Factors associated with long-acting family planning service utilization in Ethiopia: a systematic review and meta-analysis.
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ABSTRACT:
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 This search included all published and unpublished observat ...[more]
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Project description:Background:Long-acting and permanent family planning methods (LAPMs) are modern contraceptive methods that can prevent pregnancy for greater than one year and include long-acting reversible contraceptive methods (LARCs) (Intrauterine device and subdermal implants), and permanent contraceptive methods (Tubal ligation and Vasectomy). The current study aimed to assess the utilization pattern of long-acting and permanent contraceptive methods and factors associated with their utilization in Lay-Armachiho district, Amhara regional state, Ethiopia. Methods:A community-based cross-sectional study was conducted. Data were collected by using an interview method and the collected data were entered and analyzed using Statistical Package for Social Sciences (SPSS) version 20. Both binary logistics and multivariable logistic regression analyses were used to analyze predictive variables with the utilization of contraceptives. A 95% confidence interval (CI) and a P-value of <0.05 were used to declare statistical significance. Results:A total of 460 women have participated in the study. The proportion of women that utilize long-acting and permanent contraceptives was found to be 65.4%. Educational statuses, residence, attitude towards long-acting contraceptives, discussion, and joint decision-making with their spouse were factors significantly associated with the utilization of long-acting contraceptive methods. Conclusion:The current study showed that there is high utilization of LAPMs. Women's attitude, educational status, residency, frequent discussions, and a joint decision with their partners about LAPMs were significantly associated with the utilization of long-acting and permanent contraceptives. There is a significant impact of husbands (sexual partners) on the utilization and choice of contraceptive methods by women.
| S-EPMC7519844 | biostudies-literature
Project description:BackgroundEthiopia's population is currently estimated to be 117,814,659 people and continues to have countries with the highest maternal mortality rates. Family planning is one of the most effective techniques for lowering mother and child mortality, in addition to limiting rapid population expansion.ObjectiveThe aim of this study was to assess level and determinants of long-acting family planning method among reproductive age women in Harar, Eastern Ethiopia, 2021.MethodCommunity-based cross-sectional study was conducted among 845 randomly selected reproductive age women. Data were collected by trained data collector using pretested structured questionnaire. Data were coded and entered into Epidata v.3 and analyzed using SPSS v.26 software. Descriptive statistics, bivariate and multivariate logistic regression analysis was used. Variable with p-value less than 0.05 was declared as statistically significant.ResultThe prevalence of long-acting family planning method was 74.7%, while 53.6% and 46.4% was from rural and urban, respectively. The mean age of participants was 28.5 (± 5.6) years. Married women four times (AOR: 4.1; 95% CI: 1.6, 10.4) more likely to use long-acting family planning method than single women. Women with educated husband four times (AOR: 4.4; 95% CI: 1.8, 10.6) more likely to use long-acting family planning method than women with illiterate husband.ConclusionThere is high level of utilization of long-acting family planning. The women's marital status, increased education level of husbands, increasing in age of women, intention to spacing birth, and having less than five children were found to significantly increase the utilization of long-acting family planning.
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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.
| S-EPMC10490906 | biostudies-literature
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.
| S-EPMC7296650 | biostudies-literature
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.
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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.
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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.
| S-EPMC7473780 | biostudies-literature
Project description:ObjectiveThis health institution based cross section study was designed to determine factors associated with utilization of long term family planning methods among women reproductive age attending Bahir Dar health facilities.ResultA total of 406 women were interviewed in this study. The mean age (standard deviation) of the study participants was 26.96?±?6.31. About 99% of the study participants were consisted from Amhara ethnic group and 60.6% of them urban dwellers. In this study about 90.9% of the study participants had information about LTFP methods and 26.4% of them utilizing the methods. Factors like; knowledge of the women towards LTFP, spousal discussion on FP and occupation of the women affects LTFP utilization (6 times, 3 times and 4 times, respectively) when compared with their counter parts. In addition monthly income of the household was also associated to LTFP methods. In this study less percentage (26.4%) of women's utilizing LTFP methods that were significantly associated with the knowledge of women on LTFP, spousal discussion on FP, occupation of the women and monthly income of the household. As result continuous health education will be recommended.
| S-EPMC6307261 | biostudies-literature
Project description:BackgroundIn the context of high maternal morbidity and mortality in Sub-Saharan Africa, less than 80% of pregnant women receive antenatal care services. According to a 2016 national report, only 62% of pregnant women in Ethiopia made at least one antenatal care visit. The aim of this review was to systematically and quantitatively summarize the factors affecting utilization of antenatal care in Ethiopia.MethodsWe searched PubMed, Medline, EMBASE, CINAHL, Google Scholar and Maternity and Infant Care database for studies that had been conducted in Ethiopia between 2002 and 2016. We summarized the studies on the use of antenatal care services quantitatively and qualitatively. A random-effects model was conducted to obtain the pooled estimates.ResultsA total of fifteen observational studies were included in this review. The pooled prevalence of utilization of antenatal care services in Ethiopia was 63.77% (95CI 53.84-75.54). The pooled odds ratio showed that a significant positive association was found between utilization of antenatal care and urban residence (OR = 1.92, 95%CI = 1.35-2.72), women's education (OR = 1.90, 95%CI = 1.52-2.37), husband's education (OR = 1.49, 95%CI = 1.32-1.69) and planned pregnancy (OR = 2.08, 95%CI = 1.45-2.98). Based on narrative synthesis exposure to mass media, family income and accessibility of the service were strongly associated with utilization of antenatal care.ConclusionThe findings of this review found several modifiable factors such as empowering women through education and increasing their decision-making power, promoting family planning to prevent unplanned pregnancy, increasing awareness of women through mass media and making services more accessible would likely to increase utilization of antenatal care. Further research is needed on accessibility and availability of the service at the individual and community level to assess the predictors of antenatal care service utilization.
| S-EPMC6459485 | biostudies-literature
Project description:Background:unmet need for family planning is a common cause of uninteded pregnancy which mostly end up with abortion. Many studies were conducted on predictors of unmet need of family planning in Ethiopia. But, up until now, single evidence has not been synthesized and various point prevalence estimates of unmet need for family planning have been reported. Therefore, this sytematic review and meta analysis was established to identify the predictors of unmet need for family planning in Ethiopia. Methods:search engines including PubMed, Embase, CINAHL, Google Scholar, HINARI portal, and Cochrane Library were used to retrieve included articles and reported using the preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA) checklist guidelines. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was applied for critical appraisal. All observational studies done on reproductive age women and reported on unmet need for family planning were included. Unmet need for family planning is the percentage of women of reproductive age, either married or in a union, who have an unmet need for family planning to stop or delay childbearing. Random effect model was done to estimate the pooled prevalence of unmet need for family planning. Odds ratio with 95% confidence interval was considered to determine the association of identified variables with unmet need of family planning. Cochran's Q statistic, Egger's and Begg's test were carried out to assess heterogeneity and publication bias. Results:Fifteen articles and 17, 585 reproductive aged women were included to estimate the pooled prevalence of unmet need for family planning and its predictors in Ethiopia. The prevalence of unmet need for family planning in Ethiopia ranges from 26.52 to 36.39%. Age at first marriage <?18?yrs. with OR?=?2.3 (95% CI: 1.08, 4.87), women with no formal education with OR?=?1.9 (95%CI: 1.19, 3.04), partner with no formal education with OR?=?1.78 (95%CI: 1.18, 2.68) and absence of discussion with their partner about family planning with OR?=?3.52 (95%CI, 2.56, 4.87) were predictors of unmet need of family planning in Ethiopia. Conclusion:This meta analysis revealed that, the prevalence of unmet need for family planning in Ethiopia was high as compared with the United Nations sphere standard of unmet need for planning, considered to be high if it is greater than 25%. Early marriage, no formal eduaction and lack of discussion with partner on family planning were predictors of unmet need for family planning. Therefore, efforts are needed to empower women through eduaction, avoiding early marriage and facilitating dicussion of partners about family planning in order to improve family planning usage.
| S-EPMC7566059 | biostudies-literature