Family Provision Research Articles

Gaps and evidences on programming postpartum family planning services in Nepal

Background: Postpartum family planning (PPFP) is one of the strategic efforts mentioned in the National Family Planning Strategy 2011/12 and National FP Costed implementation plan 2015-2020 of Nepal. Postpartum women are recognized as one of the groups that need attention to strengthen FP services in the country. Methods: We conducted a situational analysis in Nepal from December 2019 to May 2020, to identify the needs, gaps and provide evidence for strengthening future programming in this area using a combination of three methods: (i) non-systematic literature review using Google Scholar, Pubmed, and grey literature, (ii) secondary analysis using the dataset from Nepal Demographic and Health Survey (NDHS) 2016 that was based on a two-stage, stratified, nationally representative sample of households, and (iii) virtual assessment in purposively selected eight health facilities using a standard checklist related to PPFP. Results: Results show a lower modern contraceptive uptake (22.6%) and higher unmet need (31.5%) among postpartum women compared to all currently married women (43% and 24% respectively). Three most commonly used modern contraceptive methods among postpartum women in Nepal are injectables (8%), male condoms (7%), and oral contraceptive pills (3%). The PPFP services are available only in limited health facilities and were not integrated in Antenatal care (ANC), Postnatal care (PNC), childbirth and immunization services. Provision of family planning counseling during the ANC period is not recorded in the ANC card. Male partners do not participate in family planning counseling. Similarly, the uptake of family planning services at immunization, child health, and postnatal clinics is not recorded. Conclusion: This analysis provided evidence of the current status of PPFP in the country. There are gaps and challenges especially in strategy and guidelines, training, regular supply of commodities, awareness of PPFP, recording and reporting of PPFP. These gaps should be addressed with appropriate strategies.

Raising a Child with Craniosynostosis: Psychosocial Adjustment in Caregivers.

While knowledge of the psychosocial impact of craniofacial conditions is growing, literature regarding the impact on parents remains limited. Parents of children born with a health condition may be at risk of experiencing a range of psychosocial challenges. This study conducted an initial investigation of psychosocial adjustment of parents of individuals with craniosynostosis to inform support provision for families. An online UK-wide mixed-methods survey was distributed to members of Headlines Craniofacial Support. Quantitative data including standardized measures were analysed using descriptive statistics and independent samples t-tests, and inductive content analysis was used for open-ended questions. Mothers (n = 109) and fathers (n = 9) of individuals ages 3 months to 49 years with single suture (63%) or syndromic (33%) craniosynostosis participated. Compared to the general population, parents of individuals with craniosynostosis reported higher levels of stress, anxiety, and depression; lower levels of resilience and optimism. Qualitative responses provided insight into parents' experiences of birth, diagnosis, healthcare provision, familial wellbeing, and relationships. Parents reported several unmet information and support needs, alongside a range of positive outcomes. This study illustrates the potential long-term psychosocial implications for parents raising children with craniosynostosis. There is a need for routine psychological screening for family members and provision of appropriate psychological support for those at risk for distress. Non-specialist health professionals may benefit from additional training about craniofacial conditions so they are better equipped to support and refer families.

Measuring Quality of Maternal, Neonatal, Child, Reproductive Health and Nutrition Care with tools developed by the RADAR project and tested in Sub Saharan Africa

ABSTRACT Increasing coverage of evidence-based maternal, neonatal, child, reproductive health and nutrition (MNCRHN) programs in low- and middle-income countries has coincided with dramatic improvements in health despite variable quality of implementation. Comprehensive evaluation to inform program improvement requires standardized but adaptable tools, which the Real Accountability, Data Analysis for Results (RADAR) project has developed. To inform selection of tools and methods packages (‘packages’) to measure program quality of care (QoC), we documented experiences testing the packages, which were developed and adapted based on global and local expertise, and pre- and pilot-testing. We conducted cross-sectional studies in 2018–2019 on the quality of 1) integrated community case management, 2) counseling on maternal, infant, and young child feeding, 3) intrapartum care, and 4) family planning counseling in Mali, Mozambique, Tanzania, and Malawi. Herein we describe package performance and highlight experiences that inform their selection and use. Direct observation packages provided high-quality, immediately applicable results but they required specialized expertise, in-person collection, adequate patient volume, reasonable wait times, and unambiguously ‘correct’ provision of care. General satisfaction questions from exit interview packages produced unvaryingly positive responses despite variable observed quality of care. Variation increased when questions were more targeted, but findings on caregiver and client’s recall of recommendations were more actionable. When interactive, clinical vignettes can capture knowledge of clinical care. But for conditions that can be simulated, like provision of family planning counseling, we could capture provider practice from simulated clients. Clinicians could more easily demonstrate tactile aspects of intrapartum care using observed structured clinical examinations, but this method required storage and transport of the required mannequins. Based on our findings we recommend ten questions upon which evaluators can base package selection. Findings from these packages inform programs and, in the context of comprehensive program evaluation enable us to link programs with impact.

Connecting families with schools: the bureaucratised relations of ‘accountability’ in Indian elementary schooling

Increasing community and parental connection with schools is a widely advocated means of improving levels of student learning and the quality and accountability of education systems across South Asia. This paper draws on a mixed-methods study of accountability relations in education in the Indian states of Rajasthan and Bihar. It explores two questions: what formal platforms exist to enhance connections between socially disadvantaged families and the schools serving them; and (how) do they influence engagement with student learning? It finds that various platforms have proliferated across public, low-cost private and non-government schools. But, while they promote enrolment attendance and monitoring, a substantive focus on student learning is empirically demonstrated to be missing everywhere. The paper argues that an apparently surprising similarity of (dis)connection is located in system features that are common across school types, locations and social structures. It proposes that this is a ‘field’ in which connection, facilitated by various platforms, is performed according to bureaucratised norms of accountability that even pervade family and community responses. Seeing this as a socially constituted ‘field’ that constrains meaningful discussion of learning across schooling provision for disadvantaged families contributes new insight for accountability-focused reforms in education.

Small Town Politics, Stigma, and Services: Understanding the Unique Needs of Rural Families Post-Reunification

Research pertaining to effective foster care reunification strategies is well established. However, a gap exists in the literature surrounding social services for rural families post-reunification due to a lack of service provision for families following reunification. Reunified families often need additional support to prevent future reentry into foster care. Caseworkers work closely with families, offering a unique perspective as to what social services are most effective at preventing reentry into foster care. Due to recruitment constraints in during the COVID-19 pandemic, a pilot study with a sample of four (N = 4) Department of Family and Children’s Services [DFCS] caseworkers was conducted. Utilizing a qualitative framework, this pilot study investigated a sample of caseworkers’ perceptions as related to social services for improving family unity post-reunification, as well as barriers that exist for families accessing social services in rural southeast Georgia. Findings indicate that post-reunification services must be targeted and consistent to remain effective at maintaining family unity. Implications for social services providers, families, policymakers, and child welfare advocates are discussed. Future social services research examining the nuanced relationships between the geographic and social locations of families is needed to illuminate social services that support desirable and sustainable outcomes post-reunification.

Constituent elements of masculinity taught/learned in childhood and adolescence of men who are being criminally prosecuted for violence against women/partners

The scope of this article was to understand the constituent elements of masculinity taught/learnt in childhood/adolescence and reproduced by men in criminal proceedings for conjugal violence. Oral Life History was used as a methodological reference. Interviews were conducted with 13 men in criminal proceedings for domestic violence. The data were organized according to thematic content analysis and interpreted in the light of the theoretical framework on masculinity. Based on male orality, the constitutive elements of masculinity that were taught/learnt in childhood and adolescence and reproduced by men in criminal proceedings for conjugal violence went through infidelity, overvaluation of work, family provisioning, imposition of family norms and dominance of power in relation to women. Considering that these elements are rooted in the hegemonic model, preventive actions with a focus on social, financial and health commitment are a pressing requirement.

The magnitude and determinants of depressive symptoms amongst women in early pregnancy in Southern Nigeria: A cross-sectional study.

BackgroundAntenatal depression (AD) is prevalent and associated with adverse pregnancy, maternal and child outcomes, yet no study has addressed its magnitude and predictors in early pregnancy in Nigeria.AimTo determine the prevalence and factors associated with AD in first half of pregnancy.SettingMulticentric health facilities in Southern Nigeria.MethodsA multicentric health-facilities-based cross-sectional study was conducted from January to July 2018. Using pretested structure interviewer-administered questionnaires, antenatal depressive symptoms were assessed amongst 511 pregnant mothers with the Edinburg Postnatal Depressive Scale tool. Socio-demographic, socio-economic, clinical, family and social factors were also measured. Descriptive statistics, bivariate and multivariable logistic regression analyses were employed to describe and identify factors associated with AD.ResultsThe prevalence of antenatal depressive symptoms in early pregnancy in this study was 29.4% (95% confidence interval [CI] 26.6–32.9). Factors independently associated with AD were intimate partner violence (adjusted odds ratios [AOR] = 8.10, 95% CI 5.00–13.14), marital dissatisfaction (AOR 5.48, 95% CI 3.48–8.38), poor social support (AOR 4.70; 95% CI 2.99–7.38), past history of depression (AOR 4.67; 95% CI 2.47–8.80), previous pregnancy complication (AOR 2.50, 95% CI 1.57–3.89), low socio-economic status (AOR 2.41, 95% CI 1.61–3.66) and unplanned pregnancy (AOR 2.35, 95% CI 1.47–3.64).ConclusionsThe prevalence of antenatal depression is high with modifiable risk factors requiring context-specific policies such as provision of family, social and economic support for mothers at the earliest possible contact in the antenatal period.

Family Planning Experiences and Needs of Young Women Living With and Without HIV Accessing an Integrated HIV and SRH Intervention in Zimbabwe-An Exploratory Qualitative Study.

BackgroundPeople living with HIV have higher unmet family planning needs compared to those without HIV. This is heightened for young people. However, the provision of family planning for young people within HIV programmes is uncommon. We investigated family planning uptake, acceptability of, and engagement with a service offering integrated HIV and sexual and reproductive health services for youth in a community-based setting in Zimbabwe.MethodsCHIEDZA, a community-based intervention offering integrated HIV and sexual and reproductive health services to young people aged 16–24 years, is being trialed in Zimbabwe. This exploratory qualitative study was nested within an ongoing study process evaluation. Data was collected between March-May 2021 with two sets of interviews conducted: I) twelve semi-structured interviews with young women living with HIV aged 17–25 years and II) fifteen interviews conducted with young women without HIV aged between 20 and 25 years who used a contraceptive method. A thematic analysis approach was used.ResultsBefore engaging with CHIEDZA, young women had experienced judgmental providers, on account of their age, and received misinformation about contraceptive use and inadequate information about ART-contraceptive interactions. These presented as barriers to uptake and engagement. Upon attending CHIEDZA, all the young women reported receiving non-judgmental care. For those living with HIV, they were able to access integrated HIV and family planning services that supported them having broader sexual and reproductive needs beyond their HIV diagnosis. The family planning preference of young women living with HIV included medium to long-acting contraceptives to minimize adherence challenges, and desired partner involvement in dual protection to prevent HIV transmission. CHIEDZA's ability to meet these preferences shaped uptake, acceptability, and engagement with integrated HIV and family services.ConclusionsRecommendations for an HIV and family planning integrated service for young people living with HIV include: offering a range of services (including method-mix contraceptives) to choose from; supporting their agency to engage with the services which are most acceptable to them; and providing trained, supportive, knowledgeable, and non-judgmental health providers who can provide accurate information and counsel. We recommend youth-friendly, differentiated, person-centered care that recognize the multiple and intersecting needs of young people living with HIV.

Cruise vacation experiences for Chinese families with young children

Experiencias vacacionales en crucero para familias chinas con niños pequeñosResumenPropósitoEl segmento de mercado de familias con niños pequeños es significativo para la industria de cruceros en China. Este estudio tiene como objetivo examinar la experiencia de crucero de este segmento, así como facilitar la oferta de productos y servicios de vacaciones familiares en crucero.Diseño/metodología/enfoqueEste estudio recopila comentarios en línea sobre las experiencias de crucero en las familias chinas con niños pequeños, analizando los datos en términos de texto, sentimiento y contenido.ConclusionesLos resultados del análisis del texto indican problemas con varias dimensiones de la experiencia del crucero. Pero los resultados del análisis de sentimientos, revela que solo el 56,76% de las familias chinas con niños pequeños expresaron sentimientos positivos sobre el turismo de cruceros. Casi un tercio (30,43%) expresó sentimientos negativos, y el resto fue neutral. Además, al realizar un análisis de contenido de los comentarios de sentimiento negativo, este estudio identifica áreas donde los productos y servicios de cruceros deben mejorarse.Implicaciones prácticasSe recomienda a las líneas de cruceros que mejoren la oferta de productos y servicios vacacionales familiares, así como mejorar los elementos de la experiencia física, prestar atención a la interacción humana y los factores situacionales, y atender las necesidades personales de los viajeros.Originalidad/valorEste trabajo explora la experiencia de crucero de las familias chinas con niños pequeños, que actualmente está poco desarrollada. Se aplica sistemáticamente un enfoque metodológico que incluye análisis de texto, análisis de sentimiento y análisis de contenido para ofrecer una comprensión holística y profunda de la experiencia de viaje. Se propone un marco para la experiencia del crucero, que tiene significado teórico y práctico.

Family provision claims and young children: Re R (Deceased)

Case commentary on R R (Deceased) [2021] EWHC 936 (Ch).

Navigating Dual Legal Systems

This article explains the distinctive nature of Islamic inheritance law and considers the extent to which Muslim residents in Australia can assimilate their faith-based obligations with their country-based obligations in matters of inheritance. The article identifies conflict in the Islamic and Australian intestacy rules and sets out three ways that Muslims can manage this conflict. The article considers the scope for, and feasibility of, the execution of Islamic wills in Australia to demonstrate how they assist Muslims to comply with their religious inheritance obligations. While there is no manifest inadequacy in the current legal framework that impedes Muslims from maintaining an Islamic inheritance, the article establishes two instances where Muslims remain at a disadvantage and adds to calls for reform in the area of family provision.

Traits of Womanist in Unigwe’s Night Dancer: Complementarity versus Culture

Presentations of couples as supportive are a foregrounding motif in Chika Unigwe's Night Dancer. This traditional notion is still very topical especially in ensuring that the union lasts as long as they are alive. However, the female still believe that the paramount duty of the male is family provision while the female is a care provider. Nevertheless, there is a paradigm shift, such that, resources are harnessed together to sustain the family due to economic pressure. This paper examines some negative strains of culture in marriages and how the role complementarity plays in marriage, especially in a culture where tradition emphasizes male dominance. The outcome is the ensuing interrogation of the universalizing qualities of the womanist ideology with its tenet of complementarity. This equally questions the concept of equality at the long run. Therefore, when the partners contribute financially, will the issue of dominance and superiority in marriage not be questioned? This paper concludes with the notion that despite the politics of difference that endeavours to weaken women's liberation, womanist theory is still a panacea to understanding the mindset of the women via their experiences. This will equally distinct reality from stereotypes.

Indirect effects of COVID-19 pandemic on reproductive, maternal, newborn and child health services in Pakistan.

COVID-19 is having many impacts on health, economy and social life; some due to the indirect effects of closure of health facilities to curb the spread. Closures were implemented in Pakistan from March 2020, affecting provision of reproductive, maternal, newborn and child health (RMNCH) services. To appraise the effects of containment and lockdown policies on RMNCH service utilization in order to develop an early response to avoid the catastrophic impact of COVID-19 on RMNCH in Pakistan. Routine monitoring data were analysed for indicators utilization of RMNCH care. The analysis was based on Period 1 (January-May 2020, first wave of COVID-19); Period 2 (June-September 2020, declining number of cases of COVID-19); and Period 3 (October-December 2020, second wave of COVID-19). We also compared data from May and December 2020 with corresponding months in 2019, to ascertain whether changes were due to COVID-19. Reduced utilization was noted for all RMNCH indicators during Periods 1 and 3. There was a greater decline in service utilization during the first wave, and the highest reduction (~82%) was among children aged < 5 years, who were treated for pneumonia. The number of caesarean sections dropped by 57%, followed by institutional deliveries and first postnatal visit (37% each). Service utilization increased from June to September, but the second wave of COVID-19 led to another decrease. To reinstate routine services, priority actions and key areas include continued provision of family planning services along with uninterrupted immunization campaigns and routine maternal and child services.

Literature Review: Pemberian Konseling Keluarga Berencana terhadap Pengambilan Keputusan Akseptor Memilih Keluarga Berencana Pasca Persalinan

One of the causes of the relatively fast population growth rate is because the average fertility rate or Total Fertility Rate (TFR) increases. The increase in TFR is also due to an increase in unmet need for family planning, especially in postpartum mothers. So that if the increase in TFR is not overcome by family planning programs, especially post-delivery family planning, there will be four too (4T), namely too young, too old, too many children, too often pregnancy is the cause of increased maternal and infant mortality. Objective: To review articles that discuss the provision of family planning to post-partum mothers. Methods: The author uses a literature review. In searching for several articles, this literature uses the Google Scholar, Pubmed and Scientific Director databases with inclusion criteria, namely using Indonesian and English, respondents are pregnant women in the third trimester or postpartum mothers. The articles obtained are from primary sources with a time span of 5 years (2017-2021). Results: Based on the literature review, it was found that the coverage of family planning acceptors in choosing post-delivery family planning was more likely to choose Long-Term Contraception Methods (LTCM) such as implants and IUDs, so it can be concluded that there is a significant relationship in the provision of post-delivery family planning counseling when pregnant women are in the third trimester. and at the time of postpartum to choose and decide on postnatal family planning.

Literature Review: Pemberian Konseling Keluarga Berencana terhadap Pengambilan Keputusan Akseptor Memilih Keluarga Berencana Pasca Persalinan

One of the causes of the relatively fast population growth rate is because the average fertility rate or Total Fertility Rate (TFR) increases. The increase in TFR is also due to an increase in unmet need for family planning, especially in postpartum mothers. So that if the increase in TFR is not overcome by family planning programs, especially post-delivery family planning, there will be four too (4T), namely too young, too old, too many children, too often pregnancy is the cause of increased maternal and infant mortality. Objective: To review articles that discuss the provision of family planning to post-partum mothers. Methods: The author uses a literature review. In searching for several articles, this literature uses the Google Scholar, Pubmed and Scientific Director databases with inclusion criteria, namely using Indonesian and English, respondents are pregnant women in the third trimester or postpartum mothers. The articles obtained are from primary sources with a time span of 5 years (2017-2021). Results: Based on the literature review, it was found that the coverage of family planning acceptors in choosing post-delivery family planning was more likely to choose Long-Term Contraception Methods (LTCM) such as implants and IUDs, so it can be concluded that there is a significant relationship in the provision of post-delivery family planning counseling when pregnant women are in the third trimester. and at the time of postpartum to choose and decide on postnatal family planning.

Food Insecurity and its Determinants: A Gender Perspective

Achieving food security remains one the fundamental goals of any prosperous country. Food security is a prime mover of national security, improves labour productivity and help in achieving effective human capital development. This study investigates the determinants of food insecurity according to gender perspective among households in Gombe metropolis, Gombe State of Nigeria. The data used was primary data and the data was analyzed using descriptive and logit regression model. From the descriptive results it has found that majority of the households in the study area were food secure with about 64.33% while 35.67% were food insecure. The results obtained from the logit regression model for male headed household; household size and education were the factors determining food insecurity. Furthermore, age, marital status and education were the determinants of food insecurity for female headed households. Therefore, the study recommends among others include; married women could be empowered by government and non-governmental organizations (NGOs) through skills acquisition and training so as to encourage them to be self reliant and be able to cater for their families. In addition provision of family planning measures and improves educational level of the households are also needed. Keywords: Food Insecurity: Gender: Logit Regression Model Jel Code

The Impact of the Covid-19 Pandemic on Cleft Lip and Palate Service Delivery for New Families in the United Kingdom: Medical and Community Service Provider Perspectives.

ObjectivesProfessionals in the United Kingdom providing care to new families affected by cleft lip and/or palate (CL/P) had to adapt to ensure families’ needs were met during a time of uncertainty due to Covid-19. The aims of this study were to explore the impacts of the pandemic on CL/P care provision for new families from the perspectives of professionals working in medical and community settings along with any personal impact on professionals and their reflections on the future of CL/P care.DesignSemistructured interviews (n = 27) were completed about experiences from March 2020 to October 2020 with consultant cleft surgeons (n = 15), lead clinical nurse specialists (n = 8), and staff working at the Cleft Lip and Palate Association (n = 4). Transcripts were analyzed using inductive thematic analysis.ResultsThree themes were identified: (1) the impact of Covid-19 on the provision of cleft care in the United Kingdom, including working conditions, delays to treatment, and Covid-19 policies; (2) the impact of the pandemic on professionals’ mental health, including personal distress and concerns about Covid-19 exposure; and (3) reflections on the future of CL/P care, whereby professionals expressed both hope and concern about the Covid-19 recovery effort.ConclusionsThe ongoing Covid-19 pandemic has impacted CL/P service delivery for new families significantly, warranting recommendations for cohesive psychological support for families in addition to a safe and resourced recovery effort. Support for professionals is also suggested, following existing evidence-based models for providers’ needs that address the difficulties of working throughout challenging times.

Depression, Anxiety, and Stress during COVID-19 Epidemic among Public Health Students in Thailand

By the end of March 2020, the COVID-19 epidemic were widespread in Thailand led to the closures of schools and universities. The home quarantine, social distancing, and other restrictions are likely to have psychological impact on students. This study aimed to estimate the prevalence of depression, anxiety, and stress and determine predictors among undergraduate public health students. A cross-sectional study was conducted at the School of Public Health - Walailak University. Research subjects included 463 students selected by a 2-stage random sampling. A research tool was a self-administered standardized 21-item depression, anxiety, and stress scale. An ordinal logistic regression analysis was executed to determine the predictors of depression, anxiety, and stress. The results showed that the prevalence of depression, anxiety, and stress was 24.8, 31, and 18.8%, respectively. Significant predictors of depression and anxiety were educational environment (OR = 0.35, 95% CI: 0.13 - 0.6; OR = 0.3, 95% CI: 0.2 - 0.7), and tense feelings during learning (OR = 3.57, 95% CI: 1.9 - 6.6; OR = 0.5, 95% CI: 0.2 - 0.8). Relationship with boy/girlfriends was considered a predictor of depression and stress (OR = 2.5, 95% CI: 1.2 - 4.9; OR = 0.5,95% CI: 0.2 - 0.9). Marital status of parent (OR = 15.5, 95% CI: 1.2 - 192.3) and family provision for learning (OR= 3.1, 95% CI: 1.3 - 7.6) were predictors of depression, and specialized majors (OR = 0.2, 95% CI: 0.1 - 0.7) was a predictor of stress. Noticeable worries about “My physical health”, “Health systems being overloaded”, and “Restricted liberty of movement” are also considered as predictors of depression, anxiety, and stress. The findings are needed to develop a good education environment and counseling services for cases having emotional problems.&#x0D; HIGHLIGHTS&#x0D; &#x0D; Depression, anxiety, and stress account for 24.8, 31, and 18.8 %, respectively among public health students during the COVID-19 pandemic&#x0D; Three groups of predictors are related to personal and family relationship, educational environment, and worries about COVID-19&#x0D; Establishing psychological support, reducing academic burden to fit learning needs, and improving educational environments should be urgently done&#x0D; &#x0D; GRAPHICAL ABSTRACT

“Impact on Family Planning Services in Primary Healthcare Facilities in Rural Sindh – Secondary Data Analysis of Pre- and on-going COVID-19 Crisis Period”

The current COVID-19 pandemic has devastated the improvements in family planning services during the past years. This study assessed the impact of the global pandemic that compromised the provision of family planning services in primary healthcare facilities in Sindh – Pakistan. A retrospective data from District Health Information System (DHIS) before Covid-19 (January – February 2020) and during Covid-19 (March – June 2020) was extracted on the provision of family planning services in primary healthcare facilities in Sindh. The study was conducted to understand the impact of service provision through time-series trend analysis by comparing two health facilities i.e., BHUs and BHU plus facilities on monthly average visits (Jan-Feb average) and differences in percentage change over time on the uptake of short and long-acting family planning methods. The findings suggested that due to lockdown and restrictive mobility, the family planning services have fallen drastically in terms of clients visit the health facility from the onset of the COVID-19 outbreak in the month of March 2020 and remain stagnant till June 2020 as compare to before COVID-19 period. The overall analysis revealed the largest decay in the uptake of family planning methods specifically, pills with 31% and 26% during April 2020 in BHU and BHU plus facilities. On the contrary, uptake of Implants showed 25% and 23% decline in the month of June and May in BHU and BHU plus facilities respectively, compared to the average percentage of the pre-COVID Period. The COVID-19 pandemic has adversely affected the provision of family planning services and steeply decreased the uptake of Pills and Implants in primary healthcare facilities in Sindh. On the contrary, the disruption and decrease in services have provided an opportunity to undertake further research exploration to develop future strategies and policies to combat health challenging situations in such pandemics.

“Impact on Family Planning Services in Primary Healthcare Facilities in Rural Sindh – Secondary Data Analysis of Pre- and on-going COVID-19 Crisis Period”

The current COVID-19 pandemic has devastated the improvements in family planning services during the past years. This study assessed the impact of the global pandemic that compromised the provision of family planning services in primary healthcare facilities in Sindh – Pakistan. A retrospective data from District Health Information System (DHIS) before Covid-19 (January – February 2020) and during Covid-19 (March – June 2020) was extracted on the provision of family planning services in primary healthcare facilities in Sindh. The study was conducted to understand the impact of service provision through time-series trend analysis by comparing two health facilities i.e., BHUs and BHU plus facilities on monthly average visits (Jan-Feb average) and differences in percentage change over time on the uptake of short and long-acting family planning methods. The findings suggested that due to lockdown and restrictive mobility, the family planning services have fallen drastically in terms of clients visit the health facility from the onset of the COVID-19 outbreak in the month of March 2020 and remain stagnant till June 2020 as compare to before COVID-19 period. The overall analysis revealed the largest decay in the uptake of family planning methods specifically, pills with 31% and 26% during April 2020 in BHU and BHU plus facilities. On the contrary, uptake of Implants showed 25% and 23% decline in the month of June and May in BHU and BHU plus facilities respectively, compared to the average percentage of the pre-COVID Period. The COVID-19 pandemic has adversely affected the provision of family planning services and steeply decreased the uptake of Pills and Implants in primary healthcare facilities in Sindh. On the contrary, the disruption and decrease in services have provided an opportunity to undertake further research exploration to develop future strategies and policies to combat health challenging situations in such pandemics.