Modern Family Planning Methods Research Articles

Predictive factors to access and use of family planning services by rural and semi-urban dwellers in Afikpo North Local Government area, Ebonyi State, Nigeria.

Pregnancy and childbirth are important periods when women of reproductive age frequently come in contact with healthcare facilities and providers. These periods afford them the privilege for discussion and decision on post-partum family planning with healthcare providers. Male partner consent has been shown to have a positive impact on access and uptake of modern contraception. This study was aimed at assessing the availability, uptake and male partner consent for post-partum family planning (PPFP) amongst rural and semi-urban dwellers in Afikpo North local government area of Ebonyi state, Nigeria. The study conducted on 205 postpartum women, 40 health workers at the primary health centres (PHCs) and traditional birth attendants (TBAs) in Afikpo North LGA were selected by a random sampling technique. Information was obtained via 3 categories of interviewer-administered questionnaire for the different categories of individuals involved in the study. Data analyses was done using SPSS version 21.0. The overall findings showed a high prevalence of grand multiparity (51.2%) and child-bearing at extremities of reproductive age (20.5%) despite generally good awareness of modern contraception (92.7%) and availability of family planning services and modern birth control methods in all the PHC facilities. Of note is that a good percentage of the women received antenatal care (38.1%) or had their last delivery at TBAs places (42.4%) despite the fact that only 60% of the TBAs are aware of modern family planning methods and none of them offer family planning services. The prevalence of modern contraceptive usage was 41.5% and the male partner consent was present in 72.9% of modern contraceptive users. Despite high level of awareness and availability of modern family planning services, the TBAs should be more sensitized in order to improve the uptake of PPFP.

Correlates of knowledge of family planning among people living in fishing communities of Lake Victoria, Uganda

BackgroundKnowledge of family planning (FP) is a key determinant of contraceptive use which ultimately plays a role in attainment of good health and in conduct of clinical research. People living in fishing communities (FCs) have limited access to health services including FP and are targeted for future clinical research but their knowledge of FP and its correlates are scantily known. We determined correlates of knowledge of FP among people living in FCs of L. victoria in Uganda to inform future FP education programs in FCs.MethodsWe conducted a comparative cross-sectional survey among participants aged 15–49 years from Kigungu and Nsazi. Participants were asked if they were aware of any FP method. All those who responded in the affirmative were further asked to mention what FP methods they had heard of or knew. Those who reported knowledge of at least one FP method were asked a series of questions about FP methods and their side effects. Knowledge was categorized into good or poor knowledge based on their mean total score. Poor knowledge constituted a score below the mean while good knowledge constituted a score of more than or equal to the mean total score. To further explore attitudes and perceptions of FP, ten in-depth interviews and four focus group discussions were conducted.ResultsOf the 1410 screened participants, 94.5% were aware of at least one FP method. Pills and injectable hormonal methods were the most commonly known methods. Slightly over a third (38%) had good knowledge of FP. Correlates of knowledge of FP were; being female (aOR: 1.92 95% CI: 1.39–2.67), residing in Kigungu (aOR: 4.01 95% CI: 2.77–5.81), being married (aOR: 1.59 95% CI: 1.11–2.28) and currently being in a sexual relationship (aOR: 1.75 95% CI: 1.18–2.60). Concerns about safety and effectiveness of some modern FP methods exist. Misconceptions on effects of FP like sterility, cancers and foetal abnormalities were common.ConclusionFP awareness among people living in FCs of L. Victoria in Uganda is high. However, good knowledge about specific methods tends to be low. Correlates of knowledge of FP include gender, residence, marital status and sexual engagement.

Impediments and Perceptions on the Utilization of Family Planning Services in Bauchi State, Nigeria

Health system consists of elements involved in healthcare delivery, including family planning services. At community level, health system comprises a set of local actors, relationship and processes engaged in producing, advocating and supporting health in the communities. As a component of health care delivery, family planning is an important aspect of stabilizing population growth and poverty reduction. This study assesses community perception and barriers influencing utilization of family planning services in Bauchi State, Nigeria. The study design was Focus group discussions (FGDs), qualitative in nature and in-depth interview was conducted across the three senatorial zones of Bauchi state. The study utilized Fifteen (15) Focus Group Discussions (FGDs) using women of reproductive age who had at least one child both users and non-users of modern methods of family planning method. The result shows that respondents acknowledge that barriers exist which affects the utilization of family planning,. The result also shows that some respondents oppose the use of modern methods of family planning which hinders its utilization, remedies to the barriers were offer and we conclude that majority of people in the northern Nigeria specifically Bauchi state are yet to wholeheartedly embrace the initiative because of religious and cultural beliefs and educational level of respondents affects the utilization of family planning services. It is recommended that communities should be sensitize on the benefits of family planning throughout Bauchi state, emphasis should be given on educating the health benefits of family planning to mothers

ASSESSMENT OF ADOPTION OF FAMILY PLANNING METHODS AMONG RURAL WOMEN IN KADUNA STATE OF NORTHERN NIGERIA

The study was carried out to assess the adoption of family planning methods among rural women in Kaduna State. The study revealed that over 85% of the respondents were in the productive age of between 15 - 44 years with about 60.28% in a polygamous home. The main sources of information used by the respondents were health officials (21.08%), radio (20.48%) and friends (12.65%). The results further disclosed low use of modern family planning methods (38.28%); mainly preferred use of traditional methods of family planning (61.72%) and preferred use of modern methods of family planning (38.28%). Prolonged lactation (28.70%), abstinence (21.29%) and withdrawal method (18.06%) ranked first, second and third, respectively, among traditional family planning method mainly used by the respondents. Of those using modern methods, 35.07% used oral contraceptives while 26.12% of the respondents used the condom. Majority (22.00%) of the respondents reported the perceived religious prohibition against family planning, lack of approval by husband (19.14%) and fear of side effects associated as the main constraints faced in the adoption of family planning in the study area. The study recommended raising the level of both spouses in the understanding of positive aspects of family planning methods by the public health workers through use of trusted scholars via governmental and non-governmental agencies.

Psycho-Social Predictors of Utilization of Modern Family Planning Methods among Married Men and Women in Ijebu- Igbo

This study examines the knowledge of family planning, perceived fear of side effects and social variables as predictors of utilization of family planning methods in Ijebu-Igbo. Opinions of two hundred and fifty participants who are married and residents of Ijebu Igbo were sampled using questionnaire. Five hypotheses were generated and tested using Pearson Product Moment Correlation and regression analysis. Results showed that marital status accounted for 26% of variance in utilization of family planning method, with a regression coefficient of ? = -.26 (P< .01). The five blocks of predictor variables account for only 17% of the variance; employment status, also significantly predicted utilization of family planning method (? = -.21, P < .05) explaining, together with marital status, 26% of the variance in utilization of family planning method (accounting for R2 – change of .11, P < .01). Results also showed that the lower the perceived fear of side effect, the better their level of utilization of family planning method. Religion has significant influence on the utilization of family planning methods which confirmed second hypothesis. The implications of the study were discussed and it was recommended that health education that will be tailored around knowledge of  family planning should be organized both by governmental and non-governmental organizations since it was found that knowledge of family planning methods is key to their utilization.

Determinants of Modern Contraceptive Methods Discontinuation among Women within Reproductive Age in Dire Dawa City, Eastern Ethiopia.

Background Modern family planning methods are widely believed to influence fertility reduction worldwide. Family planning had a clear effect on the health of women, children, and families worldwide especially those in developing countries. It has been shown that there are many instances in which women might discontinue contraception methods that put women's health at risk. Objectives To assess and identify Determinants of Modern Contraceptive Methods Discontinuation among Women in Reproductive age interval in Dire Dawa City. Method A cross-sectional study design was employed. A total of 811 respondent women with one-year history of modern contraceptive method usage were considered in the study. A stratified random sampling method was used to select the study participants. Data was collected using a structured questionnaire and analyzed by descriptive statistics and binary logistic regression. Result The study indicated that 634 (78.20%) of respondent mothers continued using the method that they have used before a year. Whereas 177 (21.80%) of women discontinued using the method within a year. The factors age, number of children, who made the decision on the choice of the method used, the type of contraceptive method used, and taking counseling before using the method were found significant at 5% level of significance. Conclusion Young women, respondents who have no or a small number of children, and not the decision maker on the choice of the method were more likely to discontinue. Whereas women who did not take counseling are less likely to discontinue. When compared to women who used implant those women who used pills and injectables are more likely to discontinue. Thus, the study identified factors that contribute to the discontinuation of modern contraception methods.

Does Family Planning Messages Exposure in the Preceding 12 Months Period Predict the Current Use of a Modern Family Planning Method among Women of Reproductive Age in Nigeria?

This study examined how exposure to Family Planning (FP) information can influence modern contraceptive use among women of reproductive age in Nigeria. The study used a secondary dataset from the PMA2020/NGR4 conducted in 2017. A total of 11,380 females were interviewed, which is the sample size for this study. Data analysis included Univariate, Bivariate, and Multivariate techniques. Bivariate analysis findings showed that exposure to FP information was higher among those who know a place to obtain FP services. However, other exposure such as via radio, television, newspapers, told at the health facility are also significantly associated with the modern use of FP in Nigeria (p-value <0.05). Binary logistic regression showed that show that women who heard FP information on the radio were 0.23 times as likely to report using contraception compared to those who did not. To improve family planning use various ways of conveying family planning messages should be encouraged because multiple information sources on contraception help retain the message better and extend the reach of the campaign on family planning use.

Predictors of Male Sterilization among Eligible, Modern Method of Family Planning Users in India: Evidence from a Nationwide Survey

Background: Male sterilization despite being more cost-effective compared to female sterilization is opted by very few Indian eligible couple as family planning (FP) method. Aims &amp; Objectives: To find out attributes of male sterilization among current eligible modern family planning methods users in India. Material &amp; Methods: It was an observational study, cross-sectional in design based on fourth round of national family health survey (NFHS-4) 2015-16 men’s datasheet. There were in total 112122 data, of which 11772 sample population who had completed their family, been using modern methods of family planning and wife in reproductive age (15-49) were selected for analysis. Results: Among the study subjects, 377(3.2%) underwent male sterilization. In multivariable model those who were residing in southern India; Hindu by religion; scheduled caste (SC)/scheduled tribe (ST) by caste; belonged to lower quintile of wealth index; covered by a health insurance scheme; perceived ≤2 children as ideal number of children; husbands not working and employed seasonally/occasionally were more likely to undergo male sterilization adjusted with the age of husband, wife, their place of residence and property ownership status. Conclusion: Male sterilization in the sample population was significantly predicted by the region, religion, ethnicity, socioeconomic status, husbands employment status etc.

Male partner approval on the use of modern contraceptive methods: factors determining usage among couples in Kibaha district, Tanzania

BackgroundMen in developing countries play an important role in the adoption of family planning (FP), either as actual users or supporters of their partners. Notwithstanding the universal knowledge on the contraceptive methods, their approval and use have been low among men in Tanzania. This study determined the magnitude and factors that influence men to use or approve the use of modern contraceptive methods with their spouses.MethodsA cross sectional, community-based study was conducted in Kibaha, Pwani region in 2014. A total of 365 randomly selected married and cohabiting men; aged 18 to 60 years who had at least a child below the age of 5 years were interviewed using a structured questionnaire. Descriptive statistics were performed and associations between status of men using modern FP with their partners and potential factors were tested using Chi-square and Fisher’s exact tests as appropriate. Logistic regression model was fitted to determine significant factors associated with male use of the methods with their partners.ResultsAbout 60 % of men (59.7%) reported to use modern FP methods. In the bivariate analysis, education level (odds ratio (OR) = 2.6, CI = 1.4–4.8; p = 0.002); men knowledge on any contraceptive method (OR = 24.1, CI = 7.3–79.9; p < 0.001); awareness of a nearby FP clinic (OR = 6.2, CI = 3.1–12.3; p < 0.001); number of children (OR = 2, CI = 1.1–3.6; p < 0.025) and presence of a provider during clinic visit (OR = 12.0, CI = 2.26–63.7; p < 0.004) were significantly associated with the use of FP. However, in the multivariable analysis, only knowledge on FP methods (adjusted odds ratios (AOR) =26.4; CI = 7.9–88.4, p < 0.001) and number of children a man had (AOR = 1.9; CI = 1.0–3.6, p = 0.039) remained significantly associated with the use of modern FP methods.ConclusionThis study has shown that for men to use family planning methods with their partners, knowledge of FP methods and number of children are critical factors. Visiting a FP center alone or with a spouse, and availability of FP provider (during visit) also influence this practice. These findings emphasize a need to increase knowledge on contraception and family planning services access among men.

Use of the most significant change technique to evaluate intervention in promoting childbirth spacing in Nigeria

Background: Childbirth spacing (CBS) or Family Planning (FP) methods are considered an essential component of sexual and reproductive health. It refers to the resting period between pregnancies that provides the mother with time to recuperate from pregnancy, labour and lactation. To evaluate the impact of these methods, a storytelling evaluation approach was used.Objectives: The aim of this study was to assess the outcome of behaviour change communication intervention on demand and uptake of modern CBS methods.Method: Most significant change story technique was used to evaluate the outcome of behaviour change communication intervention in two north-western Nigerian states. Impact story template was used to collate 57 stories from the field through group discussions and in-depth interviews with women of reproductive age. Transcripts from the group discussions and interviews were analysed using qualitative analytical software.Results: One story was unanimously selected. The story was about a married 15-year-old with a history of three pregnancies and two live births, who suffered pregnancy complications and miscarriage during her last pregnancy. She had learnt about CBS methods through the community volunteers working on the social and behaviour change communication (SBCC) intervention. As a result, her husband and mother-in-law were convinced and agreed that she take up a modern FP or CBS method from the primary health facility in the community. She eventually took an implant method.Conclusion: Acceptance and uptake of modern CBS methods in north-western Nigeria has been low, and this is largely because of myths and misconceptions, and religious and cultural beliefs amongst others.

Matthew the Poor: Towards Modern Birth Control Methods in the Coptic Orthodox Church

The paper is focused on the Matta el-Meskeen (Matthew the Poor) and his reflection of selected bioethical issue: birth control. The paper deals with the forming stages of the bioethical discussions within the Coptic Orthodox Church in Egypt. The research is based on Matthew the Poor´s articles and books. The first part presents his teachings about theosis as an key concept of his theology in general and bioethics in particular. The second part brings analysis of his birth control reflections and presents his observations about the role of the Church and the state in the decision making process of Christian believers.

Barriers to the uptake of modern family planning methods among female youth of Temeke District in Dar es Salaam, Tanzania: A qualitative study

ObjectivesDespite the accessibility of modern family planning (FP) methods, unwanted pregnancies remains a serious problem in Tanzania. This study aimed to identify the barriers to the uptake of modern FP methods among female youth reached by the Chaguo la Maisha project in Temeke District, Tanzania. Study designQualitative study conducted in March 2017 involving 15 female youths aged 18–24 years. Main outcome measuresPurposive sampling was used to select study participants and sampling followed the principle of data saturation. The study participants were those who received contraceptive counseling from community health mobilizers and agreed to visit a nearby health facility for FP services but did not go for the services. A semi-structured interview guide, translated into Kiswahili language was used. Data were transcribed; analyzed following qualitative content analysis. Major categories and subcategories that hindered visitations were identified. ResultsThree categories and their subcategories were identified as hindering FP method uptake. (1) individual perception factors: (a) myths and misconceptions, (b) fear of side effects, (c) fear of the possibility of being pregnant at the time of FP counseling; (2) community perception factors: discouragement from an intimate partner and closest friends; and (3) health facility system factors: unavailability of the preferred method and absence of the trained personnel for the FP method. ConclusionsThe main barriers to FP uptake were myths and misconceptions, and fear of side effects. The intimate partner or closest friends were significant decision influencers on contraceptive use, implying that FP campaigns should focus beyond the individual level.

Do modern family planning methods impact women\u2019s quality of life? Jordanian women\u2019s perspective

BackgroundAlthough Jordan has made progress in meeting Family Planning (FP) needs in last decades, recently the use of FP methods has declined significantly. Women’s personal experiences, knowledge, and perceptions of how a FP method might impact their quality of life (QoL) can influence FP decisions. However, a lack of comprehensive understanding of the impact of modern FP methods on women’s QoL continues to exist among Jordanian couples. Therefore, this study aimed to investigate the relationship between the use of common modern FP methods and QoL among Jordanian women.MethodsUsing the WHOQOL-BREF questionnaire along with other questions, non-pregnant women of reproductive age were interviewed at their homes through face-to-face structured interviews. Women who visited the obstetrics and gynecology clinic of King Abdullah University Hospital for contraceptive advice and follow-up consultations were also included.ResultsA total of 548 women aged between 18 and 49 participated in the study. Based on the WHOQOL-BREF scale, the overall mean (SD) scores of the four domains were found to be average. Our findings show that women who used Intra Uterine Devices (IUDs) and women whose husbands used condoms had better QoL in the four domains (physical health, psychological health, social relationships, and environment) than those who used Oral Contraceptives (OCs). Women who used implant and injectable hormonal contraceptives had better QoL in terms of the physical health and social relationships domains. In contrast, women who had undergone permanent sterilization had lower QoL scores in all of the four domains. Further analysis revealed that women who had undergone tubal sterilization were less satisfied overall and more likely to experience side effects than women who used OCs.ConclusionThe choice to use contraceptives and decide freely whether and when to have children is regarded as a fundamental reproductive health right and is strongly linked to women’s health and QoL. Women who use OCs and women who have undergone permanent sterilization are likely to have lower QoL than women who use IUDs or implant and injectable hormones and those whose husbands use condoms.

Knowledge, Attitude and Practice Towards Modern Family Planning Methods Among Mothers of Reproductive Age Group in Wonago Health Center, Southern Ethiopia

Back ground: The continuing growth of the world population has become an urgent global problem. Ethiopia like most countries in Sub-Saharan Africa is experiencing rapid population growth. Currently, the country’s is population is growing at a rate of 3% is one of the largest rates in the world and if it continues unabated , the population will have doubled in 23 years , preventing any gain in the national development effort. Objectives: The objective of this study was to determine the knowledge, attitude and practice of mothers towards family planning in Wonago health center. Methods: cross- sectional study was conducted from April 15, 2004 E.C to June 10, 2004 E.C., in Wonago health center, Gedeo Zone, SNNPR, Ethiopia. A total of 251 study subjects were selected by systematic sampling technique from mothers of child bearing age (15-49) who attended Wonago health center for any services. Data was collected by using interviewees. Chi-square test and odds ratio were used to assess the presence and strength of association between independent and dependent variables. Result : Out of total 251 women of reproductive age group who participated in the study 206(82.3%) had ever heard about FP, of which 202(98%) knew at least one method of FP and 116(59%) were using some method of FP at time of the study .the information about FP among reproductive age women of urban dwellers is thirteen times higher than rural dwellers OR=13.74(4.747,39.79) p-value 0.001,educational status showed statistically significant difference p-value 0.001 and women who possessed TV two times more likely had ever practiced FP methods than those who did not OR=2.599(1.441,4.6899) ,P-value 0.001. Conclusion and recommendation: In the study the major source of information on FP is from the health institution, majority of the respondents knew at least one type of modern FP methods and socio demographic factors like residence educational status are associated with information about FP and ever practice of it .community should be encouraged to use long term contraceptives so as to space their family and decrease the frequent visit to health institution Keywords: knowledge, attitude, practice, modern family planning DOI : 10.7176/JNSR/9-19-02 Publication date :October 31 st 2019

English

This study was conducted in Muk-Lami town located at 498 km from Addis Ababa and 54 km far from the Western Wollega zonal city, Ghimbi. The study was concerned with reproductive health and contraception where females in the study area have less exposure to contraceptives, choice and proper utilization of methods. This study attempted to investigate major determinants of contraceptive choice, use and side effects on female clients attending family planning services at Muk-Lami Governmental Health Center. The data was collected from women clients selected by simple random method for further information concerning choice and side effects of contraceptives among women attending family planning services. The data had been collected from 182 women between age categories of 20-49 years. The data was analyzed using SPSS version 20. Among contraceptive clients, 39.56% of women have not been informed about contraceptives. Obtained results showed that each contraception method had its own side effects that ranged from mild to severe health complications and reproductive risks on mothers. The majority (61.54%) of clients responded that they feel at least a minimum discomfort whenever using one of the modern birth control methods. Findings of this study also revealed that educated and non-educated women did not have similar and adequate knowledge on contraception. Therefore, educational experts, medical sectors and other concerned bodies including NGOs should empower women through special sex education for successful implementation of family planning programs. Key words: Birth control, contraceptive, clients, pregnancy, side effect, women

Assessment of the awareness and usages of family planning methods in the Lebanese community

BackgroundWorldwide, one in three women has unmet family planning (FP) needs because of difficulties in accessing or using contraceptives. In Lebanon, information from the scientific literature on the national prevalence...

Adding a Question About Method Switching to the Method Information Index Is a Better Predictor of Contraceptive Continuation.

The Method Information Index (MII) is 1 of 18 core indicators used to monitor progress toward achieving Family Planning 2020's goal of 120 million more women using a modern method of family planning by 2020. The 3 questions of the MII are intended to measure informed choice at method initiation. Although routinely used in the Demographic and Health Surveys and the Performance Monitoring and Accountability 2020 project in cross-sectional household surveys, the MII may not adequately reflect all key aspects of quality of care or predict contraceptive continuation. In the current study, a question was added to the MII regarding the possibility of switching to a different contraceptive method if the current method is not suitable. The revised MII is referred to as MIIplus. A total of 2,699 married women aged 15-49 who started a new episode of use of intrauterine device, injectable, or oral contraceptive pills between December 2016 and October 2017 were followed for 1 year in India and interviewed at method start and 3, 6, and 12 months later. Of these women, 2,267 were interviewed 3 months later and included in the analysis. Using 3 Cox proportional hazard models, we estimated hazard ratios for risk of discontinuation, based on the MII, MIIplus, and a recategorization of MIIplus into a 3-category variable. The modern method continuation rate 100 days (∼3 months) later was 91% overall. Women who received the information in MIIplus were more likely to continue using a method at 100 days (95%) compared to those who received information covered in the MII (82%) or less than 3 components of the MII (89%) (P<.001). Women who received all components in the MIIplus were 69% (adjusted hazard ratio, 0.31; 95% confidence interval: 0.17 to 0.61) less likely than those who received information in the MII to discontinue using a modern method 100 days later. Discontinuation was not significantly different between women who received information on less than the 3 components of the MII compared to the complete MII. We recommend including the question about the possibility of switching to another family planning method in routine measurement because it better predicts contraceptive continuation than the MII alone and ensures that another domain of quality of care is reflected in the measurement. When programs provide information on the possibility of switching, women are better informed about voluntary family planning choice and their options to continue family planning when a method is not suitable.

"When you least expect, this happens, it's already growing": Problematizing the definition of unmet need for family planning.

Background: Unmet need is an important indicator to understand baselines and set goals for family planning interventions. Women may not fall neatly in categories of met or unmet need for family planning as defined by the demographic and health surveys (DHS). We explore women’s experiences of unmet need for family planning and provide empirical examples of how the static, binary DHS definitions of met and unmet need for family planning may be problematic.Methods: Based on Social Cognitive Theory, we conducted elicitation interviews with 16 married young women between the ages of 20 and 24 in Chimaltenango, Guatemala to explore barriers to accessing and using family planning. Half the participants (n=8) were using a modern method of family planning and half (n=8) were not. The current analysis focuses on data that was coded as ambiguous or unclear for unmet need status.Results: We identified framings of ambiguity from the women’s narratives that are silenced by the dominant binary of met and unmet need. We show inconsistencies between women’s lived experiences of unmet need and how their experiences would likely be represented in DHS questionnaires: 1) successful use of natural methods; 2) the complexity of “wantedness”; 3) conceptualizing met or unmet need as a trajectory; and 4) laughter obscuring clear response.Conclusion: Family planning status is a complex trajectory that the DHS may not accurately capture. As a way to reflect the diversity of women’s family planning experiences, we suggest modifying the DHS classifications to incorporate latent met and unmet need as sub-classifications.

Role of community resource persons in improving use of modern family planning methods among women of reproductive age in a rural area in Ebonyi State, Nigeria

The study set out to determine the role of community resource persons in improving uptake of modern family planning methods among women of reproductive age in Ebonyi State. A non-randomized intervention study with control was done. A multistage sampling technique was used to select a sample of 484 in union women of reproductive age. Data were collected using a pretested structured questionnaire. Community resource persons were trained to provide culturally appropriate information on family planning to men and women in the community. Postintervention data were collected after a waiting period of 3months. In the intervention arm, use of modern methods of family planning increased significantly by 7.4% at 3months postintervention (P=0.01) compared with the control arm. The most commonly used modern methods of family planning were pills, injectables, and barrier methods in the intervention arm and implant in the control arm. The major source of modern methods of family planning was health facility both before and after the intervention in both arms. Number of living children, increasing age and husband's education were predictors of current use of modern family planning methods. Community-driven strategies are useful for increasing uptake of modern methods of family planning and are recommended.

Postpartum contraception utilization and its impact on inter pregnancy interval among mothers accessing maternity services in the public sector hospital of Hyderabad Sindh.

Objective:To find out the particulars regarding contraceptive practices in the postpartum period and to see its impact on prolonging interpregnancy interval (IPI).Methods:A cross sectional observational study was conducted in the Department of Obstetrics & Gynecology Unit 3, Liaquat University Hospital Hyderabad from 1st July to 31st December 2018. Out of 2100 total deliveries, 398 postpartum women with second or higher order births were included. Pregnant women, primiparas and those who were not willing to participate were excluded. They were interviewed face to face by principal investigator and her team members and required information was collected on predesigned Performa. Outcome variable was interpregnancy interval in months. Chi-square test was used to see associationResults:Postpartum contraception utilization (PPC) was 24.6%(n=398). Most of the women choose condoms as contraceptive method (n=41, 10.3%) followed by oral contraceptive pills (n=18, 4.5%) and intra uterine contraceptive device (n=16,4%). Method related issues were the chief reasons for discontinuation while desire to have another child soon and spouse/family disapproval were among the reasons mentioned largely by non-utilizers of modern methods of family planning. The average interpregnancy interval was 16.4±1.45. Significant association was observed between interpregnancy interval and postpartum contraception use, particularly in the users of long acting reversible contraceptive methods (P-Value 0.0001).Conclusion:Uptake and continuation of modern methods of contraception was low after last birth culminating in short interpregnancy interval. Optimal IPI was observed in those utilizing modern methods of family planning, with marked effect in users of long acting reversible contraceptive methods.