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Factors associated with long-acting family planning service utilization in Ethiopia: a systematic review and meta-analysis.

ABSTRACT: Background:Even though the modern contraceptive use was improved in Ethiopia, the utilization of long-acting family planning services is still low because of numerous factors. The aim of this systematic review was to synthesize logical evidence about factors associated with long acting family planning service utilization in Ethiopia. Methods:The participants of the study were married women of reproductive age in Ethiopia. This search included all published and unpublished observational studies written in the English language conducted before April 30, 2018, in Ethiopia. Electronic and non-electronic sources were used. PubMed, MEDLINE (EBSCO), CINHAL (EBSCO), Embase (EBSCO), POPLINE and the search engines like Google, Google Scholar Mednar and world cat log were used. The overall selected search results were 15 studies. Each study was evaluated using the Joanna Briggs Institute Quality Assessment Tool for Observational Studies. Data synthesis and statistical analysis were conducted using ReviewManagerVersion5.3.5. Results:Women's inadequate knowledge level [OR, 0.29; 95% CI: 0.10, 0.83, P?=?0.02], women's age between 15 and 34 [OR, 0.82; 95% CI: 0.53, 0.93, P?=?0.01], not having electronic media [OR, 0.65; 95% CI: 0.53, 0.79, P?

SUBMITTER: Dasa TT

PROVIDER: S-EPMC6771115 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Factors associated with long-acting family planning service utilization in Ethiopia: a systematic review and meta-analysis.

Dasa Tamirat Tesfaye TT Kassie Teshager Worku TW Roba Aklilu Abrham AA Wakwoya Elias Bekele EB Kelel Henna Umer HU

Contraception and reproductive medicine 20191001

<h4>Background</h4>Even though the modern contraceptive use was improved in Ethiopia, the utilization of long-acting family planning services is still low because of numerous factors. The aim of this systematic review was to synthesize logical evidence about factors associated with long acting family planning service utilization in Ethiopia.<h4>Methods</h4>The participants of the study were married women of reproductive age in Ethiopia. This search included all published and unpublished observat ...[more]

PMID: 31583113

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Project description:BackgroundPersons with disabilities have a right to make their own choices about their bodies, health, and lives, especially regarding their sexual and reproductive health. But they may experience more challenges than women without disabilities in having their reproductive health needs met. So there is an urgent need to scale up disability inclusion in all levels of the health system including family planning. Therefore, the objective of this study was to estimate the pooled prevalence of Family Planning Utilization and Associated Factors among Women with Disabilities in Ethiopia.MethodologyStudies were gathered from Pub Med/MEDLINE (681), Google Scholar (426), African Journal of Online (AJOL) (36), CINAHL (211), HINARI (191), Scopus (86), Science Direct (62), Excerpta Medica database (EMBA, SE) (113), DOAJ (38), Web of Science (26), Google (271), and other organization's websites (2) using a combination of search terms and Boolean operators. The modified Newcastle Ottawa Scale (NOS) for cross-sectional research was used by three authors to independently assess the quality of each study. For statistical analysis, STATATM Version 11 software was employed. For the meta-analysis, the random-effects (Der Simonian and Laird) technique was applied. The heterogeneity test was performed using I-squared (I2) statistics. A one-out sensitivity analysis was performed.ResultA total of 7 articles with 2787 participants were included in this systematic review and meta-analysis. The pooled prevalence of family planning utilization among Women with Disabilities was 29.6% (95% CI: 22.3, 36.8); I2 = 94.6%). Women who were in marital union (p<0.001) and who had a discussion with their husbands (p = 0.007) were factors significantly associated with the utilization of family planning among women with disabilities.ConclusionThe finding of this study showed that utilization of family planning among women with disability is relatively lower than the Ethiopian Demographic Health Survey 2019. Therefore, the discussions with the partner and their engagement in decisions to use family planning are critical to increase its use.

Project description:BackgroundFamily planning integration in areas where women contact the healthcare system routinely is essential for addressing the high unmet need for family planning among postpartum women and reducing the risk of short interpregnancies. Immediate postpartum family planning (IPPFP) is an integrated service, and opportunities exist for women by providing family planning (FP) counseling and contraceptives as part of care following childbirth within 48 h. Therefore, this review aimed to assess the pooled estimate of immediate postpartum family planning utilization and its associated factors in Ethiopia.MethodElectronic databases were used to conduct an extensive search of all published studies, and the digital library was used to identify any unpublished studies. An observational study that reports the prevalence/magnitude and/or associated factors/predictors/determinants of IPPFP utilization in Ethiopia was included. Data were extracted on the Microsoft Excel spreadsheet and analyzed using STATA Version 11. A random-effects model was applied to determine the pooled prevalence of immediate postpartum family planning utilization with a 95% confidence interval (CI). Inverse variance (I2) was used to identify the presence of heterogeneity, and a funnel plot and Egger's test were used to check the presence of publication bias. Subgroup analysis was conducted based on the sample size, region, and year of study to identify the source of heterogeneity.ResultOf 15 primary studies, the overall pooled prevalence of immediate postpartum family planning utilization among postpartum women in Ethiopia was 21.04% (95% CI: 13.08, 29.00). Received counseling on FP [OR: 3.59; 95% CI (1.84, 7.01; P < 0.001), having a positive attitude toward FP [OR: 3.2; 95% CI (1.23, 8.35); P = 0.017], and partner support to use FP [OR: 5.85; 95% CI (1.12, 30.54; P = 0.036) were significant predictors of immediate postpartum family planning utilization.ConclusionGenerally, IPPFP utilization in Ethiopia was insufficient. Therefore, to enhance the utilization, integrating FP counseling at all maternal service care points, strengthening community awareness to develop a favorable attitude toward family planning, and promoting partner involvement in family planning counseling are essential.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=239053, identifier: CRD42021239053.

Project description:BackgroundThere is wide variation in the utilization of institutional delivery service in Ethiopia. Various socioeconomic and cultural factors affect the decision where to give birth. Although there has been a growing interest in the assessment of institutional delivery service utilization and its predictors, nationally representative evidence is scarce. This study was aimed to estimate the pooled national prevalence of institutional delivery service utilization and associated factors in Ethiopia.MethodsStudies were accessed through PubMed, Cochrane library, Web of Science, and Google Scholar. The funnel plot and Egger's regression test were used to see publication bias, and I-squared statistic was applied to check heterogeneity of studies. A weighted Dersimonian laired random effect model was applied to estimate the pooled national prevalence and the effect size of institutional delivery service utilization and associated factors.ResultTwenty four studies were included in this review. The pooled prevalence of institutional delivery service utilization was 31% (95% Confidence interval (CI): 30, 31.2%; I2 = 0.00%). Attitude towards institutional delivery (Adjusted Odd Ratio (AOR) = 2.83; 95% CI 1.35,5.92) in 3 studies, maternal age at first pregnancy (AOR = 3.59; 95% CI 2.27,5.69) in 4 studies, residence setting (AOR = 3.84; 95% CI 1.31, 11.25) in 7 studies, educational status (AOR = 2.91;95% 1.88,4.52) in 5 studies, availability of information source (AOR = 1.80;95% CI 1.16,2.78) in 6 studies, ANC follow-up (AOR = 2.57 95% CI 1.46,4.54) in 13 studies, frequency of ANC follow up (AOR = 4.04;95% CI 1.21,13.46) in 4 studies, knowledge on danger signs during pregnancy and benefits of institutional delivery (AOR = 3.04;95% CI 1.76,5.24) in 11 studies and place of birth of the elder child (AOR = 8.44;95% CI 5.75,12.39) in 4 studies were the significant predictors of institutional delivery service utilization.ConclusionThis review found that there are several modifiable factors such as empowering women through education; promoting antenatal care to prevent home delivery; increasing awareness of women through mass media and making services more accessible would likely increase utilization of institutional delivery.

Project description:Background: Uncontrolled population development can prompt an assortment of populace issues and can be one of the reasons for increasing maternal death rates. The utilization of contraceptives in Indonesia was progressively dominated by injectable contraceptives and pill contraceptives in 2015 (52.21% and 24.36%, respectively). However, the rate of termination of the use of short-acting contraceptives by family planning clients was higher than other methods, therefore the use of short-acting contraceptives is less efficient than long acting reversible contraceptives (LARCs) for longer term spacing because it is easy to skip a treatment for economic or other reasons, which can result in unintended pregnancy. Therefore, the National Family Planning Program in Indonesia is encouraging the use of LARCs to control population growth. Pameungpeuk is a region which has the second largest population, with the highest total fertility rate in South-West Java. The proportion of active users of LARCs in Pameungpeuk is very low (10.66%). This study aimed to analyze factors associated with the utilization of LARCs among family planning clients at the Pameungpeuk Rural Hospital. Methods: This study design was cross-sectional with systematic random sampling. The sample group in this study was 84 family planning clients. We performed statistical analyses using chi-square test. Results: We found significant associations between the age of women (p=0.024), the cost of contraception (p=0.022), knowledge (p=0.042), beliefs (p=0.002), skill of health workers (p=0.008) and support from health workers (p=0.014). However, education (p=0.212), family income (p=0.087), attitude (p=0.593), exposure to information on LARCs (p=0.378), support from partners (p=0.094), support from friends (p=0.414) and the support of community leaders (p=0.367) had no significant association with the utilization of LARCs. Conclusions: These findings highlight a critical need for improved education among family planning clients at the Pameungpeuk rural hospital regarding the use of LARCs for both medical and elective reasons.

Project description:BackgroundPregnancies that occur in the first year after birth can result in adverse outcomes for the mothers and their babies. Postpartum family planning (PPFP) can save lives of many mothers and children. Only few data are available about the magnitude of PPFP use and its determinants in Addis Ababa, Ethiopia.ObjectiveTo assess PPFP utilization and associated factors in Addis Ababa, Ethiopia.MethodA facility-based cross-sectional study was conducted from April to June 2018. A total of 625 women were enrolled in the study. Statistical Package for the Social Sciences (SPSS) software was used to analyze the data. Binary logistic regression model with adjusted odd ratio (AOR) and 95% confidence interval (CI) was used to identify the factors associated with PPFP use. A p-value less than 0.05 was considered as significant.ResultThe magnitude of PPFP utilization in Addis Ababa was 71.8%. Previous family planning (FP) information (AOR = 13.2; 95% CI: (1.96, 88.07)), FP information from health facility visit (AOR = 2.23; 95% CI: (1.45, 3.43)), antenatal care (AOR = 4.96; 95% CI: (1.58, 15.64)), counseling on FP at postnatal care (AOR = 1.97; 95% CI: (1.27, 3.05)), menses resumption after birth (AOR = 1.75; 95% CI: (1.11, 2.76)), and commencing sexual activity after birth (AOR = 9.34; 95% CI: (5.39, 16.17)) were the factors associated with PPFP use.Conclusion and recommendationThough the magnitude of PPFP use is encouraging, still three out of the ten postpartum women did not use PPFP. The determinants of PPFP use were having FP information, having FP information from health facility visit, antenatal care, counseling about FP during postnatal care, menses resumption after birth, and commencing sexual activity after birth. The health system in the City and the healthcare providers should strive to reach every woman who is not accessing the PPFP services and antenatal care services, and improve counseling services on PPFP during delivery and postnatal care services.

Project description:IntroductionDisrespect and abusive care is a violation of women's basic human rights and it is serious global problem that needs urgent intervention. Poor quality client-provider interaction is commonly reported from family planning programmes. In Ethiopia, disrespect and abusive care is very common (21-78%) across health facilities.ObjectiveTo assess the status of respectful family planning service (client-provider interaction) in Sidama zone, south Ethiopia.MethodologyHealth facility-based cross-sectional study was conducted from June to August 2018. Data were collected from 920 family planning clients recruited from 40 randomly selected health facilities. The Mother on Respect index (MORi) questionnaire was used to collect the data through client exit interview. Partial proportional odds ordinal regression was employed to identify determinants of respectful family planning service.ResultAmong family planning clients, the level of respectful family planning service was found to be zero (0%) in the very low respect category, 75(18.5%) in the low respect category, 382(41.52%) in moderate respect category and 463(50.33%) in high respect category. Being a short acting method client (AOR = 0.30, 95%CI [0.12, 0.72]), being an uneducated client (AOR = 0.39, 95%CI [0.25, 0.61]) or a client with elementary education (AOR = 0.41, 95%CI [0.23, 0.73]), client's poverty (AOR = 0.75, 95%CI [0.56, 0.99]), and long waiting time (AOR = 0.46, 95%CI [0.30, 0.69])significantly reduced the odds of moderate and high respect compared to low respect. Conversely, preference of male service providers, service providers' work satisfaction and health workers' prior training on respectful care significantly increased the odds of moderate and high respect.ConclusionConsidering the current strategy of zero tolerance for disrespect and abuse in Ethiopia, the level of respectful care in this study is sub-optimal. Short term training for service providers on respectful care seems valuable to enhance the level of respectful care for family planning clients irrespective of their socioeconomic background.

Project description:ObjectiveAlthough emphasis is placed on women's decision-making power regarding family planning use in Ethiopia, the utilization of contraceptives is low. There are studies conducted in different parts of the country on women's decision-making power regarding family planning use; however, there are inconsistent findings. Thus, this study aimed to determine the pooled prevalence of women's decision-making power regarding family planning use and associated factors in Ethiopia.MethodsThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to develop the systematic review and meta-analysis. All observational studies were retrieved from online databases, including PubMed, CINAHL, Google Scholar, African Journal Online and gray literature. The data search was performed from 1 December to 16 May 2022. The quality of the studies was critically assessed using the Joanna Briggs Institute checklist. Heterogeneity among studies was examined using the I 2 statistic. RevMan version 5.3 and STATA version 14 software were used for analysis.ResultsA total of 852 studies were retrieved, and 8 studies were included in the final meta-analysis. The pooled prevalence of women's decision-making power regarding family planning use was 57 (95% confidence interval: 37, 77). Good knowledge of family planning methods (odds ratio: 2.46, 95% confidence interval: 1.65, 3.67), a positive attitude toward family planning methods (odds ratio: 2.04, 95% confidence interval: 1.3, 3.2), and having primary or higher education (odds ratio: 9.76, 95% confidence interval: 4.36, 21.99) were associated with increased odds of women's decision-making power regarding family planning use.ConclusionNearly three in five married women made decisions regarding family planning use in Ethiopia. Women with good knowledge of family planning methods, a positive attitude toward family planning methods, and women having primary or higher education were associated with increased odds of women's decision-making power regarding family planning use.

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Factors associated with long-acting family planning service utilization in Ethiopia: a systematic review and meta-analysis.

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Factors associated with long-acting family planning service utilization in Ethiopia: a systematic review and meta-analysis.

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