Postpartum Family Planning Research Articles

Upaya Peningkatan Pengetahuan Kader Dengan Modul Konseling Kb Pasca Persalinan Berdasarkan Information Motivation Behavioral Skills (IMB) Model

The application of postpartum birth control is very important because the return of fertility to a mother after giving birth is unpredictable and can occur before the arrival of the menstrual cycle, even in breastfeeding women. The first ovulation in a non-breastfeeding woman can occur as early as 34 days postpartum, even earlier. This causes during breastfeeding, women often experience unwanted pregnancy (KTD / unwanted pregnancy) at intervals close to previous pregnancies. Contraception should be used before sexual activity begins. It is therefore very strategic to start contraception as early as possible after delivery. After efforts to increase knowledge, it is hoped that cadres in the Gambirsari Health Center work area can provide counseling to mothers related to postpartum family planning. Method of implementation with lectures and discussions. The media used are modules, LCDs, laptops, and projectors. The implementation of health education is planned to be carried out at posyandu activities, namely in April-August 2020. The result of community service is that 90% of cadres know and understand better and from the results of monitoring and evaluation by meeting again at Posyandu Kinasih, 90% of cadres can explain the contents of the postpartum family planning counseling module. Based on the implementation of community service, it can be concluded that there is an increase in counseling skills, information, motivation and skills in using family planning at postpartum by cadres in the working area of ​​Puskesmas Gambirsari Surakarta.

Utilization of Extended Postpartum Family Planning among Post-Delivery Women in Mvomero District, Morogoro-Tanzania

This study aimed at examining factors associated with the use of Extended Postpartum Family Planning (EPPFP) methods among post delivery women in Mvomero District, Morogoro, Tanzania. Based on cross-sectional design, the data collection activity was conducted on March 2020 to 256 post delivery women who delivered a child between January 1, 2019 and January 31, 2020. Purposive and convenience sampling were used to get respondents of the study. Data were collected using questionnaire. Through SPSS tool, descriptive analyses comprising of Pearson’s chi squire test was employed to establish association between independent and dependent variables. The prevalence of extended postpartum family planning utilization was 46%, the utilization of EPPFP was significantly associated with awareness of the reason for EPPFP use (P-value=0.013), awareness of EPPFP method (P-value=0.014), awareness of EPPFP side effects (P-value= 0.024), counselling sessions (P-value=0.000), menses resumption (P-value=0.010), duration of sexual activity (P-value=0.011) and history of previous pregnancy (P-value=0.000). Prevalence of EPPFP utilization among post delivery women is still low in Mvomero district. Enhancement of the utilization of EPPFP during the postpartum period needs effective response by stakeholders through provision of family planning education particularly during all maternal and child health contacts.

Couples' decision-making on post-partum family planning and antenatal counselling in Uganda: A qualitative study.

BackgroundAlthough health workers have been trained to provide post-partum family planning (PPFP), uptake remains low in Uganda. An important reason is that women want the agreement of their partner, who is often absent at the time of delivery. In order to address this, we aimed to understand the views of couples and explore barriers and facilitators to implementation of antenatal couples’ counselling on PPFP in Uganda.MethodsWe conducted individual interviews with a purposive sample of 12 postpartum and 3 antenatal couples; and 34 focus groups with a total of 323 participants (68 adolescent women, 83 women aged 20–49, 79 men, 93 health workers) in four contrasting communities (urban and rural) in South-West and Central Uganda. These were recorded, transcribed, translated, and analysed thematically.ResultsAlthough most participants felt that it is important for partners to discuss family planning, half of the couples were unaware of each other’s views on contraception. Most had similar views on motivation to use family planning but not on preferred contraceptive methods. Most liked the idea of antenatal couples’ counselling on PPFP. The main barrier was the reluctance of men to attend antenatal clinics (ANC) in health facilities. Respondents felt that Village Health Teams (VHTs) could provide initial counselling on PPFP in couples’ homes (with telephone support from health workers, if needed) and encourage men to attend ANC. Suggested facilitators for men to attend ANC included health workers being more welcoming, holding ANC clinics at weekends and “outreach” clinics (in rural villages far from health facilities).ConclusionAntenatal couples’ counselling has the potential to facilitate agreement PPFP, but some men are reluctant to attend antenatal clinics. Counselling at home by VHTs as well as simple changes to the organisation of antenatal clinics, could make it possible to deliver antenatal couples’ counselling on PPFP.

Counseling at all contacts for postpartum contraceptive use: can paper-based tools help community health workers improve continuity of care? A qualitative study from Ethiopia.

Background: Globally, there has been a resurgence of interest in postpartum family planning (PPFP) to advance reproductive health outcomes. Few programs have systematically utilized all contacts a woman and her baby have with the health system, from pregnancy through the first year postpartum, to promote PPFP. Nested into a larger study covering two districts, this study assessed the use, acceptability, and feasibility of tools for tracking women's decision-making and use of PPFP in the community health system in Oromia region, Ethiopia. Community-level tracking tools included a modified Integrated Maternal and Child Health (IMCH) card with new PPFP content, and a newly developed tool for pregnant and postpartum women for use by Women Development Armies (WDAs). Proper completion of the tools was monitored during supervision visits. Methods: In-depth interviews and focus group discussions were conducted with health officials, health extension workers, and volunteers. A total of 34 audio-files were transcribed and translated into English, double-coded using MAXQDA, and analyzed using a thematic approach. Results: The results describe how HEWs used the modified IMCH card to track women's decision making through the continuum of care, to assess pregnancy risk and to strengthen client-provider interaction. Supervision data demonstrated how well HEWs completed the modified IMCH card. The WDA tool was intended to promote PPFP and encourage multiple contacts with facilities from pregnancy to extended postpartum period. HEWs have reservations about the engagement of WDAs and their use of the WDA tool. Conclusions: To conclude, the IMCH card improves counseling practices through the continuum of care and is acceptable and feasible to apply. Some elements have been incorporated into a revised national tool and can serve as example for other low-income countries with similar community health systems. Further study is warranted to determine how to engage WDAs in promoting PPFP.

Implementing a Novel Facility-Community Intervention for Strengthening Integration of Infant Nutrition and Family Planning in Mara and Kagera, Tanzania.

Tanzania has high fertility, low contraceptive prevalence and low exclusive breastfeeding (EBF). The Lake Zone, including Mara and Kagera regions, leads the country in total fertility; use of the lactational amenorrhea method (LAM) is negligible. This pre-/post-study explored the effects of a multi-level facility and community intervention (service delivery support, community engagement, media and LAM tracking) to integrate maternal and infant nutrition and postpartum family planning (FP) within existing health contacts. Mixed methods were used, including service statistics, exit interviews, patient-tracking tools for community health workers, client self-tracking tools, supervision data, focus group discussions and in-depth interviews. Results are presented using the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) implementation science framework. The intervention reached primarily the second and fourth wealth quintiles, increased FP and EBF at six weeks postpartum. LAM was very acceptable, provided an entry point for FP conversations and for addressing misconceptions, and reinforced EBF practices. Partners felt encouraged to support spousal nutrition, breastfeeding and FP. Higher adoption in Kagera may be influenced by performance-based financing. The intervention was implemented with generally high fidelity. Maintenance data reflected stakeholder interest in continuing the intervention. A multi-level facility and community intervention was feasible to implement and likely contributed to improved EBF practices and FP uptake, including LAM use.

POSTPARTUM EDUCATION IN THE WORKING AREA OF THE TEBING COMMUNITY HEALTH CENTER

Background : For early detection of complications in postpartum mothers, it is necessary to monitor the examination of postpartum mothers and increase the coverage of postpartum family planning by making at least 3 postpartum visits with time requirements, namely: the first postpartum visit during the period of 6 hours to 3 days after delivery, the second postpartum visit. within the 4th day to the 28th day after delivery, the third postpartum visit within the 29th to 42nd day after delivery. (MOH, 2012). The purpose of this study was to determine the education of postpartum mothers in the Tebing Community Health Center. Method : This study used a descriptive research design. The research was conducted in the working area of the Tebing Community Health Center. In the study, the population was postpartum mothers who were in the working area of the Tebing Community Health Center. In this study, researchers used purposive sampling technique, which is to determine a sample of the population based on specific objectives or according to the criteria desired by the researcher. The samples taken in this study were postpartum mothers in the working area of the Tebing Community Health Center. The method / technique of data collection was carried out by means of direct communication, namely by asking questions through written questionnaires with postpartum mothers who were in the working area of the Tebing Community Health Center. Univariate analysis is used to explain or describe the characteristics of each variable under study by presenting a description of the frequency distribution. Result : It is known that the majority of respondents' education is low as many as 31 respondents (70.5%) of 44 respondents Conclusion : It is known that the majority of respondents' education is low as many as 31 respondents (70.5%) of 44 respondents

Immediate Postpartum Long-Acting Reversible Contraception: A Comparison Across Six Humanitarian Country Contexts.

Postpartum family planning (FP) could prevent more than 30% of maternal deaths by effectively spacing births; this is particularly relevant in humanitarian contexts given that disproportionate maternal death occurs in countries affected by crises. In humanitarian settings, where accessing functional facilities is challenging with security risks that constrain movement, many women are unable to return for their 6-week postpartum visits and thus unable to receive FP counseling and adopt a method that suits their fertility intentions. Thus, immediate postpartum family planning (IPPFP) interventions, focused on long-acting reversible contraception (LARC) and tailored toward humanitarian contexts, could contribute to healthy timing and spacing of pregnancy, particularly among postpartum women, and improve maternal and newborn health. In 2014, Save the Children integrated postpartum intrauterine device (IUD) services into its FP package in emergency settings. In 2017, this expanded to include postpartum implant uptake as well, given updated World Health Organization guidelines. Three countries (Democratic Republic of Congo, Somalia, and Pakistan) opted for higher-intensity programming for IPPFP with a specific focus on LARC. This involved training delivery-room providers on counseling and provision of IPPFP, as well as training antenatal care nurses in counseling pregnant women on IPPFP options. Three countries (Rwanda, Syria, and Yemen) did not implement notable IPPFP interventions, although they provided the standard of care and monitored provision via monthly service delivery data. Using data from 2016 to 2019, we examined trends in immediate postpartum LARC (IPP LARC) uptake and compared countries with higher-intensity IPP LARC interventions to countries providing standard care. Tests of association were performed to assess the significance of these differences. In the country programs with higher-intensity IPPFP interventions, IPP LARC as a percentage of all deliveries was much higher overall during the July 2016–December 2019 period. The IPP LARC intervention had a significant impact on the overall proportion of women and girls who adopted an IUD or implant within the first 48 h of delivery, F(1, 250) = 523.16, p < 0.001. The mean percentage of IPP LARC among all deliveries in intervention country programs was 10.01% as compared to 0.77% in countries providing standard care. Results suggest that there is demand for IPP LARC in humanitarian contexts and that uptake increases when multipronged solutions focusing on provider training, community outreach, and service integration are applied.

Counseling at all contacts for postpartum contraceptive use: can paper-based tools help community health workers improve continuity of care? A qualitative study from Ethiopia

Background: Globally, there has been a resurgence of interest in postpartum family planning (PPFP) to advance reproductive health outcomes. Few programs have systematically utilized all contacts a woman and her baby have with the health system, from pregnancy through the first year postpartum, to promote PPFP. Nested into a larger study covering two districts, this study assessed the use, acceptability, and feasibility of tools for tracking women’s decision-making and use of PPFP in the community health system in Oromia region, Ethiopia. Community-level tracking tools included a modified Integrated Maternal and Child Health (IMCH) card with new PPFP content, and a newly developed tool for pregnant and postpartum women for use by Women Development Armies (WDAs). Proper completion of the tools was monitored during supervision visits. Methods: In-depth interviews and focus group discussions were conducted with health officials, health extension workers, and volunteers. A total of 34 audio-files were transcribed and translated into English, double-coded using MAXQDA, and analyzed using a thematic approach. Results: The results describe how HEWs used the modified IMCH card to track women’s decision making through the continuum of care, to assess pregnancy risk and to strengthen client-provider interaction. Supervision data demonstrated how well HEWs completed the modified IMCH card. The WDA tool was intended to promote PPFP and encourage multiple contacts with facilities from pregnancy to extended postpartum period. HEWs have reservations about the engagement of WDAs and their use of the WDA tool. Conclusions: To conclude, the IMCH card improves counseling practices through the continuum of care and is acceptable and feasible to apply. Some elements have been incorporated into a revised national tool and can serve as example for other low-income countries with similar community health systems. Further study is warranted to determine how to engage WDAs in promoting PPFP.

Economic Evaluation of Provision of Postpartum Intrauterine Device Services in Bangladesh and Tanzania.

Postpartum family planning is an effective means of achieving improved health outcomes for women and children, especially in low- and middle-income settings. We assessed the cost-effectiveness of an immediate postpartum intrauterine device (PPIUD) initiative compared with standard practice in Bangladesh and Tanzania (which is no immediate postpartum family planning counseling or service provision) to inform resource allocation decisions for governments and donors. A decision analysis was constructed to compare the PPIUD program with standard practice. The analysis was based on the number of PPIUD insertions, which were then modeled using the Impact 2 tool to produce estimates of cost per couple-years of protection (CYP) and cost per disability-adjusted life years (DALYs) averted. A micro-costing approach was used to estimate the costs of conducting the program, and downstream cost savings were generated by the Impact 2 tool. Results are presented first for the program as evaluated, and second, based on a hypothetical national scale-up scenario. One-way sensitivity analyses were conducted. Compared to standard practice, the PPIUD program resulted in an incremental cost-effectiveness ratio (ICER) of US$14.60 per CYP and US$91.13 per DALY averted in Bangladesh, and US$54.57 per CYP and US$67.67 per DALY averted in Tanzania. When incorporating estimated direct health care costs saved, the results for Bangladesh were dominant (PPIUD is cheaper and more effective versus standard practice). For Tanzania, the PPIUD initiative was highly cost-effective, with the ICER (incorporating direct health care costs saved) estimated at US$15.20 per CYP and US$18.90 per DALY averted compared to standard practice. For the national scale-up model, the results were dominant in both countries.Conclusions/implications: The PPIUD initiative was highly cost-effective in Bangladesh and Tanzania, and national scale-up of PPIUD could produce long-term savings in direct health care costs in both countries. These analyses provide a compelling case for national governments and international donors to invest in PPIUD as part of their family planning strategies.

Predictors of postpartum family planning in Rwanda: the influence of male involvement and healthcare experience

BackgroundStrengthened efforts in postpartum family planning (PPFP) is a key priority to accelerate progress in reproductive, maternal, newborn, and child health outcomes. This secondary data analysis explores factors associated with PPFP uptake in Rwanda. The purpose of this study was to explore variables that may influence PPFP use for postpartum women in Rwanda including health facility type, respectful maternity care, locus of control, and mental health status.MethodsThis secondary analysis of data from a cluster randomized control trial used information abstracted from questionnaires administered to women (≥ 15 years of age) at two time points—one during pregnancy (baseline) and one after delivery of the baby (follow-up). The dependent variable, PPFP uptake, was evaluated against the independent variables: respectful care, locus of control, and mental health status. These data were abstracted from linked questionnaires completed from January 2017 to February 2019. The sample size provided 97% power to detect a change at a 95% significance level with a sample size of 640 at a 15% effect size. Chi-square testing was applied for the bivariate analyses. A logistic regression model using the generalized linear model function was performed; odds ratio and adjusted (by age group and education group) odds ratio with 95% confidence interval were reported.ResultsOf the 646 respondents, although 92% reported not wanting another pregnancy within the next year, 72% used PPFP. Antenatal care wait time (p = < 0.01; Adj OR (Adj 95% CI) 21–40 min: 2.35 (1.46,3.79); 41–60 min: 1.50 (0.84,2.69); 61–450 min: 5.42 (2.86,10.75) and reporting joint healthcare decision-making between the woman and her partner (male) (p = 0.04; Adj OR (Adj 95% CI) husband/partner: 0.59 (0.35,0.97); mother and partner jointly: 1.06 (0.66,1.72) were associated with PPFP uptake.ConclusionsThese results illustrate that partner (male) involvement and improved quality of maternal health services may improve PPFP utilization in Rwanda.

Prevalence of postpartum family planning utilization and associated factors among postpartum mothers in Arba Minch town, South Ethiopia

BackgroundContraception allows women to realize their human right to decide if and when to have children and helps people to attain their desired family size. Yet 214 million women of a reproductive age in developing countries who want to avoid pregnancy are not using a modern contraceptive method. Women who have recently given birth are among the group with the highest unmet need for contraception. Therefore, this study was aimed to assess the prevalence of postpartum family planning use and associated factors among postpartum women in Southern Ethiopia.MethodsInstitution based cross-sectional study design was conducted. A structured and pretested interviewer-administered questionnaire was used to collect the data from study participants. Study participants were selected using a systematic random sampling technique by allocating proportionally to each health facility. The data was entered using EPI data version 3.1statistical software and exported to Statistical Package for Social Sciences version 22.0 for further analysis. Both bivariate and multivariate logistic regression analyses were performed to identify associated factors. P values < 0.05 with 95% confidence level was used to declare statistica significance.ResultOverall, 44% of postpartum women utilize postpartum family planning. Having an antenatal care visit [adjusted odds ratio (AOR) =1.89(95%CI, 2.42–7.90), having planned pregnancy [adjusted odds ratio (AOR) = 1.17(95%CI, 1.60–2.28)], being married (adjusted odds ratio (AOR) =2.86(1.94–8.73), and having a college and above level educational status (AOR) =1.66(1.28–3.55) were significantly associated with utilization of postpartum family planning.ConclusionThis study showed that the prevalence of postpartum family planning was 44%. Marital status, educational status of mothers, the status of pregnancy, and having an antenatal care follow-up during pregnancy were some factors associated with postpartum family planning utilization. Therefore, strengthening family planning counselling during antenatal and postnatal care visits, improving utilization of postnatal care services and improving women’s educational status are crucial steps to enhance contraceptive use among postpartum women.

Pilot monitoring and evaluation of the WHO postpartum family planning compendium mobile application: An in-depth, qualitative study.

To assess the feasibility, functionality and acceptability of a mobile application (app), the World Health Organization (WHO) Postpartum Family Planning (PPFP) Compendium, in clinical care. This prospective qualitative study was conducted among family planning providers routinely delivering PPFP care in Accra, Ghana. We conducted in-depthinterviews at baseline and 3months after app introduction. We elicited expected technological, psychological and environmental barriers to use, actual use in clinical settings, and feedback for app improvement. With inter-coder reliability, we analyzed the content of interview transcripts. Twenty providers participated in baseline interviews, and 19 participated in follow-up interviews. At baseline, providers did not have significant technological barriers to its use and felt the app was acceptable, but were concerned about the appropriateness of using an app during clinical care. At 3-month follow-up, 18 out of 19 participants reported using the app weekly, and found the app acceptable for use in clinical care. Providers recommended expanding clinical content and including similar guidance relevant to times outside the postpartum period. Use of a PPFP counseling app to aid family planning providers in clinical care delivery is feasible and acceptable. Providers recommended inclusion of similar guidance relevant to times outside the postpartum period.

Acceptability and Factors Associated with Immediate Postpartum Intrauterine Contraceptive Device Use Among Women Who Gave Birth at Government Hospitals of Gamo Zone, Southern Ethiopia, 2019.

BackgroundAn intrauterine contraceptive device is suitable for women of all reproductive age groups for preventing unwanted pregnancies. Immediate postpartum family planning (PPFP) services need to be emphasized when the woman leaves the hospital. Despite the accepted demand for PPFP, many women do not access the services. Therefore, this study aimed to assess acceptability and factors associated with immediate postpartum intrauterine contraceptive device use among women who gave birth at government hospitals of Gamo Zone, Southern Ethiopia.MethodsA cross-sectional study was conducted from March 1 to 30, 2019 with 452 participants studied using systematic random sampling technique. Data was collected using a pretested interviewer-administered questionnaire from March 1 to 30, 2019. The data were coded, cleaned and entered into Epi-data manager version 4.2.2.1 and exported to SPSS version 23 for advanced analysis. Binary logistic regression was performed to identify associated factors of immediate PPIUCD acceptability.ResultsThis study revealed that about 161 (35.6%) in 95% CI (31.0, 39.6) of the study participants accepted immediate PPIUCD. Multiparty (AOR = 2.33, 95% CI, (1.29, 4.20)), completed antenatal follow up (AOR = 3.65, 95% CI, (2.22, 5.99)), counselling (AOR= 8.38, 95% CI, (4.85, 14.48)) and prior discussion (AOR=2.57, 95% CI, (1.51, 4.36)) were statistically significant.Conclusion and RecommendationEven though 58% of the mothers were counselled about PPIUCD during the important cascade of pregnancy and 53% of the mothers completed antenatal service, efforts need to improve antenatal care services and integrate counselling services through the whole cascade of pregnancy.

Providers\u2019 perspectives of socio-cultural and health service challenges related to postpartum family planning in Alexandria, Egypt

BackgroundPostpartum family planning (PPFP) focuses on prevention of unintended pregnancy and closely spaced pregnancies through the first 12 months following childbirth. Adoption of family planning during the postpartum period in Egypt faces unique challenges. This study aimed to explore the socio-cultural and health service challenges related to PPFP in Alexandria, Egypt, from perspectives of family planning providers working in public settings.MethodsThree focus group discussions were conducted in the period from May to July 2017. It included 32 family planning physicians working in the family health centers and maternal and child health centers in Alexandria for 3 years or more. A discussion guide was prepared. Analysis of data was done using thematic data analysis using a deductive approach.ResultsThe working experience of participants ranged from 3 to 30 years. The most frequently reported reasons for unmet need for PPFP were cultural norms about the contraceptive effects of lactation and inaccurate knowledge of women about the conditions for appropriate use of the lactation amenorrhea as a contraceptive method. The most commonly cited challenge related to the quality of service was the inadequate health education services about PPFP. Lack of training and supervision of community health workers was one of the underlying causes of the perceived inadequacy of the service.ConclusionsMass media campaigns advocating for family planning are urgently needed with full support from the government. Improvement of health education services is a must. Redistribution of family planning providers with an increase in the staff members is highly recommended.

Assessing knowledge, attitudes, and practice of health providers towards the provision of postpartum intrauterine devices in Nepal: a two-year follow-up

BackgroundHealth service providers play a key role in addressing women’s need for postpartum pregnancy prevention. Yet, in Nepal, little is known about providers’ knowledge, attitudes, and practice (KAP) on providing postpartum family planning (PPFP), particularly the immediate postpartum intrauterine device (PPIUD). This paper assesses providers KAP towards the provision of PPIUDs in Nepal prior to a PPIUD intervention to gain a baseline insight and analyzes whether their KAP changes both 6 and 24 months after the start of the intervention.MethodsData come from a randomized trial assessing the impact of a PPIUD intervention in Nepal between 2015 and 2017. We interviewed 96 providers working in six study hospitals who completed a baseline interview and follow-up interviews at 6 and 24 months. We used descriptive analysis, McNemar’s test and the Wilcoxon signed-rank test to assess KAP of providers over 2 years.ResultsThe PPIUD KAP scores improved significantly between the baseline and 6-month follow-up. Knowledge scores increased from 2.9 out of 4 to 3.5, attitude scores increased from 4 out of 7 to 5.3, and practice scores increased from 0.9 out of 3 to 2.8. There was a significant increase in positive attitude and practice between 6 and 24 months. Knowledge on a women’s chance of getting pregnant while using an IUD was poor. Attitudes on recommending a PPIUD to different women significantly improved, however, attitudes towards recommending a PPIUD to unmarried women and women who have had an ectopic pregnancy improved the least. Practice of PPIUD counseling and insertion improved significantly from baseline to 24 months, from 10.4 and 9.4% to 99% respectively.ConclusionsAlthough KAP improved significantly among providers during the PPIUD intervention, providers’ knowledge on a women’s chance of getting pregnant while using an IUD and attitudes towards recommending a PPIUD to unmarried women and women who have had an ectopic pregnancy improved the least. Provider KAP could be improved further through ongoing and more in-depth training to maintain providers’ knowledge, reduce provider bias and misconceptions about PPIUD eligibility, and to ensure providers understand the importance of birth spacing.

HUBUNGAN PENGETAHUAN IBU PASCA SALIN DENGAN PERILAKU IBU PASCA SALIN DALAM KEPESERTAAN KB PASCA SALIN DI PUSKESMAS TEBING TAHUN 2017

Post-partum contraception is the immediate use of contraceptive devices after the delivery process up to 42 days after. The principle of choosing kind of contraceptive method are not to interfere thebreast milk production of the mother. Precisely, this study aims to determine whether there is a correlation of the knowledge levels and the attitude of the post-partum mothers on the family planning. This research employed analytic research design with cross sectional approach. The study was conducted from March to July 2017 at Tebing Community Health Centre. The population investigated was2 months post-partum mothers with sample of 42 respondents in total derived from the accidental sampling technique. As the research instruments, the researchers used questionnaires to be distributed and fulfilled by the 42 respondents. The data gathered was analyzed by univariate and bivariate Chi-Square statistical test. The result of the test shows that 10 respondents (62,5%) have good knowledge level of post-partum family planning and 6 respondents (37,5%) possess good knowledge level yetdo not attend the post-partum family planning. Meanwhile, 4 respondents (15,4%) are lack of knowledge on post-partum family planning and 22 respondents (84,6%) have less knowledge level and do not take the post-partum family planning. In conclusion, based in the findings elaborated,it is noted that there is a correlation between the knowledge and attitude of post-partum mothers on their participation in family planning program. As the suggestion, it is expected thatall respondents of post-partum mothers can possibly apply information and knowledge about the post-partum family planning in real life contexts.

Knowledge and utilization of family planning among rural postpartum women in Southwest Nigeria.

Background:In Nigeria, contraceptive use has remained low, 12% for any modern method, despite the huge resources committed to family planning programs by stakeholders. This study was carried out to assess the knowledge and utilization of family planning and determine predictors of utilization of family planning among postpartum women attending primary health care centers (PHCs) in a selected rural area of Lagos State, southwest Nigeria.Methods:This was a descriptive cross-sectional study conducted among 325 postpartum women attending PHCs in Ibeju-Lekki local government area of Lagos State selected using a multi-stage sampling technique. A pretested, interviewer-administered questionnaire was used to collate data which was analyzed using the IBM SPSS Statistics version 23.Result:The mean age was 29.94 ± 5.14 years. All the respondents (100%) had heard of contraceptive methods, however only 38 (11.7%) had good knowledge of family planning. About 38.5% of the respondents used modern family planning methods during the postpartum period. The most commonly used methods were male condoms (26.3%) and implants (17.0%). The significant predictors of postpartum family planning (PPFP) were non-intention to have more children [AOR = 1.88 (95% CI: 1.14–3.11)], and good knowledge of family [AOR = 2.31 (95% CI: 1.11–4.81)].Conclusion:It is recommended that interventions be designed to educate and advocate for the use of family planning methods not only to stop childbearing but also to space pregnancies. Education about family planning should also be intensified to improve knowledge of family planning, and thus practice.

Family planning utilization and associated factors among postpartum women in Addis Ababa, Ethiopia, 2018

BackgroundPregnancies that occur in the first year after birth can result in adverse outcomes for the mothers and their babies. Postpartum family planning (PPFP) can save lives of many mothers and children. Only few data are available about the magnitude of PPFP use and its determinants in Addis Ababa, Ethiopia.ObjectiveTo assess PPFP utilization and associated factors in Addis Ababa, Ethiopia.MethodA facility-based cross-sectional study was conducted from April to June 2018. A total of 625 women were enrolled in the study. Statistical Package for the Social Sciences (SPSS) software was used to analyze the data. Binary logistic regression model with adjusted odd ratio (AOR) and 95% confidence interval (CI) was used to identify the factors associated with PPFP use. A p-value less than 0.05 was considered as significant.ResultThe magnitude of PPFP utilization in Addis Ababa was 71.8%. Previous family planning (FP) information (AOR = 13.2; 95% CI: (1.96, 88.07)), FP information from health facility visit (AOR = 2.23; 95% CI: (1.45, 3.43)), antenatal care (AOR = 4.96; 95% CI: (1.58, 15.64)), counseling on FP at postnatal care (AOR = 1.97; 95% CI: (1.27, 3.05)), menses resumption after birth (AOR = 1.75; 95% CI: (1.11, 2.76)), and commencing sexual activity after birth (AOR = 9.34; 95% CI: (5.39, 16.17)) were the factors associated with PPFP use.Conclusion and recommendationThough the magnitude of PPFP use is encouraging, still three out of the ten postpartum women did not use PPFP. The determinants of PPFP use were having FP information, having FP information from health facility visit, antenatal care, counseling about FP during postnatal care, menses resumption after birth, and commencing sexual activity after birth. The health system in the City and the healthcare providers should strive to reach every woman who is not accessing the PPFP services and antenatal care services, and improve counseling services on PPFP during delivery and postnatal care services.

Article Review Case Analysis of Post-Placenta IUD Expulsion

Indonesian Government has launched various programs to overcome population problems. Postpartum Family planning program is included in maternal insurance program, so every partum mother can immediately insert Post-placenta IUD for free. The failure of inserting IUD contraception in Indonesia reached 37.75%. The result of this review can be taken into consideration regarding goverment policy about Postpartum Family Planing Programe. The design of this study is literature review. The selected articles are those relating to IUD Post-placenta expulsion. Database PubMed used to cellecting article. We only take article that published from 2010 – 2018. The analysis of 11 journals showed that the IUD post-placenta have rates of expulsion varies from some article, the lowest 1,4 % and highest 24 %. Then delayed insertion of IUD have expulsion rates 0 % up to 37%. This review supports the evidence that insertion of an IUD Postplacenta after vaginal delivery or caesarean delivery is safe. Expulsion rates should be further studied in larger randomised controlled trials.

Case Analysis of Post-Placenta IUD Expulsion

Indonesian Government has launched various programs to overcome population problems. Postpartum Family planning program is included in maternal insurance program, so every partum mother can immediately insert Post-placenta IUD for free. The failure of inserting IUD contraception in Indonesia reached 37.75%. The result of this review can be taken into consideration regarding goverment policy about Postpartum Family Planing Programe. The design of this study is literature review. The selected articles are those relating to IUD Post-placenta expulsion. Database PubMed used to cellecting article. We only take article that published from 2010 – 2018. The analysis of 11 journals showed that the IUD post-placenta have rates of expulsion varies from some article, the lowest 1,4 % and highest 24 %. Then delayed insertion of IUD have expulsion rates 0 % up to 37%. This review supports the evidence that insertion of an IUD Postplacenta after vaginal delivery or caesarean delivery is safe. Expulsion rates should be further studied in larger randomised controlled trials.