and observations. The results of this study show that the motivators in the district have met the requirements as effective communicators in counseling. The motivational approach proposed by motivators shows the need for greater encouragement for men to take an active role in Family Planning (KB) programs. Efforts to increase promotion and information related to male family planning through social media, newspapers, and other information sources are important steps that are expected to increase the acceptance and participation of men in family planning programs, so that families can choose the family planning method that best suits their needs.

Pemodelan Faktor-Faktor yang Memengaruhi Kejadian HIV/AIDS di Provinsi Jawa Barat

Indonesia is focusing on preparing for Indonesia’s Golden 2045 through the Golden Generation. The Golden Generation is expected to be the country's quality and superior human resource. The province of West Java, with the largest population in Indonesia, plays an important role in realizing Indonesia's Golden 2045 ambition. However, the high HIV/AIDS incidence in West Java is a major challenge that could potentially hinder Indonesia’s achievement of the 2045 Gold Plan. The Ministry of Health has launched the Three Zero HIV/AIDS concept to meet one of Indonesia's Golden 2045 pillars. Based on this, the study aims to identify factors that influence the number of HIV/AIDS cases in West Java. The HIV/AIDS case is a data count, so the approach used in this study is Poisson Regression. The results of the study showed that the number of cases of violence (X1), the percentage of use of condom contraceptives among members of the Family Planning (KB) program (X2), population density (X3), the proportion of poor population (X4), and number of health facilities per 100,000 inhabitants (X5) were related to cases of HIV/AIDS in the West Java Province. It is seen from the p-value of each variable X is 0.0 except the population density is worth 0.003. Having identified significant factors influencing cases of HIV/AIDS in West Java, the government is expected to enhance cooperation with relevant agencies in reducing the risk of the number of cases in Western Java. Thus, Three Zero in West Java can be achieved by 2030.

The Right Prescription for Family Bliss: A Cross-Sectional Study on Community Satisfaction in Indonesian Family Planning Programs

Although significant progress has been achieved over many decades, sustaining the success of family planning programs in Indonesia requires a deep understanding of the factors that influence community satisfaction among those involved. This study surveyed 503 Family Planning Field Workers (PKBs) across Indonesia’s regions to identify the main factors encouraging satisfaction among communities participating in these programs. A structured online questionnaire was distributed to collect data on the sociodemographic factors influencing satisfaction, which were then analyzed using multiple linear regression. The results showed that effective follow-up on community feedback (β = 0.233, p < 0.001), implementing a rights-based approach (β = 0.207, p < 0.001), enabling community participation (β = 0.147, p < 0.001), collaborating with healthcare providers and facilities (β = 0.159, p < 0.001), and monitoring and evaluating programs (β = 0.155, p < 0.001) were significant positive predictors. More notable, the regression model accounted for a considerable 74.7% of the variation in community satisfaction, pointing to how significant the explanatory power of the identified factors was in predicting the level of satisfaction among communities participating in family planning programs. Actions must be developed to enhance reproductive health and manage population growth by focusing on key factors such as responsive communication, rights, integrated services, community involvement, and evaluations, which are what matters most for family planning programs.

Accelerated demographic and economic transition calls for resolute socioeconomic policies

Population management seemed to have gotten underway quite well in 1970. But no sooner had the program gained traction than the Roman Catholic hierarchy and conservative groups voiced their strong opposition to family planning, which President Marcos, Sr. accommodated for political expediency. Thus, with a failed family planning program, declining fertility – a necessary condition for demographic transition towards faster economic growth, higher employment, and poverty reduction could not be achieved. A hugely missed opportunity graphically illustrated when comparing the Philippines and Thailand in particular, which had virtually identical key demographic-economic indicators in 1970 but drastically diverged by 2020. Apparently, the former ‘sowed the wind and is reaping the whirlwind’ – a cogent motivation moving forward for overcoming failures and balancing population and the economy better by adopting judiciously chosen policy options.

TEMPORARY REMOVAL: Drivers of Anemia Reduction among Women of Reproductive Age in Senegal: A Country Case Study

BackgroundIn Senegal, anemia prevalence among women of reproductive age (WRA) decreased from 59% in 2005 to 54% in 2017. However, determinants of reduction in disease burden under challenging public health conditions have not been studied. ObjectiveTo conduct a systematic in-depth assessment of the quantitative and qualitative determinants of anemia reduction among WRA in Senegal between 2005 and 2017. MethodsStandard Exemplars in Global Health methodology was used for quantitative analyses using Senegal’s Demographic and Health Surveys. Qualitative analyses included a systematic literature review, program/policy analysis, and interviews with key stakeholders. A final Oaxaca-Blinder decomposition analysis (OBDA) evaluated the relative contribution of direct and indirect factors. ResultsAmong non-pregnant women (NPW), mean hemoglobin (Hb) increased from 11.4 g/dL in 2005 to 11.7 g/dL in 2017 (p<0.0001), corresponding to a 5%-point decline in anemia prevalence (58% to 53%). However, inequities by geographical region, household wealth, women’s educational attainment, urban compared to rural residence, and antenatal care (ANC) during last pregnancy continue to persist. During this time period, several indirect nutrition programs were implemented, with stakeholders acknowledging the importance of these programs, but agreeing there needs to be more consistency, evaluation, and oversight for them to be effective. Our OBDA explained 59% of the observed change in mean Hb, with family planning (25%), malaria prevention programs (17%), use of iron and folic acid (IFA) during last pregnancy (17%), and improvement in women’s empowerment (12%) emerging as drivers of anemia decline, corroborating our qualitative and policy analyses. ConclusionsDespite a reduction in anemia prevalence, anemia remains a severe public health problem in Senegal. To protect the gains achieved to date, as well as accelerate reduction in WRA anemia burden, focused efforts to reduce gender and social disparities, and improve coverage of health services, such as family planning, IFA, and antimalarial programs, are needed.

Is Indirect Taxes Bad for the Poor? Examining the Determinants of Poverty in Pakistan

This study investigates the determinants of poverty in Pakistan from 1985 to 2023, focusing on unemployment, inflation, indirect taxes, secondary school enrollment, and total population as key variables. Employing the Augmented Dickey-Fuller unit root test, the analysis finds that while many variables exhibit non-stationary behavior at levels, they become stationary at first difference, ensuring the reliability of time series analysis. The ARDL Bounds Analysis confirms the significant relationship between poverty and its predictors, indicating that changes in these variables markedly impact poverty levels. The estimated long-run and short-run results highlight the significant roles of inflation, secondary school enrollment, total population, and unemployment in influencing poverty, with diagnostic tests affirming the model's robustness. The study underscores the positive relationship between secondary school enrollment and poverty reduction, advocating for increased investment in education. The analysis reveals that indirect taxes do not significantly impact poverty levels, yet suggests a review of the tax structure to ensure it does not disproportionately burden low-income households. A progressive tax system could aid in wealth redistribution and support poverty reduction efforts. The positive correlation between total population and poverty levels indicates that rapid population growth strains resources and infrastructure, highlighting the need for effective population management strategies, including family planning programs and investments in healthcare and education. Unemployment's significant impact on poverty calls for targeted interventions to create job opportunities. Policymakers should promote economic diversification, support SMEs, and implement active labor market policies such as job training and placement programs. While higher inflation rates are associated with lower poverty levels in this analysis, maintaining inflation within a manageable range is crucial to avoid eroding purchasing power and harming economic stability. The study advocates for continuous and comprehensive data collection to enable timely and evidence-based interventions, enhancing the effectiveness of poverty reduction strategies. Prioritizing inclusive economic growth, fostering an environment conducive to investment, innovation, and entrepreneurship can create jobs and reduce poverty, ultimately supporting sustainable socio-economic development.

Understanding the association between family planning and fertility reduction in Southeast Asia: a scoping review

ObjectivesWe aimed to explore and understand the extent and type of evidence on fertility reduction and its association with family planning (FP) in Southeast Asia.DesignScoping review, following the methodological principles...

Modern contraceptive utilization and associated factors among younger and older married youth women in Ethiopia: Evidence from Ethiopia Mini Demographic and Health Survey 2019.

Utilization of modern contraceptives increases over time but it was still low and varies across ages among married youth woman. This study revealed the prevalence of modern contraceptives and its associated factors among younger and older married youth women. A cross-sectional study design was applied to the sample of EMDHS 2019. Multilevel logistic regressions were carried out using STATA version 16 to identify the individual and community-level factors of modern contraceptive utilization. Adjusted odds ratios with a 95% confidence interval and variables with a p-value < 0.05 were considered to be significant determinants of modern contraceptive utilization. In the EMDHS 2019, a total of 3290 married women between ages 15 and 34 were included. Among these 1210 (36.7%) and 2080 (63%) women, they were age groups of 15-24 and 25-34 years, respectively. Modern contraceptive utilization among women aged 15-24 and 25-34 years was 54.23% and 52.6%, respectively. Injection is a commonly used modern contraceptive method. In this study, factors associated with modern contraceptive utilization among women aged 15-24 years include women who had primary education [AOR = 2.22; 95% CI: 1.02-4.83], who had three or more children in the household [AOR = 14.29; 95% CI: 1.61-126.25], Protestants [AOR = 0.29; 95% CI: 0.14-0.61], five to seven households [AOR = 0.34; 95% CI: 0.17-0.69], and region [AOR = 6.98; 95%:2.30-21.16]. On other hand, factors associated with modern contraceptive utilization among women aged 25-34 were women who had one or two under-five children in the household [AOR = 1.66; 95% CI: 1.03-2.68] and region [AOR = 3.54; 95%CI: 1.79-6.97]. More than 50% of participants used modern contraceptives in both age groups and, the associated factor of modern contraceptive utilization varied among this age group. Health managers and policymakers need to consider age group, region, educational status, religion, and fertility level in planning of family planning program.

Factors that influence cadre participation in the managing the family planning program in Banjarmasin City

The increasing population can lead to complex problems. One way to reduce the population is by implementing family planning programs. The success of the family planning program is largely determined by the participation of family planning cadres in each region. The purpose of this research was to analyze the factors that influence cadre participation in the management of family planning programs. The research method uses a cross-sectional design by analyzing the influence of age, education, length of time as a cadre, appreciation and motivation on participation. The research was conducted in the city of Banjarmasin. The sampling technique used is purposive sampling with a sample size of 61 cadres. Data analysis using the Kruskal Wallis test. The results of the study found that there was an influence of motivation on cadre participation with a p value of 0.005 &lt; α (0.05), while the variables of age, education, length of time to cadre and appreciation did not have a significant effect. The motivation of cadres must always be improved for the success of family planning programs.

DETERMINANTS OF POOR HOUSEHOLDS IN SOUTH SUMATRA USING A MULTILEVEL LOGISTIC MODEL

Poverty is still one of the problems experienced by all countries, including Indonesia. According to BPS, in March 2021, the poverty rate in Indonesia was 10.14 percent. South Sumatra is a province with a poverty rate, which is the tenth-highest nationwide and the third-highest on Sumatra Island. This poverty rate is accompanied by a contraction in economic growth in 2021 by 3.58 percent. This condition indicates a contradiction and suggests that poverty still needs to be resolved. Moreover, the disparity in social and economic aspects across regions could potentially make the poverty rate high. This research aims to see the individual and regional or contextual factors affecting poor households. To simultaneously capture the effects of individual and regional level, we perform a Multilevel Logistic model using hierarchical structured poverty data from SUSENAS. The result shows that 4 (four) variables at individual level, which are the number of household members, the status of residence building, health insurance, and saving ownership, had a significant effect on the poor household. The region with high unemployment rate tend to have a high percentage of poor households. This result indicates that local government need to have policies that can affect poor households directly, such as socializing more about health insurance program and family planning program, as well as supervision in social aid distribution. Moreover, they need to create a program that can employ more people in order to decrease the percentage of poor households in such regions.