Unmet Need For Family Planning Research Articles

Boosting Contraceptive Uptake in Urban Uganda: Older Women Benefit When Layering Adolescent and Youth Interventions Onto Existing Family Planning Programming.

Uganda has a large young population with a high unmet need for family planning (FP). Although there have been many efforts to improve access to and uptake of contraception, improvements have been slow. The Ministry of Health Uganda partnered with The Challenge Initiative (TCI) to implement a novel multipronged approach layering adolescent and youth sexual reproductive health (AYSRH) onto a functioning general FP program for women of reproductive age in 3 local governments of Buikwe, Mukono, and Iganga. We describe the approach and aim to determine whether layering AYSRH interventions onto an existing program resulted in increased contraceptive uptake among adolescents and youth aged 10-24 years and among women aged 25-49 years. We analyzed service statistics from the Uganda Health Management Information System to assess contraceptive uptake for adolescents and youth (aged 10-24 years) and older women (aged 25-49 years) before and after the implementation of the AYSRH approach in 3 areas (Buikwe, Iganga, and Mukono) compared to 11 areas where only the general FP program was implemented and the Uganda country total. This analysis showed that before the start of TCI's support, levels of contraceptive uptake were similar in all local governments. However, after implementation, there was an increase in uptake for general FP program only areas (1.7-point advantage over country total) and an even greater increase in general FP+AYSRH areas (2.4-point advantage over FP only programming). This was observed in both adolescents and youth aged 10-24 years and among women aged 25-49 years. The layering of TCI's AYSRH interventions onto a well-functioning FP platform not only increased contraceptive uptake among adolescents and youth aged 10-24 years but also boosted uptake among women older than age 25 years.

Trends and predictors of unmet need for family planning among women living with HIV in Zambia: implications for elimination of vertical transmission of HIV

BackgroundPrevention of vertical (mother to child) transmission of HIV is one of the key strategies towards HIV epidemic control. Despite considerable progress over the past decade in Zambia, the country is yet to reach global and national target for elimination of vertical transmission of HIV. Avoidance of unintended pregnancy among women living with HIV is one of the cost-effective interventions in a comprehensive approach to prevent vertical transmission of HIV. Therefore, this study aimed at ascertaining trends in and predictors of unmet need for family planning among women living with HIV in Zambia.MethodsThe study employed a repeated cross sectional (RCS) study design, using data from the three (3) most recent consecutive rounds of the Zambia Demographic and Health Survey (ZDHS) conducted in 2007, 2013/2014 and 2018. The study used data from a total of 27,153 women aged 15–49 years over the three survey periods among whom 4,113 had an HIV positive result following a rigorous HIV testing algorithm of the demographic and health surveys, and these constituted our sample size of women living with HIV. We used descriptive statistics and logistic regression analyses to respectively ascertain trends in and predictors of unmet need for family planning among women living with HIV.ResultsOver the three survey points, unmet need for family planning among women living with HIV has largely remained unchanged from 20.8% in 2007 to 20.5% in 2013/14 and 21.1% in 2018 DHS. Residence, age of women, household wealth, woman’s parity, employment, and age of spouse emerged as significant predictors of unmet need for family planning among women living with HIV in Zambia.ConclusionPreventing HIV infection in a child preserves life, contributes to improving quality of life from its early stages and averts lifetime costs of HIV treatment and associated healthcare costs. There is need to consider optimization of interventions to prevent vertical transmission of HIV including shaping programming regarding preventing unintended pregnancies among women living with HIV. Among other aspects, policy and practice need to strengthen SRH/HIV integration and better target rural residents, younger women, those with high parity and consider positive male engagement to reduce unmet need for family planning among women living with HIV.

Trends in prevalence of unmet need for family planning in India: patterns of change across 36 States and Union Territories, 1993–2021

BackgroundEliminating unmet need for family planning by 2030 is a global priority for ensuring healthy lives and promoting well-being for all at all ages. We estimate the sub-national trends in prevalence of unmet need for family planning over 30 years in India and study differences based on socio-economic and demographic factors.MethodsWe used data from five National Family Health Surveys (NFHS) conducted between 1993 to 2021 for the 36 states/Union Territories (UTs) of India. The study population included women of ages 15–49 years who were married or in a union at the time of the survey. The outcome was unmet need for family planning which captures the prevalence of fecund and sexually active women not using contraception, who want to delay or limit childbearing. We calculated the standardized absolute change to estimate the change in prevalence on an annual basis across all states/UTs. We examined the patterning of prevalence of across demographic and socioeconomic characteristics and estimated the headcount of women with unmet need in 2021.ResultsThe prevalence of unmet need in India decreased from 20·6% (95% CI: 20·1– 21·2%) in 1993, to 9·4% (95% CI: 9·3–9·6%) in 2021. Median unmet need prevalence across states/UTs decreased from 17·80% in 1993 to 8·95% in 2021. The north-eastern states of Meghalaya (26·9%, 95% CI: 25·3–28·6%) and Mizoram (18·9%, 95% CI: 17·2–20·6%), followed by the northern states of Bihar (13·6%, 95% CI: 13·1–14·1%) and Uttar Pradesh (12·9%, 95% CI: 12·5–13·2%), had the highest unmet need prevalence in 2021. As of 2021, the estimated number of women with an unmet need for family planning was 24,194,428. Uttar Pradesh, Bihar, Maharashtra, and West Bengal accounted for half of this headcount. Women of ages 15–19 and those belonging the poorest wealth quintile had a relatively high prevalence of unmet need in 2021.ConclusionsThe existing initiatives under the National Family Planning Programme should be strengthened, and new policies should be developed with a focus on states/UTs with high prevalence, to ensure unmet need for family planning is eliminated by 2030.

IJCM_67A: Unmet need for family planning and the factors affecting it in rural area of Udupi district, Karnataka

Background: The world population is expected to increase from 8 billion currently to 9.7 billion in 2050. China (1.4 billion) and India (1.4 billion) remain the two most populous countries of the world representing 18 percent of the world’s population respectively. Unmet need for contraception and unintended pregnancy are important public health concerns for India in this context. Objectives: 1. To estimate the prevalence of unmet need for family planning among eligible couples. 2. To assess the knowledge and attitude towards contraceptive usage among the eligible couples Methodology: After obtaining the approval of institutional ethics committee, a cross sectional study was conducted in Shirva, a rural area of Udupi district, Karnataka. List of eligible couples residing in areas coming under the sub centres of CHC Shirva which is a field practice area of the Department of Community Medicine, KMC, Manipal was obtained. Married women of the age group 18-49 years who are were included in the study. Data was collected by personal interviews using a semi structured, pre -designed, pre-tested questionnaire. Data was analyzed using SPSS version 26. Regression analyses was performed to find out the independent effect of various factors. Results: From the preliminary analysis of 539 participants, the unmet need for family planning was found to be 43.4%. The mean age was found to be 33.68 with a standard deviation of 6.27. The mean age at marriage and the mean age at birth of first child were found to be 22.40 and 22.97 respectively. Most of participants belonged to Hindu religion (57%), followed by Muslims (38.2%) and Christians (4.6%). 36.7% were educated up to secondary school and 21.3% up to graduation and above. Conclusion: From this study, the unmet need for family planning was found to be high.

Life skills and reproductive health empowerment intervention for newly married women and their families to reduce unintended pregnancy in India: protocol for the TARANG cluster randomised controlled trial

IntroductionIn South Asia, younger women have high rates of unmet need for family planning and low empowerment. Life skills interventions can equip young women with agency, but the effectiveness of...

Knowledge Attitude and Barriers to the Use of Family Planning Among Married Men and Women at Fort Portal Hospital-Kabarole-Uganda.

According to the Uganda Demographic and Health Survey, most women and men knew some family planning methods but only about 29%of married women were using contraceptives. 20% of women had an unmet need for family planning. We examined knowledge, attitudes and contraceptive practice as well as factors related to contraceptive use in Fort Portal region Uganda. Methods: Data were collected between Sept-Nov 2023 among 160 married couples using a multi-stage sampling design. Quantitative data was based on semi-structured questionnaires and was triangulated with qualitative data collected during focus group discussions. We compared proportions and performed logistic regression analysis. The concept of family planning was well-known in the studied population. Sex-stratified analysis showed pills and injectables were commonly known by both sexes, while long-term contraceptive methods were better known by women, and traditional methods as well as emergency contraception by men. Formal education was the most important factor associated with better knowledge about contraceptive methods (aOR = 2.07, p,0.001), in particular among women (aOR women = 2.77 vs. aOR men = 1.49; p,0.001). In general, only 1 out of 160 men ever used contraception, while 65% and 44% of females ever used and were currently using contraception respectively. The high knowledge of contraceptives did not match with the high contraceptive practice in the study area. The study demonstrated that mere physical access (proximity to clinics for family planning) and awareness of contraceptives are not sufficient to ensure that contraceptive needs are met. Thus, projects aiming at increasing contraceptive use should contemplate and establish better counselling about contraceptive side effects and method switches. Furthermore, in all family planning activities, both wives’ and husbands’ participation should be considered. Keywords: Family planning, Contraceptive use, Women, Men, Married couples.

Characterizing Family Planning Utilization in Adult Women and Adolescents in Pohnpei, Federerated States of Micronesia.

Increasing family planning xutilization in low-income countries to improve health outcomes of women and children is a global priority. The Federated States of Micronesia (FSM) has poor maternal child health outcomes; therefore, this study aimed to examine family planning utilization in Pohnpei State, FSM. This cross-sectional study sought to characterize family planning utilization in adult women of reproductive age and high school age adolescents in Pohnpei using representative survey data collected in 2019 (N = 570 and N = 1726, respectively). Chi-square tests were used to determine significant factors associated with family planning utilization. Among adult women of reproductive age (18-49years old) not trying to get pregnant, 31.6% reported using contraception during last intercourse. Contraceptive use was significantly lower among younger women (18-24years old) (21.7%, p = 0.021), unmarried women (18.6%, p < 0.001), those without health insurance (28.7%, p = 0.030), those who have never had a pap smear (20.5%, p < 0.001), and those who have never been pregnant (14.5%, p < 0.002). Among adolescents who reported being sexually active, 28.5% reported using any contraception at last intercourse and 22.6% reported using a condom at last intercourse. Condom use among sexually active adolescents was lowest among 12th graders (13.5%, p < 0.001) and girls (16.8%, p = 0.004). Our findings suggest that young, unmarried, never pregnant women face an unmet need for family planning. Additionally, women with lower access to and use of healthcare services have lower use of family planning.

Assessing the Relationship between Short Birth-to-Pregnancy Interval and the Maternal and Perinatal Outcomes among Multiparous Women in Northern Ghana

Introduction: The World Health Organization (WHO) recommends an optimal Birth-to-Pregnancy Interval (BPI) of 24-59 months, or a 33-month interval between two successive births, to reduce the risk of untoward maternal and newborn outcomes. Short Birth to Pregnancy Interval (SBPI) and unmet need for Family Planning (FP) are the major contributors to rapid population growth and increased maternal and newborn mortalities. The purpose of this study was to assess the adverse perinatal and maternal outcomes associated with SBPI among multiparous women in three municipalities of the Upper East Region (UER) of Ghana.&#x0D; Materials and Methods: We employed a cross-sectional design conducted among 904 women aged 15-49 attending Antenatal Care (ANC) clinics in three municipalities in the UER who had at least two successive live births prior to data collection. A multistage cluster sampling technique was employed to recruit respondents for this study. This was conducted in four steps. Out of the 46 health facilities, we randomly selected 25 respondents using the systematic random selection method. Data was collected using a structured questionnaire, incorporated into the electronic data collection tool (Kobo collect), and administered by trained research assistants. Birth interval was categorized according to the WHO’s classification: &lt;24 months as SBPI, 24-≥59 months as Optimal Birth to Pregnancy Interval (OBPI), and &gt;59 months as Long Birth to Pregnancy Interval (LBPI).&#x0D; Results: Of the 904 respondents, the majority (56.2%) had an OBPI, while 36.9% had a SBPI. Factors that influenced SBPI were parity, mode of delivery, and the educational status of woman’s partner. Participants with a higher parity (≥5 children) had 0.67 times the potential of spacing their births (AOR 0.67; 95% CI 0.46-0.98; p = 0.040). Women who experienced a Caesarean Section (CS) delivery were 3.28 times more likely to have LBPI (AOR 3.28; 95% CI 1.02–10.62; p=0.047). Respondents whose partners had secondary education had a 1.87 chance (AOR 2.07; 95% CI 1.09–3.96; p=0.027) of spacing their births. The birth complications reported were retained products of conception (41.9%), pregnancy-induced hypertension (27.9%), postpartum hemorrhage (11.6%), obstructed labor (10.5%), sepsis (38.1%), neonatal jaundice (23.8%), low birth weight (19%), and preterm birth (14.3%).&#x0D; Conclusion: A significant proportion of the participants in this study reported having a short duration between the birth of one child and the conception of the next. This was associated with various adverse maternal and perinatal outcomes, such as birth complications and mortalities. The study emphasizes the need for health professionals to address challenges in contraceptive uptake, especially among multiparous women, and promote optimal birth spacing to improve maternal and perinatal outcomes.

Determinants of unmet need for family planning among currently married reproductive age women at Dewa Chefa District of Oromia special zone, Amhara region, Ethiopia, 2021; a case-control study

BackgroundUnmet need for family planning is a proportion of women among reproductive age group who want to stop or delay childbearing but are not using any method of contraception. One in ten married women face unmet need for family planning world-wide whereas, one in five women in Africa. Thus, by understanding factors associated with unmet need specific to the study area; the study contributes to planning and intervention of programs, gives additional finding for controversies in earlier studies, and also helps as a baseline for other researchers conducting studies on similar topics.MethodsA community-based unmatched case-control study was conducted from March 29-April 25, 2021 G.C on 462 currently married reproductive age women (154 cases and 308 controls) in Dewa Chefa District. Currently married reproductive-age women who were fecund, and wanted to limit or delay childbearing but were not using any contraceptive methods were taken as cases and currently married reproductive-age women who were using family planning or did not want to use were taken as controls. A structured and pre-tested questionnaire was used to collect data. Collected data were entered into Epi-data 3.1 and exported to SPSS 23 for analysis. Binary Logistic regression was conducted and variables with p-value < 0.05 were taken as statistically significant.ResultsA total of 462 women participated in this study, with 100% response rate. The mean age of the respondents was 27.92 years (with SD of ± 6.3) Age of woman 35–49 [AOR = 6.6 (1.1–39)], having poor knowledge on family planning [AOR = 1.9 (1.1–3.1)], using family planning decided by husband [AOR = 3.8 (2.1–6.9)], using family planning decided together [AOR = 2.3 (1.07–5.1)] and have no support and disapproval of husband for family planning use [AOR = 2.1 (1.08-4)] were factors significantly associated with unmet need.Conclusion and recommendationsAge of the woman, main decider of family planning use, knowledge about family planning and support and approval of spouse for family planning use were found to have significant association with unmet need for family planning. Thus, family planning providers, District health office, and other concerned bodies should strengthen female empowerment and male involvement in the program with strong couple counseling to reduce unmet need.

A grand multipara woman in the modern era: A case of public health dilemma from an urban slum

With the advancement in family planning practices and shifting norms from “hum do hamare do” to “one child,” there still exist mothers who are delivering their 10th children. Such an example is a woman residing in an urban slum in the Khordha district of Odisha, India. She has never used any modern methods of contraception. Neither the health workers in that area could fulfill her unmet need for family planning. The helpless mother missed all the antenatal checkups as she did not have anyone to accompany her to the hospital. Three of her children were delivered at home and none of them were immunized to date. She has become a victim of domestic violence by her husband, who is addicted to alcohol. She has done two medical terminations of pregnancy due to non-usage of any contraception. Neither she is able to provide herself nor her children sufficient food every day, as she is not able to go to work in her post-partum period. Her alcoholic husband is not able to earn regularly and there is no other family member to support her. There is no Accredited Social Health Activist appointed for that area whom she can rely on. We need to look at what is the cause of such a scenario – Is it poverty, lack of awareness, lack of education, or our health system has failed to achieve universal health coverage.

Spatial distribution and determinants of unmet need for family planning among all reproductive‑age women in Uganda: a multi‑level logistic regression modeling approach and spatial analysis

IntroductionUnmet need for family planning is defined as the percentage of sexually active and fecund women who want to delay the next birth (birth spacing) or who want to stop childbirth (birth limiting) beyond two years but who are not using any modern or traditional method of contraception. Despite the provision of family planning services, the unmet need of family planning remains a challenge in low- and middle-income countries (LMICs). Thus, this study aimed to assess the spatial distribution and determinant factors of unmet need for family planning among all reproductive‑age women in Uganda.MethodsA secondary data analysis was done based on 2016 Ugandan Demographic and Health Surveys (UDHS). Total weighted samples of 18,506 women were included. Data processing and analysis were performed using SPSS Version 26, STATA 14.2, ArcGIS 10.8, and SaTScan 10.1.2 software. Spatial autocorrelation and hotspot analysis was made using Global Moran’s index (Moran’s I) and Gettis-OrdGi*statistics, respectively. Determinants of unmet needs for family planning were identified by multi-level logistic regression analysis. Variables with a p-value < 0.05 were declared statistically significant predictors.ResultsThe spatial distribution of unmet need for family planning among women of reproductive age in Uganda was found to be clustered (Global Moran’s I = 0.27, Z-score of 12.71, and p-value < 0.0001). In the multivariable multilevel logistic regression analysis; women in West Nile (AOR = 1.86, 95% CI: 1.39, 2.47), aged 25–49 years old (AOR = .84; 95% CI .72, .99), highly educated (AOR = .69; 95% CI .54, .88), Muslim (AOR = 1.20, 95% CI: 1.03, 1.39), high wealth status (AOR = .73, 95% CI: .64, .82), and had five or more living child (AOR = 1.69, 95% CI: 1.51, 1.88) were significant predictors of unmet need for family planning. Significant hotspot areas were identified in West Nile, Acholi, Teso, and Busoga regions.ConclusionA significant clustering of unmet need for family planning were found in Uganda. Moreover, age, educational status, religion, wealth status, number of alive children, and region were significant predictors of unmet need for family planning. Therefore, in order to minimize the burdens associated with unmet need, an interventions focusing on promotion of sexual and reproductive health service should be addressed to the identified hotspot areas.

Assessing the Relationship between Short Birth-to-Pregnancy Interval and the Maternal and Perinatal Outcomes among Multiparous Women in Northern Ghana

Introduction: The World Health Organization (WHO) recommends an optimal Birth-to-Pregnancy Interval (BPI) of 24-59 months, or a 33- month interval between two successive births to reduce the risk of untoward maternal and newborn outcomes. Short Birth to Pregnancy Interval (SBPI), and unmet need for Family Planning (FP) are the major contributors to rapid population growth and increased maternal and newborn mortalities. The purpose of this study was to assess the adverse perinatal and maternal outcomes associated with SBPI among multiparous women in three municipalities of the Upper East Region (UER) of Ghana. Materials and Methods:The study employed the Cross-sectional Design conducted among 904 women aged 15-49 years attending Antenatal Care (ANC) clinics in three municipalities in the UER who had at least two successive live births prior to data collection. Data was collected using structured questionnaire, incorporated into the electronic data collection tool, Kobo collect and administered by trained research assistants. Birth interval was categorized according to the WHO’s classification, &lt;24 months as SBPI, 24-≥59 months as Optimal Birth to Pregnancy Interval (OBPI) and &gt;59 months as Long Birth to Pregnancy Interval (LBPI). Results: Of the 904 respondents, the majority (56.2%) had an OBPI, while 36.9% had a SBPI. Factors that influenced SBPI were parity, mode of delivery, and the educational status of women’s partner. Participants with a higher parity (≥5 children) had 0.67 times the potential of spacing their births (AOR 0.67; 95% CI 0.46-0.98; p = 0.040). Women who experienced a Caesarean Section (CS) delivery were 3.28 times more likely to have LBPI (AOR 3.28; 95% CI 1.02-10.62; p=0.047). Respondents whose partners had secondary education had a 1.87 chance (AOR 2.07; 95% CI 1.09-3.96; p=0.027) of spacing their births. The birth complications reported were retained products of conception (41.9%), pregnancy-induced hypertension (27.9%), postpartum hemorrhage (11.6%), obstructed labor (10.5%), sepsis (38.1%), neonatal jaundice (23.8%), lowbirth-weight (19%), and preterm birth (14.3%). Conclusion and Global Health Implications: The study recommends health professionals in direct contact with maternal, reproductive, and child health to be proactive in FP counseling, and to support women decision making.

Effects of a community-based, multi-level family planning intervention on theoretically grounded intermediate outcomes for couples in rural Uganda: Results from a mixed methods pilot evaluation.

This study tested the theoretically grounded conceptual model of a multi-level intervention, Family Health = Family Wealth (FH = FW), by examining FH = FW's effect on intermediate outcomes among couples in rural Uganda. FH = FW is grounded in the social-ecological model and the social psychological theory of transformative communication. A pilot quasi-experimental controlled trial. Two matched clusters (communities) were randomly allocated to receive the FH = FW intervention or an attention/time-matched water, sanitation and hygiene intervention (N = 140, 35 couples per arm). Quantitative outcomes were collected through interviewer-administered questionnaires at baseline, 7-months and 10-months follow-up. Focus group discussions (n = 39) and semi-structured interviews (n = 27) were conducted with subsets of FH = FW participants after data collection. Generalized estimated equations tested intervention effects on quantitative outcomes, and qualitative data were analysed through thematic analysis-these data were mixed and are presented by level of the social-ecological model. The findings demonstrated an intervention effect on family planning determinants across social-ecological levels. Improved individual-level family planning knowledge, attitudes and intentions, and reduced inequitable gender attitudes, were observed in intervention versus comparator, corroborated by the qualitative findings. Interpersonal-level changes included improved communication, shared decision-making and equitable relationship dynamics. At the community level, FH = FW increased perceived acceptance of family planning among others (norms), and the qualitative findings highlighted how FH = FW's transformative communication approach reshaped definitions of a successful family to better align with family planning. This mixed methods pilot evaluation supports FH = FW's theoretically grounded conceptual model and ability to affect multi-level drivers of a high unmet need for family planning.

Trend and determinants of unmet need for family planning among married women in Ethiopia, evidence from Ethiopian demographic and health survey 2000-2016; multilevel analysis.

Unmet need refers to the gap between women's desires and contraception use to monitor their fertility level. According to the data, unplanned pregnancies are more likely to result in miscarriage and other obstetric difficulties, have poor maternal health care usage, and have a higher risk of having babies who are underweight. Information on the trend of unmet family planning needs in Ethiopia is scarce. The aim of this study was to examine the trend and determinants of unmet need for family planning among married or in union women in Ethiopia from 2000 to 2016. Cross-sectional study design from secondary data was performed. Data for the study was obtained from four consecutive Ethiopian Demographic Health Surveys 2000 to 2016. The survey employs a nationally representative sample of households using a multistage stratified sampling technique. A descriptive analysis was done to see the trend in unmet need. Multivariable, multilevel logistic regression was performed to assess individual and community-level determinants. An adjusted odds ratio (AOR) at a 95% confidence interval and a p-value of 0.05 were used to declare the level of significance. Unmet need declined by 40.2%, from 37.3% to 22.3%, from 2000 to 2016. Rural (AOR = 1.42; 95% CI: 1.27-1.59), number of living children > = 5 (AOR = 1.14 (1.04-1.24), age at first marriage > = 18 years (AOR = 1.15; 95% CI: 1.09-1.21), knowing at least one method of Family Planning (FP) (AOR = 1.57; 95% CI: 1.43-1.72), and no previous use of FP (1.27 (1.20-1.36) were associated with increased unmet need. While women between the ages of 20 and 24 (AOR = 0.71; 95% CI: 0.64-0.79), 25-29 (AOR = 0.62; 95% CI: 0.55-0.70), 40-44 (AOR = 0.43; 95% CI: 0.39-0.50), 45-49 (AOR = 0.21; 95% CI: 0.18-0.24), the richest wealth index (AOR = 0.88; 95% CI: 0.80-0.96. The level of unmet need has decreased significantly in Ethiopia over the past 16 years. Age, educational level, media exposure, number of living children, age at first marriage, parity, previous use of FP, knowledge of FP, wealth index, regional setting, residence (rural), and survey year all have an association with an unmet need for family planning.

Assessment of Unmet Needs of Family Planning in Extended Postpartum Period in Women of Urban Slum of Maharashtra

Abstract Context: Unmet need for family planning (FP) refers to the gap between the intentions to use FP methods and actual use. This poses a challenge to the FP program. Aims: The aim of this study was to find out the extent of unmet needs, associated sociodemographic factors, and possible reasons for unmet needs among women during the extended postpartum period (EPP). Settings and Design: This was a cross-sectional analytical study in a slum community of Nagpur coming under a preview of urban primary health center. Subjects and Methods: The listing of females who are in EPP was made. Two hundred seventy women were selected by systematic random sampling for a period of 7 months in an urban slum using pretested semi-structured questionnaire. Statistical Analysis Used: Descriptive statistics was used for summarization of the data. Statistical association was determined using the Chi-square test. Results: In the present study, the extent of unmet needs during EPP was 145 (39.189%), 110 (75.862%) for spacing the birth, and 35 (24.137%) for limiting the birth. Unmet need was significantly associated with socioeconomic status and number of living children. The main reason for the unmet need for FP was fear of side effects. (n = 127, 87.56%). Conclusions: The extended period of postpartum is an opportunity to provide FP services by adding more components on counseling and alleviating fear among women.

Unmet Need for Contraceptive among Tribal Married Women of Rangamati District, Bangladesh

Background: The unmet need for contraceptives refers to the discrepancy between some women's objectives towards conception and their use of contraception, which has been a central indicator for monitoring the progress of family planning programs. Objective: This study set out to identify and evaluate the unmet need for contraceptives among married tribal women between the ages of 15 to 49. Materials and Methods: A descriptive cross-sectional study was carried out between January 2022 to December 2022 in Belaichari Upazilla of the Rangamati district. Two hundred and six married indigenous women (15–49 years old) were surveyed house–to–house. Data on the characteristics of contraceptive uses, unmet needs, and correlations were collected by interviewing the participants using a pre-designed, semi-structured questionnaire. Results: The mean age of the participants was 28.07 ± 6.09 years, and most were Buddhist (63.6%). The contraceptive prevalence rate was found to be 41.3%. Overall, unmet need for family planning was 16.5%, and the age of the woman, religion, and profession of the husband were found to be significantly associated with the unmet need for contraceptive. Apprehension of side effects and difficulty in using were reported as two common reasons for unmet needs. Conclusion: Contraceptive services should place priority on improving the information and counseling they provide and the range of methods they offer. All sexually active women need information about their risk of becoming pregnant and about the choices of methods that could meet their needs.

Determinants of unmet need for family planning among HIV-positive women of reproductive age in a treatment and care center Jos, Northcentral Nigeria

Introduction: About half of Nigeria’s population living with HIV are women. Therefore, the use of contraceptives is useful for HIV prevention. The aim of this study was to assess the unmet need for family planning and its associated factors among HIV-positive women of reproductive age in Jos, North-central. Nigeria.Method: This facility-based cross-sectional study was conducted among 335 HIV positive women of reproductive age attending the (APIN) Public Health Initiative Centre of the Jos University Teaching Hospital in Plateau State. A systematic sampling technique was used to select participants. Pre-tested intervieweradministered questionnaires were used for data collection and statistical analysis done using the SPSS version 23 software package. A logistic regression model was used to identify determinants of unmet needs for family planning. Ethical approval was obtained for the study.Results: The mean age of the respondents was 37.44 ± 6.40 years. Unmet need for family planning was 25.4% and the commonest reasons cited include partner opposition and fear of side effects. Marital status, duration of HIV diagnosis, duration on HAART, use of condom during the last sexual act, partner/husband support, and desire for more children were found to be associated with unmet need for family planning. Predictors of unmet need for family planning were marital status (AOR=0.15, P-value-0.030), duration of HIV diagnosis (AOR=5.09, P-value-0.005), duration on HAARTs (AOR=2.64, P-value-0.03) and desire for more children (AOR=0.42, P-value-0.001).Conclusion: HIV-positive women of reproductive age in Jos have high unmet needs for family planning and will benefit from early reproductive health education which includes couple counseling on contraceptive use.

Unmet Need for Family Planning and Spousal Separation in Nepal: A Spatial and Multilevel Analysis.

Objectives: In Nepal, where increasing numbers of married couples live apart due to migration, progress in reducing unmet need for family planning (UMN) is stagnant. This study aims to identify spatial patterns of UMN of married women and spousal separation in Nepal and explore associations between UMN and spousal separation at individual- and district-levels. Methods: We used 2016 Nepal Demographic and Health Surveys data to conduct spatial and multilevel logistic analyses. Results: This study shows evidence of similar geographical patterns in UMN of married women and spousal separation. At the individual level, women living with their spouses had 88% (aOR = 0.12, 95% CI 0.11-0.13) decreased odds of experiencing UMN compared to those living apart from their spouses. While not statistically significant, increasing odds of UMN were observed with higher prevalence of spousal separation at the district level. Conclusion: This study contributes to the existing literature by showing similar geographical patterns of UMN and spousal separation across Nepal and demonstrating both individual and contextual effects of spousal separation on UMN among married women. Theoretical and policy implications are discussed.

Early Child Marriages, Unintended Pregnancies, and its impact on the Health of Young Girls in South Punjab

Background: Unwanted pregnancies are a significant public health issue in South Punjab, Pakistan, largely due to low contraception use and a substantial unmet need for family planning. The high fertility rate and maternal mortality in the region are further compounded by the prevalence of unwanted pregnancies, which also contribute to educational dropouts among girls and affect maternal health adversely. Objective: This study aimed to analyze the impact of education level, household size, wealth index, and type of residency on pregnancy intentions among women in Southern Punjab. Methods: Utilizing a survey design, data from 1,100 women aged 13 to 49, both from slum and non-slum areas across several districts in Southern Punjab, were analysed. Logistic regression and simple percentages were employed to assess the associations between socio-demographic factors and pregnancy intentions. Results: The results indicated that women with higher education levels had a higher proportion of intended pregnancies (220 out of 320, 68.75%) compared to those with no education (20 out of 70, 28.57%). In terms of household size, smaller households (1-2 persons) had a higher incidence of intended pregnancies (60 out of 130, 46.15%) compared to larger households (6 or more persons, 230 out of 490, 46.94%). Regarding the wealth index, the 'rich' category showed a higher likelihood of intended pregnancies (200 out of 255, 78.43%) compared to the 'poor' category (200 out of 530, 37.74%). Additionally, women residing in non-slum areas reported a higher rate of intended pregnancies (340 out of 550, 61.82%) than those in slum areas (350 out of 550, 63.64%). Conclusion: The study underscores the influence of socio-demographic factors on pregnancy intentions. Education level, household size, wealth index, and type of residency are pivotal in determining the likelihood of intended pregnancies. Tailoring family planning initiatives to these factors can significantly improve reproductive health outcomes in Southern Punjab.

Invest in Future: Prioritising Youth Family Planning

Dividend of our much-touted youth bulge will remain a pipedream unless our policy makers realise the need for investing in the health, education, and general wellbeing of the young. Our young population is at a greater risk than adults when using contraceptive services. This risk results from a lack of early education in human reproductive system as well as the cultural taboos surrounding the subject. Affordability, accessibility, and knowledge of contraception are inadequate for young women and couples who would want to space pregnancies. Individuals’ reproductive intentions remain uninformed by critical awareness that swells the number of unintended pregnancies, further aggravated by hazardous unprofessionally administered abortions.&#x0D; ONE-THIRD OF YOUNG MARRIED WOMEN HAVE A DESIRE TO USE CONTRACEPTION&#x0D; There are misconceptions that family planning is for older or married women, despite the fact that many adolescent girls are sexually active. Nearly one third of the young married women, aged 15-19, have a desire to use contraception but are not currently using any contraceptive methods in Pakistan.&#x0D; EARLY INITIATION OF CHILDBEARING IS LINKED TO EDUCATION, OR LACK OF IT&#x0D; Universally, early childbearing before age 18 is associated with many sociodemographic and economic risk factors for young women. For instance, having a child during teenage has adverse consequences for both mother and child’s health. Similarly, women who marry before they are 18 are more likely to drop out of school and are less likely to work.&#x0D; In Pakistan, eight percent of teenage women between 15-19 have begun child bearing and it has remained unchanged since 2012-13 (NIPS 2018). Young women, aged 15-19, with no formal education are at a higher risk of teenage childbearing. Around 15 percent of the teenage ever-married girls with no formal education had already begun childbearing.&#x0D; DISCONNECT BETWEEN KNOWLEDGE AND USE OF CONTRACEPTION AMONG MARRIED WOMEN AGED 15-19&#x0D; Around 93 percent of currently married teenage women (15-19 years) are not using any contraceptive methods. However, when it comes to knowledge about contraceptive use, only 9 percent of the teenage women did not know any family planning method. A vast majority of women (90.5 percent) know about modern contraceptive methods (Figure 3a &amp; 3b).&#x0D; UNINTENDED FERTILITY AND UNMET NEED FOR FAMILY PLANNING AMONG YOUNG WOMEN &#x0D; Despite the universal knowledge of family planning methods, particularly modern methods, the lack of use of contraception results in unintended fertility. According to PDHS 2017-18, around 4 percent of the births among mothers less than 20 years old are mistimed. Unmet need for family planning is higher among women aged 15-19. Nearly 18 percent of the young currently married women have an unmet need for family planning in Pakistan (NIPS 2018).