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The benefits of family planning (FP) use in Benin: an application of the Demographic Dividend Model (DemDiv).

ABSTRACT: Background: Despite the increasing interest in improving access to and utilization of family planning (FP) methods, contraceptives prevalence rates remain low in Benin, and its benefits are not well studied. This study projected FP's benefits for maternal health and child survival over the Sustainable Development Goals period. Methods: The Demographic Dividend Model created by the Health Policy Project using a large range of data was applied based exclusively on assumptions on FP policy options between 2015 and 2030. Results: It was found that, under the base scenario with no improvements in FP, education and economic variables, however unrealistic, the number of children per Beninese woman would be the same in 2030 as it was in 2015 - about 4.5 children per woman. Benin's age structure would remain very young and be dominated by dependents. But, FP-scenarios of improvements in contraceptive variables alone showed a negative and linear relationship between FP use and maternal and child deaths. Under the optimistic scenario, increasing access to and use of FP alone from 7.9% (2015) to 33.95% (2030) will save lives of about 200,000 under five year children and 10,000 mothers by 2030. In addition, the average number of children per woman will fall to 3.5 increasing female life expectancy by 5 years. Benin's age structure will be balanced with more working age people. The country will also record an increase in its human development indicator. Conclusion: To accelerate progresses towards improvement of maternal health and child survival, and get on track in meeting related health targets of SDGs, the present study revealed the importance of strengthening actions toward access to and use of FP in Benin Republic. There is also a need to strengthen education and economic policies to successfully harness the demographic dividend.

SUBMITTER: Dansou J

PROVIDER: S-EPMC6826173 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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The benefits of family planning (FP) use in Benin: an application of the Demographic Dividend Model (DemDiv).

Dansou Justin J

Gates open research 20190402

<b>Background</b>: Despite the increasing interest in improving access to and utilization of family planning (FP) methods, contraceptives prevalence rates remain low in Benin, and its benefits are not well studied. This study projected FP's benefits for maternal health and child survival over the Sustainable Development Goals period. <b>Methods</b>: The Demographic Dividend Model created by the Health Policy Project using a large range of data was applied based exclusively on assumptions on FP p ...[more]

PMID: 31723727

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Project description:BackgroundIntegrating measures of respectful care is an important priority in family planning programs, aligned with maternal health efforts. Ensuring women can make autonomous reproductive health decisions is an important indicator of respectful care. While scales have been developed and validated in family planning for dimensions of person-centered care, none focus specifically on decision-making autonomy. The Mothers Autonomy in Decision-Making (MADM) scale measures autonomy in decision-making during maternity care. We adapted the MADM scale to measure autonomy surrounding a woman's decision to use a contraceptive method within the context of contraceptive counselling. This study presents a psychometric validation of the Family Planning Autonomous Decision-Making (FP-ADM) scale using data from Argentina, Ghana, and India.Methods and findingsWe used cross-sectional data from women in four subnational areas in Argentina (n = 890), Ghana (n = 1,114), and India (n = 1,130). In each area, 20 primary sampling units (PSUs) were randomly selected based on probability proportional to size. Households were randomly selected in Ghana and India. In Argentina, all facilities providing reproductive and maternal health services within selected PSUs were included and women were randomly selected upon exiting the facility. Interviews were conducted with a sample of 360 women per district. In total, 890 women completed the FP-ADM in Argentina, 1,114 in Ghana and 1,130 in India. To measure autonomous decision-making within FP service delivery, we adapted the items of the MADM scale to focus on family planning. To assess the scale's psychometric properties, we first examined the eigenvalues and conducted a parallel analysis to determine the number of factors. We then conducted exploratory factor analysis to determine which items to retain. The resulting factors were then identified based on the corresponding items. Internal consistency reliability was assessed with Cronbach's alpha. We assessed both convergent and divergent construct validity by examining associations with expected outcomes related to the underlying construct. The Eigenvalues and parallel analysis suggested a two-factor solution. The two underlying dimensions of the construct were identified as "Bidirectional Exchange of Information" (Factor 1) and "Empowered Choice" (Factor 2). Cronbach's alpha was calculated for the full scale and each subscale. Results suggested good internal consistency of the scale. There was a strong, significant positive association between whether a woman expressed satisfaction with quality of care received from the healthcare provider and her FP-ADM score in all three countries and a significant negative association between a woman's FP-ADM score and her stated desire to switch contraceptive methods in the future.ConclusionsOur results suggest the FP-ADM is a valid instrument to assess decision-making autonomy in contraceptive counseling and service delivery in diverse low- and middle-income countries. The scale evidenced strong construct, convergent, and divergent validity and high internal consistency reliability. Use of the FP-ADM scale could contribute to improved measurement of person-centered family planning services.

Project description:BackgroundUnmet need for family planning exceeds 33% in Uganda. One approach to decreasing unmet need is promoting male involvement in family planning. Male disapproval of use of family planning by their female partners and misconceptions about side effects are barriers to family planning globally and in Uganda in particular. Researchers have conducted a number of qualitative studies in recent years to examine different aspects of family planning among Ugandan men. The present study aimed to quantify men's knowledge of family planning in rural Uganda to understand how better to involve men in couples' contraceptive decision-making, particularly in low-resource settings.MethodsData were derived from in-person, researcher-administered surveys of men in a rural agrarian district in Uganda (N =?178). Participant demographics and knowledge of family planning methods, side effects, and use were queried. Descriptive statistics were used for analysis.ResultsMen were 34 years of age on average (range 18-71) and about half (56%) had a primary school education or less. Ninety-eight percent reported any knowledge of family planning, with 73% of men reporting obtaining information via radio and only 43% from health workers. The most common method known by men was the male condom (72%), but more than half also knew of injections (54%) and pills (52%). Relatively few men reported knowing about the most effective reversible contraceptive methods, intrauterine devices and implants (both 16%). Men identified many common contraceptive side-effects, such as vaginal bleeding (31%), and misconceptions about side effects, such as increased risk of infertility and birth defects, were relatively uncommon (both <?10%). About half of all men reported ever using a family planning method (53%), and 40% reported current use.ConclusionsThis study's quantitative results build on those of recent qualitative studies and provide information about the types of family planning information men are lacking and avenues for getting this information to them.

Dataset Information

The benefits of family planning (FP) use in Benin: an application of the Demographic Dividend Model (DemDiv).

Publications

The benefits of family planning (FP) use in Benin: an application of the Demographic Dividend Model (DemDiv).

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