FPwatch: Facility-based Survey Data for Family Planning Market Analysis in Five FP2020-focus Countries.
Ontology highlight
ABSTRACT:
SUBMITTER: Babazadeh S
PROVIDER: S-EPMC6589922 | biostudies-literature | 2018 Dec
REPOSITORIES: biostudies-literature
Publications
FPwatch: Facility-based Survey Data for Family Planning Market Analysis in Five FP2020-focus Countries.
Babazadeh Saleh S Thanel Katherine K Garfinkel Danielle D Riley Christina C Bertrand Jane J Shaw Bryan B
Studies in family planning 20181119 4
This article describes datasets for the FPwatch Project, a comprehensive facility-based family planning survey conducted by Population Services International in five countries in Africa and Asia from 2015 to 2017. Contents cover research design and background, methodology, sample selection, data collection, an overview of FPwatch indicators, and quality assurance measures taken. These datasets from the Democratic Republic of Congo, Ethiopia, India, Myanmar, and Nigeria complement other facility- ...[more]
Similar Datasets
Project description:BackgroundFamily planning (FP) can lengthen birth intervals and potentially reduce the risk of foetal death, low birthweight, prematurity, and being small for gestational age. Effective FP is most easily achieved through access to and acceptability of modern contraceptive methods (MCMs). This study aimed to identify mechanisms of acceptability and the contexts in which they are triggered and to generate theories to improve the selection and implementation of effective interventions by studying an intervention integrating FP with childhood immunisation services.MethodsQualitative interpretative synthesis of findings from realist evaluations of FP interventions in five African countries was guided by an analytical framework. Empirical mechanisms of acceptability were identified from semi-structured interviews and focus group discussions with key stakeholders (N = 253). The context in which these mechanisms were triggered was also defined. Empirical mechanisms of acceptability were matched to constructs of a theoretical framework of acceptability. Context-acceptability theories (CATs) were developed, which summarised constructs of acceptability triggered for specific actors in specified contexts. Examples of interventions that may be used to trigger acceptability for these actors were described.ResultsSeven CATs were developed for contexts with strong beliefs in religious values and with powerful religious leaders, a traditional desire for large families, stigmatisation of MCM use, male partners who are non-accepting of FP, and rumours or experiences of MCM side effects. Acceptability mechanisms included alignment with values and beliefs without requiring compromise, actors' certainty about their ability to avoid harm and make the intervention work, and understanding the intervention and how it works. Additionally, acceptability by one group of actors was found to alter the context, triggering acceptability mechanisms amongst others.ConclusionsThis study demonstrated the value of embedding realist approaches within implementation research. CATs are transferable theories that answer the question: given the context, what construct of acceptability does an intervention need to trigger, or more simply, what intervention do we need to apply here to achieve our outcomes? CATs facilitate transfer of interventions across geographies within defined contexts.
| S-EPMC7805098 | biostudies-literature
Project description:BackgroundDuring the post-partum period, most women wish to delay or prevent future pregnancies. Despite this, the unmet need for family planning up to a year after delivery is higher than at any other time. This study aims to assess fertility intention, contraceptive usage and unmet need for family planning amongst women who are six weeks postpartum, as well as to identify those at greatest risk of having an unmet need for family planning during this period.MethodsUsing the NICHD Global Network for Women's and Children's Health Research's multi-site, prospective, ongoing, active surveillance system to track pregnancies and births in 100 rural geographic clusters in 5 countries (India, Pakistan, Zambia, Kenya and Guatemala), we assessed fertility intention and contraceptive usage at day 42 post-partum.ResultsWe gathered data on 36,687 women in the post-partum period. Less than 5% of these women wished to have another pregnancy within the year. Despite this, rates of modern contraceptive usage varied widely and unmet need ranged from 25% to 96%. Even amongst users of modern contraceptives, the uptake of the most effective long-acting reversible contraceptives (intrauterine devices) was low. Women of age less than 20 years, parity of two or less, limited education and those who deliver at home were at highest risk for having unmet need.ConclusionsSix weeks postpartum, almost all women wish to delay or prevent a future pregnancy. Even in sites where early contraceptive adoption is common, there is substantial unmet need for family planning. This is consistently highest amongst women below the age of 20 years. Interventions aimed at increasing the adoption of effective contraceptive methods are urgently needed in the majority of sites in order to reduce unmet need and to improve both maternal and infant outcomes, especially amongst young women.Study registrationClinicaltrials.gov (ID# NCT01073475).
| S-EPMC4464604 | biostudies-literature
Project description:IntroductionThis study aimed to build the emergent body of evidence of family planning and maternal and child health (FPMCH) service integration benefits that can be useful in reaching the target of sustainable development goals (SDGs).MethodsWe utilized data from the 2015 Nepal Health Facility Survey and used the World Health Organization service readiness manual for defining the service readiness indicator score of all services related to FPMCH integration. Composite readiness index for all services including family planning, antenatal care service, delivery and newborn service readiness index, and curative child care service readiness index was considered for the integration of all services (i.e. readiness for FPMCH). Multivariable linear regression models were fitted to examine the association between covariates and readiness score to provide integrated services.ResultsThe mean readiness score of integrated services in health facilities in Nepal was 52.1%. The services in private hospitals and peripheral health facilities had significantly lower readiness scores of integrated services compared to government hospitals. Compared to Province 3(Province 3 holds the national capital), Province 2 had significantly lower and Province 7 had significantly higher readiness scores. There is a marginally significantly higher readiness score of integrated services in the facilities where management meetings are held compared to where management meetings are never conducted. Interestingly, health facilities where external supervision occurred in the last 4 months had better service readiness of integrated services compared with those facilities with no external supervision. Similarly, the facilities that performed the routine quality assurance activities and facilities having a system for collecting opinion and being reviewed had a higher integrated services readiness score than their counterparts.ConclusionThis study found a scope of improvement in management practices in the health sector of Nepal especially for supportive supervision, quality assurance (QA) activities, monthly management meetings, and a system of collecting and reviewing opinions from the clients. Strengthening management practices especially, promoting supportive supervision and adhering to QA protocols may improve HF readiness to implement integrated FPMCH in Nepal. Being low readiness, there is an urgent need for policy reform to improve the integrated service readiness, particularly in Province 2.
| S-EPMC8880709 | biostudies-literature
Project description:In this systematic review, we gather evidence on community financing schemes and insurance programs for family planning in developing countries, and we assess the impact of these programs on primary outcomes related to contraceptive use. To identify and evaluate the research findings, we adopt a four-stage review process that employs a weight-of-evidence and risk-of-bias analytic approach. Out of 19,138 references that were identified, only four studies were included in our final analysis, and only one study was determined to be of high quality. In the four studies, the evidence on the impact of community-based financing on family planning and fertility outcomes is inconclusive. These limited and mixed findings suggest that either: 1) more high-quality evidence on community-based financing for family planning is needed before any conclusions can be made; or 2) community-based financing for family planning may, in fact, have little or no effect on family planning outcomes.
| S-EPMC6084349 | biostudies-literature
Project description:Background: With growing populations of young people, low and middle-income countries have renewed focus on reaching both unmarried and married youth with family planning (FP) services. Young people themselves bring an important perspective to guide future programmatic directions. Methods: In October 2018, 207 youth leaders in FP from around the world completed an online survey prior to their participation at the International Conference on Family Planning (ICFP). These youth leaders provided their perspectives on the most important influencers for youth FP use, how easy or hard it is for youth to obtain FP, preferred sources of FP methods for youth, and perceptions of commonly used terms in FP programming. We examined differences in perceptions of unmarried and married youth's access to and use of FP using bivariate analyses. Results: Respondents reported that peers/friends were the most important influencer on use of FP among unmarried youth (80.2%), while spouse/partner was the most important for married youth (80.4%). Oral contraceptive pills, injectable contraception, and contraceptive implants were perceived as significantly harder for unmarried youth to access. Privacy, confidentiality, and anonymity were all important factors for the locations to access FP for unmarried youth, while married youth were more influenced by cost. None of the commonly used terms for FP were perceived positively by a majority of respondents, with the exception of 'birth spacing' by African respondents (51.0%). Conclusions: These findings indicate that the preferences and needs of unmarried youth are different than married youth, but that all young people face barriers accessing FP. Unmarried youth seeking family planning are more influenced by peers and friends and continue to face difficulty accessing methods compared to married youth. These findings indicate the importance of including youth perspectives in development of youth-focused family planning programs.
| S-EPMC6978846 | biostudies-literature
Project description:BackgroundThe World Health Organization (WHO) launched an initiative to plan for the sustainability of integrated community case management (iCCM) programmes supported by the Rapid Access Expansion (RAcE) Programme in five African countries in 2016. WHO contracted experts to facilitate sustainability planning among Ministries of Health, WHO, nongovernmental organisation grantees, and other stakeholders.MethodsWe designed an iterative and unique process for each RAcE project area which involved creating a sustainability framework to guide planning; convening meetings to identify and prioritise elements of the framework; forming technical working groups to build country ownership; and, ultimately, creating roadmaps to guide efforts to fully transfer ownership of the iCCM programmes to host countries. For this analysis, we compared priorities identified in roadmaps across RAcE project sites, examined progress against roadmaps via transition plans, and produced recommendations for short-term actions based on roadmap priorities that were unaddressed or needed further attention.ResultsThis article describes the sustainability planning process, roadmap priorities, progress against roadmaps, and recommendations made for each project area. We found a few patterns among the prioritised roadmap elements. Overall, every project area identified priorities related to policy and coordination of external stakeholders including funders; supply chain management; service delivery and referral system; and communication and social mobilisation, indicating that these factors have persisted despite iCCM programme maturity, and are also of concern to new programmes. We also found that a facilitated process to identify and document programme priorities in roadmaps, along with deliberately planning for transition from an external implementer to a national system could support the sustainability of iCCM programmes by facilitating teams of stakeholders to accomplish explicit tasks related to transitioning the programme.ConclusionsCertain common elements are of concern for sustaining iCCM programmes across countries, among them political leadership, supply chain management, data processes, human resources, and community engagement. Adapting and using a sustainability planning approach created an inclusive and comprehensive dialogue about systemic factors that influence the sustainability of iCCM services and facilitated changes to health systems in each country.
| S-EPMC6596361 | biostudies-literature
Project description:Internal migration's effect on family planning behavior depends upon migration circumstances. While many studies describe instability and displacement's effect on family planning access, fewer studies consider the positive association between internal migration and family planning behavior. Using Performance Monitoring for Action (PMA) survey data, we examine the relationship between internal migration and unmet need for family planning in Ethiopia from 2017-2018. We describe determinants of family planning behavior by migrant status and model migration's effect on unmet need for family planning using multilevel logistic regression. Internal migrants studied tend to be more educated and wealthier and have less unmet need than non-migrants, likely due to different fertility preferences and human capital. This contributes to existing research by illustrating how rural-urban migration in Ethiopia relates to family planning behaviour. Findings will be of interest to social scientists and policymakers evaluating family planning resource allocation to reduce unmet need in African contexts.
| S-EPMC8248275 | biostudies-literature
Project description:BackgroundMany studies have shown that work stressors have a negative impact on health. It is therefore important to gain an understanding of how work stressors can be reduced. Recent studies have shown that employees in countries with high investments into labour market policies less often report exposure to work stressors. Although these studies are indicative of an influence of the political level on work stressors, they are based on cross-sectional cross-country analyses where causal assumptions are problematic. The aim of this study is to extend the existing evidence by longitudinally testing whether changes in labour market policies are related to changes in work stressors.MethodsWe used comparative longitudinal survey data from the European Working Conditions Survey (27 countries; for the years 2005, 2010, 2015). The measurement of work stressors is based on two established work stress models: effort-reward imbalance (ERI) and job demand-control (job strain). To measure labour market policies, we used information on active (ALMP) and passive labour market policies (PLMP). After excluding persons with missing data, 64,659 participants were eligible for the ERI and 67,114 for job strain analyses. Estimation results are provided by three-way multilevel models (individuals, country-years, country), which allow us to estimate longitudinal and cross-country macro-effects.ResultsAn increase in ALMP leads to a decrease of ERI. The analyses for the subcomponents 'effort' and 'reward' showed that mainly the 'reward' component is positively associated with ALMP. The association between ALMP and 'reward' shows that an increase in ALMP investments is related to an increase in rewards. Yet, no significant longitudinal associations between ALMP and job strain, and between PLMP and the work stressors, were observed.ConclusionsThe study extends the current knowledge with longitudinal information by showing that an increase in ALMP is associated with an increase in rewards and a decrease of ERI. These longitudinal analyses may support a causal interpretation. The findings of this study have important policy implications. Our main result suggests that investments into ALMP can lead to better working conditions.
| S-EPMC7488105 | biostudies-literature
Project description:ObjectivesIncreasing access to skilled birth attendance, usually via childbirth in health facilities, is a key intervention to reduce maternal and perinatal mortality and morbidity. Yet, in some countries of sub-Saharan Africa, the uptake is <50%. Age and parity are determinants of facility-based delivery, but are strongly correlated in high fertility settings. This analysis assessed the independent effect of age on facility-based delivery by restricting to first-order births. It was hypothesised that older first-time mothers in this setting might have lower uptake of facility-based deliveries than women in the most common age groups for first birth.SettingThe most recent Demographic and Health Surveys from 34 sub-Saharan African countries were used to assess women's delivery locations.Participants72 772 women having their first birth in the 5 years preceding the surveys were included in the analysis.Primary and secondary outcome measuresProportions and 95% CIs of facility-based deliveries were estimated overall and by country. Multivariable logistic regression was used to calculate the odds of facility-based delivery for different maternal age groups (15-19, 20-24 and ≥25 years) for a pooled sample of all countries.Results59.9% of women had a facility-based delivery for their first birth (95% CI 58.6 to 61.2), ranging from 19.4% in Chad to 96.6% in Rwanda. Compared with women aged 15-19 years, the adjusted odds of having a facility-based delivery for those aged 20-24 was 1.4 (95% CI 1.3 to 1.5, p<0.001) and for those aged ≥25, 1.9 (95% CI 1.6 to 2.2, p<0.001).ConclusionsOlder age at first birth was independently associated with significantly higher odds of facility-based delivery. This went against the hypothesis. Further mixed-method research is needed to explore how increased age improves uptake of facility-based delivery. Promoting facility-based delivery, while ensuring quality of care, should be prioritised to improve birth outcomes in sub-Saharan Africa.
| S-EPMC5905782 | biostudies-literature
Project description:BackgroundIn Mozambique, both the government and partners have undertaken efforts over the last decade to improve FP (family planning) services, especially through training health care providers and promoting the uptake of LARCs (Long Acting Reversible Contraceptives). Despite this, uptake of FP methods has not increased significantly. This study aims to examine women's knowledge on LARCs, including their main sources of information, and the quality of care of FP services in rural areas.MethodsWe conducted a repeated cross-sectional study, interviewing 417 women leaving FP consultations in 15 health facilities in Maputo Province, Mozambique. The main quality outputs measured were: 1)discussed, preferred and received contraceptive methods, 2)information received on usage and side-effects, 3)client-provider interaction, 4)being informed about the need for a follow-up visit 5)health examinations conducted and travel time to the facility. In addition, knowledge on LARCs was measured among the clients as well as sources of information regarding FP methods. Taking into account the design effect of the study, Chi-square statistics were used to detect differences between groups and linear regression analyses to identify associations between sources of information and higher knowledge.ResultsWe found that IUDs (intrauterine devices) and implants were discussed in 23 and 33% of the consultations respectively, but only administered in a very few cases(< 1%). Half of the women were counselled on side-effects of contraceptives; this did not differ between first time clients and follow-up clients. Almost all women(98%) were satisfied with the received service and 83% of the women found the waiting time acceptable. Health examinations were performed on 18% of the women. Overall, women's knowledge about LARCs was poor and misconceptions are still common. Women who had received FP information through outreach activities had better knowledge than those counselled at a facility.ConclusionsOur study highlights that only a minority of the women received information regarding LARCs during the consultation and that usage is almost non-existent. Counseling about all types of contraceptives during the consultation is sub-optimal, resulting in poorly informed clients. Multifaceted long-term interventions, focusing on both users and providers, are needed to improve uptake of contraceptives (including LARCs) in rural areas.
| S-EPMC6291923 | biostudies-literature