Family Planning Research Articles

SELF-DISCLOSURE TECHNIQUES TO INCREASE SELF-CONFIDENCE IN WOMEN WITH HIV/AIDS

This research is entitled Individual Counseling Using Self-Disclosure Techniques to Increase Self-Confidence in Women Suffering from HIV/AIDS (Case Study on "M" at the Indonesian Family Planning Association, South Sumatra). The background to this research is based on problems that occur with clients where clients experience a sense of lack of self-confidence as a person with B20. This research aims to determine individual counseling using Self Disclosure techniques to increase self-confidence. The method used in this research is a qualitative approach using field research. The data collection techniques use observation, interviews and documentation methods. Meanwhile, the data analysis techniques used are pattern matching, data explanation and time series analysis. The results of this research show that there are two factors that influence client M's self-confidence, namely internal and external factors. After using the Self Disclosure technique, there appeared to be a change where client M had experienced changes in increasing his self-confidence.

Validity and Reliability of the Turkish Version of the Reproductive Autonomy Scale

Objective: This study aimed to determine the reliability and validity of the Reproductive Autonomy Scale (RES), which is a measurement tool that will determine the views of women in Turkey regarding reproductive autonomy by adapting it to the Turkish language and culture. Material and Methods: This was a cross-sectional, methodological research study. A purposive sampling technique was employed to recruit 237 women who applied to the gynecology polyclinic between February 2019 and August 2019. Results: The consistency of the scale, which was translated into Turkish and then back to English, was determined with expert opinion (Kendall W =0.101; p>0.05). The Cronbach's alpha coefficient was 0.72 for the total scale and 0.70 to 0.85 for the subscales. Factor analysis revealed three subscales that explained 58.4% of the total variance. Based on the confirmatory factor analysis, the goodness of fit index was 0.92, the comparative fit index was 0.95, and the non-normed fit index was 0.94. Conclusion: The RAS is valid and reliable for the determination of reproductive autonomy among Turkish women. These results suggested that RAS could be used in family planning programs to identify coercion or barriers against contraception, understand the limitations of reproductive autonomy, and improve women's health.

Men’s involvement in family planning programs: an exploratory study from Karachi, Pakistan

BackgroundIn Pakistan, family planning has traditionally been perceived as primarily a women’s concern, resulting in the exclusion of men from relevant initiatives. This situation is further exacerbated by cultural and social barriers that hinder men’s access to family planning services. This study addresses a significant research gap by assessing the extent of family planning service provision for men in urban areas of Karachi. It delves into the exploration of men’s involvement in family planning service delivery, identifies existing gaps in services catering to men, records men’s perceptions of accessibility and acceptability of these services, and ultimately offers recommendations to enhance men’s involvement and strengthen service provision to better meet their needs.MethodsWe employed a qualitative exploratory research design using semi-structured interviews to investigate perceptions regarding family planning service provision to men. This approach involved 25 interviews, comprising eight key informant interviews with stakeholders, eight with service providers, and nine in-depth interviews with married men.ResultsThis study highlights the limited engagement of men in family planning programs, primarily due to entrenched sociocultural norms that confine female healthcare providers to serving women, hindering men’s involvement. While national and provincial policies endorse men’s participation, they lack defined roles for male providers. Behavioral and information-sharing barriers at the community level discourage male healthcare providers from collaborating with females. Family planning programs, except for NGO-led vasectomy projects, fail to adequately address men’s needs. Despite policy recognition, implementation remains inadequate. Bridging the men’s involvement gap necessitates more male providers and improved contraceptive stigma combat training. Further research is vital to explore effective methods for involving men in community and service delivery in family planning.ConclusionThere is a need to change the perception that contraception is solely the responsibility of women, as men’s participation in family planning in Karachi is limited. Engaging men can yield positive health and non-health outcomes. Culturally sensitive services, developed with community input using a couple-centered approach, are crucial for equitable family planning. Further research is needed to explore men’s inclusion strategies in service provision and utilization.

Análise SWOT de uma experiência de estágio em Medicina Geral e Familiar na ilha de São Vicente em Cabo Verde

A 3-week internship at a health center in Cape Verde allowed a reflective analysis of the situation of Primary Health Care in the country. This experience is presented using the strengths, weaknesses, opportunities and threats (SWOT) analysis and an integrative literature review. The authors identified strengths (organization of appointments, accessibility to Nutrition and Psychology care, training of family doctors), weaknesses (child health surveillance, maternal health and family planning mostly carried out without the support of medical staff; lack of computerization; underuse of physical and human resources; shortage of materials; unavailability of certain medicines; the need to evacuate complex cases), opportunities (young population, openness to educational actions, growing interest of foreign doctors in doing internships in the country) and threats (geography, non-free family planning, socioeconomic conditions, cultural particularities). The authors hope that this study will contribute to a constructive approach that will help improve healthcare in Cape Verde.

Societal Upheaval and the Contraceptive Transition

AbstractHuman development and family planning programs since the 1970s have led to a fast‐rising prevalence of modern contraceptive means at the global level. However, countries with rising but still low levels of contraceptive use experienced an increasing number of societal upheavals, including armed conflicts, sudden and high‐intensity natural disasters, as well as dramatic effects of health epidemics. This may challenge the continued diffusion of modern means of birth regulation as well as their adherent use. To better understand the role of societal upheavals in the contraceptive transition, we provide a narrative literature review of their multidimensional pathways of influence in the contraceptive decision‐making process. The review suggests four main findings. First, well‐known contemporary barriers to contraceptive use become more salient during societal upheavals. Second, historical barriers reemerge predominantly. Third, societal upheavals exert specific effects on the contraceptive transition, such as through birth replacement, the repopulation of communities, and the sexual vulnerability of girls and young women. Fourth, there are more pathways leading to a reduced (rather than a heightened) contraceptive prevalence. The conclusion discusses the implications of those insights for the contraceptive transition, provides a critical perspective of the literature, and draws avenues for future research.

A-319 Capillary Blood Collection for Egg-cellent Reproductive Insights

Abstract Background In the United States, an estimated 13% of women between the ages of 15 and 49 years, experience impaired reproductive potential (fecundity). Assessment of fecundity typically requires an in-person physician visit and venous blood collection to evaluate hormone levels and identify potential reproductive health conditions. Exploring less invasive, at-home sampling options could offer couples insights into their personal reproductive abilities, providing peace of mind and aiding in family planning. Methods Capillary blood, obtained using the Tasso®+ capillary blood collection device coupled with a BD Microtainer® serum tube, was utilized for measurements of analytes associated with female fecundity (follicle stimulating hormone, luteinizing hormone, estradiol, progesterone, anti-Müllerian hormone, and prolactin). These are all FDA-approved assays measured on Roche cobas® e801, assay parameters remained unchanged. Professional and self-collected capillary serum samples were acquired in parallel with the standard venous serum samples, to compare clinical equivalency of the capillary sampling option. In addition to isothermal stability studies at room temperature (20-25°C) and refrigerated (2-8°C) conditions, shipping excursion studies based on ISTA 7D recommendations were performed using a novel packaging solution to control sample temperature and thus, specimen integrity. Studies to assess matrix equivalency, linearity, and imprecision of this alternate sample type were also performed to demonstrate analytical performance. Results Method comparison of venous and professional collection of capillary samples demonstrated correlations (R) ≥ 0.9720 with slopes ranging from 0.919 to 0.971 and mean biases within ±8.2% for all analytes (n = 19-79). Self-collected capillary serum samples demonstrated correlations (R) ≥ 0.9827 with slopes that ranged from 0.841 to 0.985 and mean biases within ±10.7% (n = 16-26). Isothermal stability was demonstrated for each analyte up to 7 days at room temperature and refrigerated conditions. Simulated shipping excursion results were found to be acceptable for both winter and summer conditions with mean biases for each analyte within ±10.2% and ±19.2%, respectively. Matrix equivalency, linearity, and imprecision results adhered to current CLIA acceptance limits for each respective measurement. Conclusions The analytical and stability results affirm the feasibility of collecting capillary serum in a patient-centric manner, providing women with relevant information about their reproductive health.

The utilization of family planning among women of reproductive age attending a teaching hospital, Oyo State, Nigeria

The utilization of family planning among women of reproductive age attending a teaching hospital, Oyo State, Nigeria

Family planning policy and gender in Nigeria: A thematic analysis of the government's health policy perspective.

Family Planning (FP) lets people control the number and timing of child-births through using contraceptives and/or restoring fertility. Nigeria has several FP policies for managing its population, yet contraceptives usage remains suboptimal despite high FP awareness, suggesting that several factors might be inhibiting FP uptake. The literature spotlights gender as factoring into FP use due to Nigeria's patriarchal society, with men positioned as gatekeepers to women's sexual/reproductive health/expression. Therefore, we investigate if/how gender is considered in Nigeria's FP policies. We thematically analysed the 'National Reproductive Health Policy', 'National Family Planning Communication Plan' and 'Nigeria Family Planning Blueprint (Scale-Up Plan)', from a critical realist viewpoint. Our analysis generated an overarching theme-'A Gendered Human Right', with three further themes: Women's Right-Women's Issue', 'Adolescent Girls-not left out' and 'Men's Right as Supporters'. FP was portrayed as the right of women, adolescents (particularly girls≥10yrs) and men. It was highly feminised, with women, not men, majorly shouldering the FP responsibility and women's FP access was presented as hindered by men. Moreover, we advance recommendations for optimising Nigeria's policies to address gender imbalances hampering women's FP access and uphold the rights of all people, women/girls especially.

Stress and Women Physicians: Effects on Infertility and Family Planning

Burnout is an occupational stress phenomenon with physical, cognitive and emotional components. Women physicians encounter distinctive factors that contribute to occupational stress and burnout. The physiological underpinnings of burnout and its connection to fertility have been studied primarily through the hypothalamic-pituitary-adrenal axis. Among women physicians, both individual and organizational factors related to burnout can result in delays in family planning and infertility. Women physicians considering family planning express concerns about being negatively perceived and the effect on career advancement. Women physicians are more likely to require assisted reproductive technologies and experience complications during pregnancy. An emphasis on early education of reproductive options and use of evidence based psychological interventions during the treatment of infertility can reduce stress and improve outcomes. [ Psychiatr Ann . 2024;54(10):e277–e281.]

Family Planning and Children's Human Capital: Experimental Evidence From Urban Malawi

We conduct a randomized controlled trial that provides pregnant and immediate postpartum women with improved access to family planning through counseling, free transportation to a clinic, and financial reimbursement for family planning services over two years. We study the effects of our intervention on child growth and development outcomes among 1,034 children born to participating women directly before the intervention rollout. We find that children born to mothers assigned to the family planning intervention arm were 0.28–0.34 standard deviations taller for their age and 10.7–12.0 percentage points less likely to be stunted within a year of exposure to the intervention. Children born to mothers assigned to the intervention arm also scored 0.17–0.20 standard deviations higher on a caregiver-reported measure of cognitive development after two years of intervention exposure. Although the nonmeasurement of children is a challenge in our study, our estimates are robust to multiple methods of correcting for potential attrition bias. Our results are consistent with models of fertility that link couples’ fertility decisions to child health and human capital. Our results also suggest that improved access to family planning might have positive downstream effects on child health beyond contraceptive use and fertility outcomes.

Implementation of Gender Equality Policy at Village Community Empowerment Office, Population Control, Family Planning, Women's Empowerment and Child Protection (PMDPPKBPPPA) in Barru Regency

Gender inequality has long been a national issue whose handling requires awareness from various parties so that the government issued a gender equality policy contained in the Sustainable Development Goals (SDGs) program with the policy of Law Number 1 of 2017 concerning Gender Mainstreaming. With these problems, researchers will analyze the implementation of gender equality policies at the PMDPPKBPPPA Office of Barru Regency so that gender injustice can be minimized. The method used is a qualitative approach with a case study research type. The results showed that the implementation of gender equality policies has been well implemented supported by George Edward III's theory with indicators of Communication, Resources, Disposition and Bureaucratic Structure. Communication of policy implementers is well established, adequate resource readiness, highly dedicated disposition of implementers and non-overlapping bureaucratic structures. So it can be concluded that the implementation of gender equality policies at the PMDPPKBPPPA Office of Barru Regency has been well implemented even though there are still indicators that need to be improved by policy implementers located on communication indicators where socialization is not optimal.

Patient-centered pregnancy planning in multiple sclerosis: evidence for a new era.

A few decades ago, women diagnosed with multiple sclerosis were discouraged from becoming pregnant. However, with new knowledge about the disease and treatments, this recommendation has changed, and it is pregnancy after the diagnosis of the disease is no longer contraindicated, with family planning being essential in this process. This review aims to provide a comprehensive overview of the family planning process for people with multiple sclerosis.

Effect of Levonorgestrel Implant on Lactation and Infant Growth: A Review

Background: Family Planning is a way to regulate the number of children born and the spacing of pregnancies through information, education, and the use of contraceptives. Postpartum contraception is important to obtain an optimal interpregnancy interval. Postpartum contraception should be initiated early; one of which is Long-Acting Reversible Contraception (LARC). Levonorgestrel can be used to prevent pregnancy because it interferes with ovulation, implantation, and fertilization. Objectives: This study aimed to assess the efficacy and effects of using levonorgestrel implants on breastfeeding and infant growth. Methods: Primary data were in the form of research papers obtained from ScienceDirect, PubMed, and Google Scholar published from the period 2010-2018. The keywords for the searches included: “levonorgestrel”, “levonorgestrel (LNG)-releasing implant”, “levonorgestrel on lactogenesis”, “levonorgestrel on infant growth”, and “levonorgestrel on breastfeeding”, which were used alone or in combination. Results: The 20 selected articles were reviewed based on five identified phrases. Levonorgestrel subdermal implants were shown to be a good choice for women who wanted effective contraception. When used by breastfeeding mothers, levonorgestrel subdermal implants affected neither infant growth (0-1 year of age) nor lactation duration. Conclusions: Levonorgestrel subdermal implants can be effective long-term contraception. These implants are safe for breastfeeding mothers and do not affect infant growth.

Patient needs in women of childbearing age with psoriasis: retrospective analysis from the German PsoBest registry.

Women of childbearing age (WoCBA) with psoriasis face additional burden related to contraindications of systemic treatments during pregnancy/lactation and to the physical and psychosocial impact of psoriasis on their intimate/sexual relationships. Within a people-centered health care model, this study aimed to identify specific patient needs and their correlates in WoCBA (18-45 years), in comparison to same-age men and women above 45 years. Baseline data from the German PsoBest registry, including patients with moderate/severe plaque-type psoriasis with the indication for systemic therapy, were retrospectively analyzed. Psoriasis severity was assessed with the Psoriasis Area and Severity Index and patient-reported outcomes included EuroQoL Visual Analogue Scale, Dermatology Life Quality Index (DLQI), and Patient Needs Questionnaire. The participants were 2308 WoCBA, 3634 men between 18 and 45 years of age, and 3401 women older than 45 years. In comparison to both control groups, WoCBA reported more DLQI impairments and higher needs to reduce social impairments (eg, "to be able to lead a normal working life"; "to be less burdened in your partnership"; "to be able to have a normal sex life"). These patient needs were associated with having psoriasis arthritis, previous systemic therapy, worse general health, and more DLQI impairments. Retrospective analysis of an established dataset limited the examination of specific developmental, sexual, and reproductive variables. The specific needs of WoCBA with psoriasis were particularly related to the work context/financial stability and intimate relationships, which are crucial aspects in family planning. These results claim for a sex/age-sensitive approach in the psoriasis health care, by considering these needs as qualifiers in the clinical decision for systemic treatment.

Problems of Family Planning in India: Some Issues

Focusing on the magnitude of family planning in India, it is necessary to strengthen all its aspects through government programs, and training given by NGOs or ASHA workers to mothers and families. Family planning also deals with the reproductive healthcare of the mother as well as preventing her from different kinds of disease. It helps to improve the quality of life of the mother, child, and family as a whole.

Television and family demography: Evidence from a natural experiment in East Germany

This paper examines the causal effects of television exposure on individual decisions regarding marriage, divorce, and family planning by utilizing a natural experiment in the German Democratic Republic during the period of German division. I exploit the fact that individuals in some East German areas could not receive Western television due to their place of residence before reunification in 1990. By analyzing survey data from the German Socio-Economic Panel, my results reveal that exposure to Western TV significantly reduced the likelihood of marriage and childbirth while increasing the probability of divorce among East Germans. Analyzing administrative data at the county level supports these findings. In addition, survey data from the late 1980s indicates that the observed effects are primarily due to changes in attitudes towards relationships and family life, particularly among women.

Awareness on obstetric fistula and associated factors among women health development army, in the South Gondar zone, Amhara region, Ethiopia: A cross sectional study.

Obstetric fistula is a severe birth injury that profoundly impacts women's health, social well-being, economic stability, and psychological state. While it can be prevented with timely emergency obstetric care, a significant barrier in many developing regions, including the study area, is the lack of awareness among women. This study aimed to evaluate the level of awareness about obstetric fistula and the factors influencing it among the Women Health Development Army in the South Gondar zone of the Amhara region, Ethiopia, in 2020. A community-based cross-sectional study was done from July to December 2020, involving 633 women. Participants were selected using a multistage stratified sampling method. Data were collected using a pretested, interviewer-administered structured questionnaire. Data entry was performed using EpiData version 3.1, and analysis was conducted with SPSS version 23.0. Multivariable logistic regression models were employed to identify influencing factors, with a p < 0.05 considered statistically significant. This study found that 55.3% (95% CI, 51.6%-57.2%) of study participants had a good awareness of obstetrics fistula. Significantly associated factors include; no history of ANC (AOR = 0.52: 95% CI, 0.31, 0.86), living >30 min away from a health facility (AOR = 0.43: 95% CI, 0.23, 0.81), no history of abortion (AOR = 0.37: 95% CI, 0.19, 0.72), Injectable and implant users (AOR = 3.60: 95% CI, 1.98, 6.53), having four to six pregnancy (AOR = 1.87: 95% CI, 1.22, 2.87) and lack of communication material in the house (AOR = 0.19: 95% CI, 0.10, 0.37). This study found that 55.3% of women have a good awareness of obstetrics fistula. ANC follow-up history, abortion history, type of family planning, type of communication, number of pregnancies, availability of health facility, and distance of health facility were significantly associated with awareness of obstetric fistula. Hence, local and national efforts should be made to enhance access to information at home and basic maternal health services including antenatal care.

Society of Family Planning Committee Statement: Contraception and body weight

Understanding the relationship between contraception and body weight is an important clinical consideration. Body weight and size has the potential to affect fertility and the effectiveness of some contraceptive methods, although historically this association has not been applied within a person-centered context that would allow individuals to select their preferred contraceptive method. Further, individuals with higher body weights and larger sizes have unmet contraceptive care and counseling needs. This document aims to provide evidence-based, person-centered, and equity-driven recommendations that destigmatize contraceptive care across all body weights. Clinicians should: provide person-centered, unbiased contraceptive care, including counseling pregnant-capable individuals on their risk of pregnancy based on sexual practices and contraceptive use regardless of body weight or size; utilize evidence-based and person-centered contraceptive counseling to offer the full range of contraceptive methods regardless of body weight or size; counsel patients about any risks and benefits associated with body weight and size to assist in their selection of contraceptive methods, including emergency contraception; counsel individuals about the potential for weight change, particularly weight gain, associated with contraceptive methods as a possible factor in decision-making; and counsel individuals regarding the potential impact of weight management approaches, such as bariatric surgery and glucagon-like peptide 1 (GLP-1) agonists, on contraceptive efficacy.

Improving access and quality of primary healthcare through women and adolescents' user committees: A mixed-methods case study in Kinshasa, Democratic Republic of the Congo.

Patient engagement is seen as a fundamental strategy for achieving quality patient-centred care, especially in community-based primary healthcare. Despite growing interest in patient engagement in Sub-Saharan Africa, few patient engagement initiatives have been identified, and those often are limited to lower levels of engagement, in participation in health research or in health system improvement. With the aim of giving a voice to under-represented community groups in healthcare governance, the Access to Health services in Kinshasa (ASSK) project supported the implementation of primary health services user committees in the Democratic Republic of the Congo, designed to enable the representation of two user groups with specific unmet sexual and reproductive health (SRH) needs: women and adolescents. Using a mixed-method case study design combining quantitative secondary data (from the national health management information system-DHIS2) and qualitative data from two research World Café (WC1: Women user committees (WUC) n=55; WC2: Adolescents user committee (AUC) n=63), this paper looks at the implementation facilitators and barriers, and at the results of this initiative. Women and adolescent members of the user committees highlighted that their participation resulted in increased knowledge of SRH and their related rights, as well as in their 'soft skills' such as communication and leadership. In addition, participants reported greater transparency and accountability on the part of the community primary health centres (e.g. by displaying fees for procedures to counter over-billing). Ultimately, WUC and AUC were associated with improved health practices in the community such as increased use of SRH services (increase of 613% for Makala and 160% for Maluku II), including adolescent family planning (increase of 320% for Makala and 12% for Maluku II) and assisted childbirth for women15-49years old (increase of 283% for Makala and 23% for Maluku II)). Patient user committees for specific marginalised or under-represented groups appear to be an effective way of improving the quality of primary health care services. Further research is needed to better understand how to maximise its potential.

Attitude of Post-Graduate Students towards Family Planning in Ilorin Metropolis, Kwara State

Family planning can be considered beneficial to an extent and it involves the use of contraceptives to stop unwanted pregnancies. Thus, this study investigated attitude of post-graduate students towards family planning in Ilorin metropolis, Kwara state. Descriptive research design of survey type was adopted for this study. The population for this study consisted of post graduates in Ilorin, Kwara state. The sample of two hundred were randomly selected. The sampling technique that was used in this study was purposive sampling technique. The instrument that was used for this study is a researcher-developed questionnaire tagged “Attitude of Post-graduate Students Towards Family Planning Question (APSTFPQ)". In analyzing the data collected for this study, both descriptive and inferential statistical analyses were employed. The demographic data collected was analyzed using percentages and ranking order. In testing the hypotheses generated, t-test and Analysis of variance (ANOVA) statistics were used to analyze the hypotheses generated for the study at 0.05 level of significance. The study revealed that the attitude of post graduate students towards family planning in Ilorin metropolis was positive. There was no significant difference in the attitude of post graduate students towards family planning based on age, course of study and number of children while significant difference was observed on level of educational attainment. Based on the findings of this study, it was recommended that awareness should be created among post graduate students about family planning to improve the attitude of the students towards family planning, Counsellors in tertiary institutions should organize seminars and workshops on family planning and its importance, post graduate students irrespective of age, course of study and number of children should make it as a habit to engage in family planning.