Unmet Need For Family Research Articles

Unmet need for family planning among eligible couples in urban slums of Prayagraj District, Uttar Pradesh, India

Background: Unmet need for family planning is the major problem in developing countries. The use of family planning methods is better in urban areas as compared to rural areas and it is worse in urban slums. Thus unmet need for family planning is more in urban slums. Aims and objectives: To find out the prevalence of unmet need and to estimate the factors associated with unmet need for Family Planning.Methods: A community based cross sectional study was carried out on eligible couples selected from urban slums of Allahabad district by multistage random sampling and were interviewed by using pre-tested schedule. Data analysis was done by using SPSS version 21.Results: The study revealed that 22.47% (80/356) of eligible couples had unmet need for family planning. The most common reason for unmet need was irregular supply of family planning methods (31.25%), followed by opposition from husband/family members (21.25%), fear of side effects of using any family planning methods (17.25%), lack of knowledge regarding any family planning methods (13.75%). The unmet need for family planning was found to be associated with number of live births, education of female participants and occupation of male participants.Conclusions: The unmet need for family planning is high in slums areas and to improve the condition awareness should be created.

Unmet Need for Family Planning among Women of Reproductive Age Group in a Rural Area of Kanchipuram District, Tamil Nadu

Background: Population of the world is in an increasing trend and India accounts for 17.5% of the global population. As Indian women have different levels of awareness and acceptance of family planning, it may lead to their unmet need for family planning. Objective: To assess the unmet need for family planning and its determinants among women of reproductive age group in a rural area of Kanchipuram District, Tamil Nadu. Materials and Method: A cross sectional study was conducted among 140 women of reproductive age group 15- 45 years in Pulipakkam village of Kanchipuram District over a period of three months (April - June 2019). Data collection was done using a pretested semi- structured questionnaire by personal interview method. The households were selected by simple random sampling. Data analysis was done using SPSS 16V. Association between variables were computed by chi-square test with 5% level of significance. Results: Of the 140 study participants, 132(94.3%) of them were married and 133(95%) of the women were homemakers. The overall prevalence of unmet need for family planning was 16.42%. 69.56% women mentioned fear of side effects as the commonest reason followed by husband’s disapproval(13.04%) and cultural/ religious beliefs (8.69%). Conclusion: The prevalence of unmet need for family planning is high among the women of Pulipakkam village, which may lead to unwanted pregnancies and pose a serious threat to the mother, family and society.

PENANGANAN UNMET NEED KB DI KAMPUNG KB: STUDI KASUS DI DUA KAMPUNG KB DI KABUPATEN CIANJUR

One of the tasks of  Kampung KB (Keluarga Berencana) is to reduce the proportion of unmet need for family planning by utilizing family planning field officers and gaining support from related institutions. This study aims to analyze the process of handling the unmet need for family planning in two Kampung KB in Cianjur Regency. The research used a qualitative approach in forms of individual in-depth interviews and focus group discussions. Data are analyzed descriptively based on case studies. The findings indicate that data recording instruments used daily in the research sites have not been able to identify groups of women with unmet need for family planning. Therefore, the existing services of family planning information have not been based on the needs of the target group. After the formation of Kampung KB, family planning information services and contraception services were more vigorous. While all of the services ease couples of childbearing age with unmet need for family planning to get related information and contraception, monitoring and evaluation activities still cannot be carried out because of the unavailability of officers as well as the target group and post-service data. In addition, there is no clear division of labor between the board Kampung KB and other family planning field officers in each stage of the handling of unmet need for family planning.

Predictors of Unmet Need for Family Planning among HIV Positive Women in Care in Federal Teaching Hospital Gombe, Nigeria

Background: Elimination of mother-to-child transmission (EMTCT) of Human Immunodeficiency Virus (HIV) requires adequate and continuous use of family planning commodities among women of reproductive age. This can be made possible by reducing the proportion of HIV positive women with unmet need for family planning. The study aims to determine the factors associated with having unmet need among women in HIV care.
 Methods: A cross sectional study was conducted using an interviewer administered questionnaire to study 325 women on HIV care. Cluster sampling technique was used to select the study respondents from the clinic.
 Results: Less than half of the respondents (40%) were currently using family planning, 35% had unmet need for family planning with 53.6% having unmet need for spacing while 46.4% having unmet need for limiting. Women with no history of previous use of family planning were fifteen times more likely to have unmet need for family planning than those with history of previous use of family planning (p value <0.001, CI 2.511-15.770). Also women with more than five deliveries were eight times more likely to have unmet need for family planning (p value 0.004, CI 0.001-0.279) while women with 2-5 deliveries are four times likely to have unmet need for family planning (p value 0.035, CI 0.005-0.832).
 Conclusion: A high proportion of women receiving ART care still have unmet need for family planning despite incorporating this service in HIV care. It is therefore important to target high risk groups to reduce the proportion of women with unmet need for family planning which will invariable reduce mother to child transmission of HIV.

Survey on understanding of socio-demographic factors responsible for unmet need of family planning from the selected locality in Agra

Despite the progress that has been recorded in area of family planning, an increasing number of women reporting the need for the contraceptives tells the urgency of the situation. Data collected from both developing and developed world put forth a whooping number as 120 million women who have reported that they are willing to delay the pregnancy but are not using any method of contraception. According to world health organization (WHO) Unmet need for family planning is defined as the percentage of women of reproductive age, either married or in a union, who have an unmet need for family planning. The concept of unmet need has already been defined through many studies, as it is the percentage of the women who wish to delay the childbirth but are not using any form of contraception. Since reporting of the unmet need of family planning depends upon the desire of the women to report such an issue which is still considered a taboo in Indian families. It is for this reason; unmet need is called as an inconsistent and fluid indicator of the reproductive potential of the women. It is postulated that, if the unmet need of the selected population is met through interventions, it could help in reducing the population and also help in bringing down child mortality in addition to maternal mortality and morbidity. This study from the selected location from Agra in Uttar Pradesh has brought in light certain observations among the women who were not using any method of contraception. We have through this study have reported that more than 73 percent of the women wanted to stop childbearing. Women who were using any of the choicest method of contraception, among them 34 percent of the women were reporting desire to become pregnant. 67 percent of the women wanted to delay the pregnancy for one to two years, 48 percent of the women from among the selected population in this category did not want to have any more children. The aim of this study was to establish a co-relation between various factors that exerts their affects on presence of unmet need for family planning and use of family planning methods with a reported decrease in pregnancy among the women who did not want any more children.

Determinants of Unmet Need for Family Planning among Married Women Age 15-49 in Sumatera Utara Province (Analysis of 2017 RPJMN Data)

Unmet need is still a serious problem that has relevance to development in the field of population. TheIndonesian Demographic and Health survey shows the percentage of unmet need for family planningincreased in 2017 by 11%. This analysis aims to find out the important determinants that contributed tounmet need for family planning in Sumatera Utara Province.The analysis used secondary data from 2017 National Mid-Term Development Plan (RPJMN) Data carriedout by National Population and Family Planning Board (BkkbN). The population in this analysis are allmarried women of childbearing age and the samples are married women of childbearing age who did notuse contraception The dependent variable is unmet need and determinant variables are socio-demographiccharacteristics (age, education, occupation, wealth quintile, number of living children and residence),knowledge of contraceptive method and service delivery factors namely exposure to family planninginformation and family planning officers visit.There are 795 women childbearing age who do not use contraception as many as 37.5% have unmet need(9.6% of unmet need for spacing pregnancy, 27.9% of unmet need for limiting pregnancy). Thus, 1 out of6 married women has unmet need. Variables of women’s age, number of children still alive, knowledge,family planning officers visit are important determinants that contributed to unmet need for family planningin Sumatera Utara Province with the most contributed variable is age. Communication, Information andEducation (IEC) efforts need to be improved on married women using mass media and family planningofficers visit. Collaborating with local community and traditional leaders in the paradigm shift about thenumber of children are important part in reducing unmet need for family planning in Sumatera UtaraProvince.

Side effect concerns and their impact on women\u2019s uptake of modern family planning methods in rural Ghana: a mixed methods study

BackgroundDespite availability of modern contraceptive methods and documented unmet need for family planning in Ghana, many women still report forgoing modern contraceptive use due to anticipated side effects. The goal of this study was to examine the use of modern family planning, in particular hormonal methods, in one district in rural Ghana, and to understand the role that side effects play in women’s decisions to start or continue use.MethodsThis exploratory mixed-methods study included 281 surveys and 33 in-depth interviews of women 18–49 years old in the Amansie West District of Ghana between May and July 2018. The survey assessed contraceptive use and potential predictors of use. In-depth interviews examined the context around uptake and continuation of contraceptive use, with a particular focus on the role of perceived and experienced side effects.ResultsThe prevalence of unmet need for modern family planning among sexually active women who wanted to avoid pregnancy (n = 135) was 68.9%. No factors were found to be significantly different in comparing those with a met need and unmet for modern family planning. Qualitative interviews revealed significant concerns about side effects stemming from previous method experiences and/or rumors regarding short-term impacts and perceived long-term consequences of family planning use. Side effects mentioned include menstrual changes (heavier bleeding, amenorrhea or oligomenorrhea), infertility and childbirth complications.ConclusionAs programs have improved women’s ability to access modern family planning, it is paramount to address patient-level barriers to uptake, in particular information about side effects and misconceptions about long-term use. Unintended pregnancies can be reduced through comprehensive counseling about contraceptive options including accurate information about side effects, and the development of new contraceptive technologies that meet women’s needs in low-income countries.

Contraceptive Use in Adolescent Girls and Adult Women in Low- and Middle-Income Countries

Preventing unwanted pregnancy through adequate use of contraceptives among adolescent girls is essential for improving maternal and child health and social well-being. To estimate the levels and trends of contraceptive use in adolescent girls (age 15-19 years) compared with adult women (age 20-34 years). This survey study used data from 261 Demographic and Health Surveys or Multiple Cluster Indicator Surveys conducted in 103 low- and middle-income countries between 2000 and 2017. Modern contraceptive use in 90 countries and unmet need for family planning in 73 countries for adolescent girls and adult women were assessed at country and aggregate levels. Data analyses for this study were conducted between March 2019 and December 2019. Modern contraceptive use and unmet need for family planning, estimated between adolescent girls and adult women for absolute inequality and relative inequality (defined as the ratio in service use between adult women and adolescent girls). Inequalities by wealth and place of residence in each age group were also assessed. A total of 832 673 adolescent girls and 2 156 268 adult women were included in the analysis. Adolescent girls were significantly less likely to use modern contraceptives (31.6% [95% CI, 30.3% to 32.8%] vs 43.5% [95% CI, 42.4% to 44.7%]; absolute inequality, 11.9 percentage points [PPs] [95% CI, 11.7 to 12.1 PPs]; relative inequality, 1.38 PPs [95% CI, 1.36 to 1.40 PPs]) and more likely to have an unmet need for family planning (50.8% [95% CI, 49.0% to 52.5%] vs 36.4% [95% CI, 34.9% to 35.8%]; absolute inequality, -14.4 PPs [95% CI, -15.8 to -15.0 PPs]; relative inequality, 0.72 PPs [95% CI, 0.69 to 0.75 PPs]). Contraceptive use generally improved over time (aggregate-level use of contraceptives increased from 17.8% [95% CI, 16.6% to 19.0%] in 2000-2006 to 27.2% [95% CI, 26.6% to 27.8%] in 2013-2017 for adolescents and from 30.9% [95% CI, 29.8% to 32.0%] in 2000-2006 to 40.3% [95% CI, 39.8% to 40.8%] in 2013-2017 for adult women), but inequalities between adolescents and adult women persisted. Aggregate-level prevalence of unmet need for family planning decreased only among adult women (from 45.8% [95% CI, 44.9% to 46.7%] in 2000-2006 to 38.0% [95% CI, 37.3% to 38.7%] in 2013-2017). For adolescents, the prevalence remained at approximately 52% over time. The inequality between the 2 age groups therefore significantly increased from 7.5 PPs (95% CI, 6.5 to 8.4 PPs) in 2000 to 2006 to 14.0 PPs (95% CI, 13.4 to 14.6 PPs) in 2013 to 2017. An increasing gap between adolescent girls and adult women was found in 18 countries for modern contraceptive use and in 20 countries for unmet need for family planning. In India, for example, both age groups had increased percentage of unmet need for family planning over time, from 16.2% (95% CI, 15.9% to 16.6%) in 2006 to 29.8% (95% CI, 29.6% to 30.1%) in 2015 for adult women and from 23.9% (95% CI, 23.0% to 24.9%) to 64.5% (95% CI, 63.3% to 65.7%) among adolescents. Thus, inequality increased from 7.7 PPs (95% CI, 7.2 to 8.2 PPs) in 2006 to 34.7 PPs (95% CI, 34.2 to 35.1 PPs) in 2015. Despite a growing focus on contraception in the past decade with initiatives such as Family Planning 2020, adolescent girls continue to lag behind adult women in contraceptive use. There is a pressing need to develop age-appropriate strategies for increasing access and maintaining contraceptive use in sexually active adolescent girls.

Spatial Distribution 0f Unmet Need for Family Planning among Married Women Aged Between 15-49 Years: Evidence from Ethiopia Demographic and Health Survey 2016

Introduction: Worldwide, 12% of married women with an age range of 15-49 years have an unmet need for contraception. In Ethiopia unmet need for family planning was high when compared to a developed country (24.5% vs 10% respectively). This high unmet need for family planning show gaps between women reproductive desire to avoid pregnancy and contraceptive behavior. This study shows spatial distribution of this unmet need for family planning among zone of Ethiopia. Objective: The aim of the study was to assess the spatial distribution of unmet need for family planning among married women aged b/w 15 to 49 year in Ethiopia. Methods: Cross-sectional study design was applied using Ethiopia demographic and health survey 2016 data. The sample size was 10,223 married women aged between 15-49 years. Spatial analysis was done using spatial autocorrelation Moran’s I and spatial scan statics was applied to local significant clusters based on Bernoulli model. Results: In Ethiopia, prevalence of unmet need for family planning was 22.3% (95% CI: 21.5%, 23.1%). The highest unmet need for family planning was spatially clustered in Jimma, Arsi, West Arsi, Southwest Shewa, Borena, Guji, West and East Hararge, Agnewak whereas the lowest in Fik, Gode, Afder, Liben Argoba, Afoder, and Sheka zones. Spatial scan statistics identified primary clusters (LLR=55.74, P<0.001) in Arsi, West Arsi, Bale, West Harrarge zone and secondary clusters (LLR=20.26, P<0.001) in Jimma, Southwest Shewa, Gurage, Silti, Hadiya, Yem and Wolayita zone.Conclusions: The study finding shows that insured patients perceived with a higher level of quality of care and satisfaction score. However, non-insured patients received high proportion score on objective quality of care measurements. Therefore, to improve patient experiences at health centers and achieve financial risk protection through CBHI, program managers and health care providers should ensure quality of services to the standards at the health facility to insured and noninsured community members. Conclusions: The prevalence of unmet need in Ethiopia is high. Statistical significant primary and secondary clusters were detected. Unmet need for family planning is important to prioritize family planning strategy, which enables to know about the distribution of unmet need across zone of the nation Therefore, exerting much effort on this area is supreme important as it has significant public health contributions.

Determinants of Modern Contraceptive Use and Unmet Need for Family Planning among the Urban Poor

This study aims to examine modern contraceptive use and unmet need of family planning of urban poor populations in Rajasthan and Uttar Pradesh as a part of IPE Global Project PAHAL (Partnerships for Affordable Healthcare Access and Longevity). Findings from the study reflect that the unmet need of family planning among the married women in the selected states was more than 15%. Women having three children reported the highest use of modern contraceptive methods and the lowest was found among the women having no child. Use of modern contraception was low among the women who were the head of the households. Working women, women belonging to richest wealth quintile, women whose husbands reported to be working and women from male headed households were less likely to have unmet need for family planning. The findings of the present study indicate a remarkably low prevalence of modern contraceptive use indicating considerable high unmet need. This can be a concern and special emphasis of the policy makers should be on this since it is well researched that modern contraceptive use and addressing unmet need are of overriding importance in reducing pregnancy related morbidity, preventing unintended pregnancies that lead to abortion and will gradually improve reproductive well-being among women.

HUBUNGAN TINGKAT PENDIDIKAN, TEMPAT TINGGAL DAN INFORMASIPETUGAS LAPANGAN KELUARGA BERENCANA (PLKB) TERHADAP UNMET NEED KB PADA WANITA KAWIN

Family Planning Program has some indicators of success; one of the indicators is unmet needs of family planning services. The success of the unmet need indicator services is the decrease of unmet need to 9.9% in 2019. In 2012, the number of unmet need for family planning amounted to 11.4%. This study aims to identify whether there is a correlation of the education level, residence, and information of family planning field officers with unmet needs for family planning in East Java. This research was conducted with a cross-sectional design with the data from the 2012 Indonesian Demographic and Health Survey. There is a correlation of the education level (p=0.000), residence (p=0.010), and information of family planning field officer (p = 0.048) with the unmet needs for family planning. The research cocludes that education level, residence, and information from health centre affect the unmet need for family planning.

HUBUNGAN TINGKAT PENDIDIKAN, TEMPAT TINGGAL DAN INFORMASIPETUGAS LAPANGAN KELUARGA BERENCANA (PLKB) TERHADAP UNMET NEED KB PADA WANITA KAWIN

Family Planning Program has some indicators of success; one of the indicators is unmet needs of family planning services. The success of the unmet need indicator services is the decrease of unmet need to 9.9% in 2019. In 2012, the number of unmet need for family planning amounted to 11.4%. This study aims to identify whether there is a correlation of the education level, residence, and information of family planning field officers with unmet needs for family planning in East Java. This research was conducted with a cross-sectional design with the data from the 2012 Indonesian Demographic and Health Survey. There is a correlation of the education level (p=0.000), residence (p=0.010), and information of family planning field officer (p = 0.048) with the unmet needs for family planning. The research cocludes that education level, residence, and information from health centre affect the unmet need for family planning.

Unmet need for family planning and associated factors among currently married reproductive age women in Tiro Afeta District, South West Ethiopia, 2017: cross-sectional study

BackgroundUnmet need for family planning in Oromia region was very high (28.9%) compared to other regions in Ethiopia. To address problems associated with unmet need for family planning locally available evidences are essential, however, there were no clear evidences on unmet need for family planning in Tiro Afeta district. This study aims to assess the magnitude and associated factors of unmet need for family planning among currently married women in Tiro Afeta district, South West Ethiopia, 2017.MethodsCommunity based cross sectional study was conducted in April, 2017. A total of 348 currently married women of reproductive age were enrolled from eight villages selected by simple random sampling and using proportional to size allocation. Data were entered using EpiData 3.1 and analyzed by SPSS version 22. Adjusted odds ratios at 95% confidence interval with p-value of < 0.05 were considered as significant variables.ResultsUnmet need for family planning among currently married women in Tiro Afeta was 26.1%. Factors significantly associated with unmet need for family planning were: never use of family planning before survey (AOR: 5.09, 95% CI: 2.73–9.50); multiparity (AOR: 3.02, 95% CI: 1.56–5.85); perceived husband’s attitude as disapproval (AOR: 2.75, 95% CI: 1.43–5.26); lack of counseling from health workers (AOR: 2.07, 95% CI: 1.11–3.85); and unavailability of Radio and/or Television in the house (AOR: 2.05, 95% CI: 1.15–3.66).ConclusionUnmet need for family planning in Tiro Afeta was higher than national average but lower than Oromia region. Never use of family planning, women’s parity, husband’s attitude towards contraceptives, women counseling and unavailability of Radio and/or Television in the respondent’s home were significantly associated factors with unmet need for family planning. Therefore, the service providers and the district health office should strengthen counseling and partner involvement to reduce unmet need for family planning.

The roles of intra-household gendered dominance in unmet need for family planning across Myanmar

Background: Unmet need for family planning in Myanmar (estimated 15.8% by the UN in 2017) is relatively high compared to other South East Asia countries. Moreover, Social Institutions and Gender Index in Myanmar is very high and cultural norms promote childbearing. Thus, this paper was conducted to examine role of intra-household gendered dominance (IHGD) in unmet need for family planning across Myanmar to set more effective intervention for family planning. Methods: The study utilized secondary data from 2015–2016 MDHS. Total 7,652 married women in reproductive age (MWRA) were included and 16% of them had unmet need for family planning. Binary Logistic Regression Analysis was conducted to examine the association of each explanatory variables with outcomes variables. Results: IHGD factors which are decision on women’s health and women’s attitude towards wife beating are significantly associated with unmet need. Moreover, socio-economic factors which are place of residence and women’s education level have significant impact on unmet need as well. Conclusion: Based on the findings of this study, the government of Myanmar should address dominance of social and cultural gender norms by conducting gender equality awareness campaign and family planning program should target to reach rural and uneducated women.

Spatio-temporal variations in unmet need for family planning in Ghana: 2003\u20132014

Ghana has long prioritized family planning as a key strategy for improving health and socioeconomic development. However, despite the heavy investments in the sector over the last decade, the family planning program has not successfully improved the country’s family planning indicators. In this study, we describe the spatial and temporal patterns of unmet need for family planning from 2003 to 2014 and mainly estimate the socioeconomic factors affecting it. Using data from the 2003, 2008, and 2014 Ghana Demographic and Health Surveys, we map the regional and temporal trends in unmet need for family planning and used Bayesian multilevel logistic regression models to estimate the effects of individual-level socioeconomic characteristics on unmet need for family planning. The results show that there are considerable regional disparities in unmet need for family planning for the study period. These disparities show diverse trends among the ten regions in the country over the study period. The patterns of unmet need for family planning are considerably affected by socioeconomic factors such as educational attainment, household wealth, marital, and work status, as well as age, ethnicity, parity, and time (year). Both socioeconomic and demographic factors play a significant role in the patterns of unmet need for family planning in Ghana. There is the need to formulate consistently effective family planning policies focusing mainly on the higher risk groups of women in the country.

Unmet Need of Family Planning Among Married Women of Reproductive Age in Rural Areas of Manikganj District

Aims: Introduction: Bangladesh has impressive gains in indicators related to population and family planning. Therefore, the unmet need for family planning should be addressed with utmost importance.&#x0D; Materials and Methods: A descriptive type of cross sectional study was conducted at four villages of Saturia Upazilla of Manikganj district to find out unmet need of family planning among married women of reproductive age including the status of contraceptive use and obstacles toward using family planning methods. The duration of study was from November 2017 to March 2018. The sample size was 480 in number.&#x0D; Results: In the study, 87.5% respondents were Muslims. Regarding level of education 18.75% of the respondents was illiterate, 22.19% of the respondents completed their primary education and 31.35% passed the secondary school certificate Examination. Most of the respondents (92.92%) were housewives. Out of 480 families, 51% belongs to nuclear family. 23.13% of the respondents had income below 10,000 Tk. and about 27.50% had an income more than 20,000 Tk. Among 480 respondents, 42.06% had 2 living children and about 33.78% had a single child. 89.17% of the respondents knew about contraceptive method. OCP was the most preferred method among 57.62% respondents. 61% respondents were using contraceptive method. The reason for not using any contraceptive method were fear of side effects (28.03%), eager to conceive (13.63%), and non-co-operative attitude of the husband (7.58%). In this study 58.13% respondents had the knowledge about permanent method of contraception.&#x0D; Conclusion: Family planning is more of a health necessity than an option. Though family planning program has remarkable success over the past decade, but still there is unmet need.&#x0D; Anwer Khan Modern Medical College Journal Vol. 10, No. 1: Jan 2019, P 23-27

Unmet Need for Family Planning among Urban and Rural Married Women in Yangon Region, Myanmar-a Cross-Sectional Study.

Despite increasing contraceptive use and prevalence, many women who want to avoid or delay pregnancy are not using contraceptives. This results in unintended pregnancies, which increases the risk of unsafe abortions. This study aimed to explore the extent of the unmet need for family planning (FP) among urban and rural married women in Myanmar and their demand for and satisfaction with FP. A cross-sectional survey using adapted Demographic and Health surveys questions was conducted in south and north Yangon from September 2016 to November 2016. A total of 1100 currently married women of 18–49 years participated. The contraceptive prevalence was 67.2% in total, 63% urban, and 70% rural. About 19.4% (95% CI: 16.7%–22.4%) of the studied women had an unmet need for FP, significantly higher in urban than rural women (22.6% versus 16.6%). Rural women also showed significant lesser odds (adjusted OR: 0.63; 95% CI: 0.461–0.849) of unmet need than the urban counterparts. About 86% of the women had demand for contraception and 77% of them satisfied their demand. The study population revealed a fairly good contraceptive coverage; however, a considerable proportion of women had an unmet need for FP, especially the urban women. The demand for contraception is increasing, and contraceptive services need to expand coverage to marginalized groups in order to reduce the risk of unsafe abortions.

Socio-demographic determinants of unmet need for family planning among married women in Pakistan

BackgroundFamily planning is considered as an effective tool to control population and to bring improvement in maternal and child health. The Government of Pakistan has been continuously struggling to improve the availability of family planning services. However, like many other developing countries of the world, unmet need for family planning still exists in the country. According to Pakistan Demographic and Health Survey 2012–13, the prevalence of unmet need for family planning is 21% in the country. The objective of this study is to investigate the determinants of unmet need for family planning among married women in Pakistan.MethodsSecondary data of Pakistan Demographic and Health Survey 2012–13 has been used to analyze the determinants of unmet need for family planning through Binary and Multinomial Logistic regressions.ResultsOutcomes of the study show that the likelihood of unmet need for family planning among married women in Pakistan goes on to decrease with an increase in their age and education. The likelihood of unmet need for family planning decreases with the increase in wealth status of women’s household, number of living children and husband’s education. Similarly, the women residing in rural areas are more likely to have unmet need for family planning as compared with women living in urban areas. The women who lack mass media exposure, who are not employed and who have fear of side effects for using contraceptives are more likely to have unmet need for family planning.ConclusionsFear of side effects for using contraceptives has been identified as the major cause of unmet need for family planning in Pakistan. The Government of Pakistan has been putting a lot of efforts to convince people about the usefulness of population control programs. A huge media campaign has been launched to persuade people about the benefits of birth control. But the efforts of the government do not seem to be very much effective to clear the perception of people about side effects of contraceptive use. Hence, fear of side effects still remains one of the most important reason behind unmet need for family planning.

Predictors of unmet need for family planning among all women of reproductive age in Ethiopia

IntroductionContraception is a good indicator of the extent to which couples have access to reproductive health services. Survey data on unmet need can provide overall direction by helping to pinpoint the obstacles in society and weaknesses in services that need to be overcome. This study is significant as it provides strong policy recommendations for the design and implementation of economic and non-economic interventions into family planning utilization by all eligible women.ObjectiveTo Identify Predictors of Unmet Need of Family Planning in Ethiopia.MethodsA national level survey by performance monitoring and accountability (PMA 2020), which conducted between March and April 2016 among 7552 all women of 15–49 years were utilized. Stata® version13 were used for survey data for analysis using weighted frequency to give equal chances for enumeration areas represented. Binary and multivariate logistic regression employed. P-value < 0.05 were used to declare independent predictors of unmet need for family planning in Ethiopia.Result7494 women responded to the interview giving response rate of 99.2%. Overall unmet need for family planning was 1, 214 (16.2%) of which 772 (10.3%) was for spacing and 450 (6.0%) for limiting. Overall unmet need was 540 (7.2%) in urban and 1431(19.1%) in rural areas of the Ethiopia. Statistically significant predictors with this were found to be women’s age 0.73 AOR [95% C.I 0.6–0.9], being lower wealth 0.22 AOR [95% C.I 0.07–0.6] as compared to lowest, parity 2.1 AOR [95% C.I 1.4–2.9], number of children at first use of contraceptive 1.1 AOR [95% C.I 1.03–1.19], having final say with provider 0.03 AOR [95% C.I 0.003–0.23] as compared with own decision making.ConclusionUnmet need of family planning in Ethiopia was generally high especially with significant disparity in residence and regional states. Socio-demographic factors (age and wealth status) and obstetric factor (parity) were found to be significant factor. Informed decision making for provision of contraceptives and enhancing women’s awareness starting their childbearing life with family planning were recommended.

Integrating postpartum contraceptive counseling and IUD insertion services into maternity care in Nepal: results from stepped-wedge randomized controlled trial

BackgroundIn Nepal, 54% of women have an unmet need for family planning within the 2 years following a birth. Provision of a long-acting and reversible contraceptive method at the time of birth in health facilities could improve access to postpartum family planning for women who want to space or limit their births. This paper examines the impact of an intervention that introduced postpartum contraceptive counseling in antenatal care and immediate postpartum intra-uterine device (PPIUD) insertion services following institutional delivery, with the intent to eventually integrate PPIUD counseling and insertion services as part of routine maternity care in Nepal.MethodsThis study took place in six large tertiary hospitals. All women who gave birth in these hospitals in the 18-month period between September 2015 and March 2017 were asked to participate. A total of 75,587 women (99.6% consent rate) gave consent to be interviewed while in postnatal ward after delivery and before discharge from hospital. We use a stepped-wedge cluster randomized design with randomization of the intervention timing at the hospital level. The baseline data collection began prior to the intervention in all hospitals and the intervention was introduced into the hospitals in two steps, with first group of three hospitals implementing the intervention 3 months after the baseline had begun, and second group of three hospitals implementing the intervention 9 months after the baseline had begun. We estimate the overall effect using a linear regression with a wild bootstrap to estimate valid standard errors given the cluster randomized design. We also estimate the effect of being counseled on PPIUD uptake.ResultsOur Intent-to-Treat analysis shows that being exposed to the intervention increased PPIUD counseling among women by 25 percentage points (pp) [95% CI: 14–40 pp], and PPIUD uptake by four percentage points [95% CI: 3–6 pp]. Our adherence-adjusted estimate shows that, on average, being counseled due to the intervention increased PPIUD uptake by about 17 percentage points [95% CI: 14–40 pp].ConclusionsThe intervention increased PPIUD counseling rates and PPIUD uptake among women in the six study hospitals. If counseling had covered all women in the sample, PPIUD uptake would have been higher. Our results suggest that providing high quality counseling and insertion services generates higher demand for PPIUD services and could reduce unmet need.Trial registrationTrial registered on March 11, 2016 with ClinicalTrials.gov, NCT02718222.