Determinants of family planning service uptake and use of contraceptives among postpartum women in rural Uganda.
Ontology highlight
ABSTRACT:
SUBMITTER: Sileo KM
PROVIDER: S-EPMC4644123 | biostudies-other | 2015 Dec
REPOSITORIES: biostudies-other
Publications
Determinants of family planning service uptake and use of contraceptives among postpartum women in rural Uganda.
Sileo Katelyn M KM Wanyenze Rhoda K RK Lule Haruna H Kiene Susan M SM
International journal of public health 20150513 8
<h4>Objective</h4>Uganda has one of the highest unmet needs for family planning globally, which is associated with negative health outcomes for women and population-level public health implications. The present cross-sectional study identified factors influencing family planning service uptake and contraceptive use among postpartum women in rural Uganda.<h4>Methods</h4>Participants were 258 women who attended antenatal care at a rural Ugandan hospital. We used logistic regression models in SPSS ...[more]
Similar Datasets
Project description:OBJECTIVE:To determine the prevalence and factors associated with dyslipidaemias in women using hormonal contraceptives. DESIGN:Cross-sectional study SETTING: Mulago Hospital, Kampala, Uganda PARTICIPANTS: Three hundred and eighty-four consenting women, aged 18-49 years, who had used hormonal contraceptives for at least 3?months prior to the study. STUDY OUTCOME:Dyslipidaemias (defined as derangements in lipid profile levels which included total cholesterol ?200?mg/dL, high-density lipoprotein <40?mg/dL, triglyceride >150?mg/dL or low-density lipoprotein ?160?mg/dL) for which the prevalence and associated factors were obtained. RESULTS:The prevalence of dyslipidaemias was 63.3% (95% CI: 58.4 to 68.1). Body mass index (BMI) (PR=1.33, 95%?CI: 1.15 to 1.54, p<0.001) and use of antiretroviral therapy (ART) (PR=1.21, 95%?CI: 1.03 to 1.42, p=0.020) were the factors significantly associated with dyslipidaemias. CONCLUSION:Dyslipidaemias were present in more than half the participants, and this puts them at risk for cardiovascular diseases. The high-risk groups were women with a BMI greater than 25?Kg/m2 and those who were on ART. Therefore, lipid profiles should be assessed in women using hormonal contraceptives in order to manage them better.
| S-EPMC6196835 | biostudies-other
Project description:IntroductionGlobally, most postpartum pregnancies are unplanned, mainly as a result of low level of knowledge and fear of contraceptive use especially in low-income settings. The aim of this study was to evaluate the effect of prenatal contraceptive counselling on postpartum contraceptive use and pregnancy outcomes after one year.MethodsSixteen health centres were equally and randomly allocated to control and intervention arms. Mothers were consecutively recruited during their first antenatal clinic consultations. In the intervention arm Village Health Team members made home visits and provided prenatal contraceptive advice and made telephone consultations with health workers for advice while in the control arm mothers received routine antenatal care offered in the health centres. Data were collected in 2014 in the two districts of Kiryandongo and Masindi. This data was collected 12-14 months postpartum. Mothers were asked about their family planning intentions, contraceptive use and screened for pregnancy using human Chorionic Gonadotropin (hCG) levels. Socio-demographic and obstetric indices were recorded. Our primary outcomes of interests were current use of modern contraceptive, decision to use a modern contraceptive method and pregnancy status. Multilevel analysis using the xtmelogit stata command was used to determine differences between intervention and control groups.ResultsA total of 1,385 women, 748 (control) and 627 (intervention) were recruited. About 80% initiated breastfeeding within six hours of delivery 78.4% (control) and 80.4% (intervention). About half of the mothers in each arm had considered to delay the next pregnancy 47.1% (control) and 49% (intervention). Of these 71.4% in the control and 87% in the intervention had considered to use a modern contraceptive method, only 28.2% of the control and 31.6% in the intervention were current modern contraceptive users signifying unmet contraceptive needs among immediate postpartum mothers. Regarding pregnancy, 3.3% and 5.7% of the women were found to be pregnant in the control and intervention arms respectively. There were no statistical differences between the control and intervention arms for all primary outcomes of interests.ConclusionPrenatal contraceptive counseling did not affect postpartum contraceptive use among immediate postpartum mothers in Masindi and Kiryandongo districts. Interventions aiming at improving postpartum contraceptive use should focus on addressing unmet contraceptive needs.
| S-EPMC4546801 | biostudies-literature
Project description:ObjectiveThis study examined the association between family planning counselling receipt during the 12 months preceding the survey and postpartum modern contraceptive uptake in Ethiopia. We hypothesised that receiving family planning counselling either within the community setting by a field health worker or at a health facility by a healthcare attendant during the 12 months preceding the survey improves postpartum modern contraceptive uptake.DesignWe used a cross-sectional study of the Ethiopian Demographic and Health Survey conducted in 2016.SettingEthiopia.ParticipantsA total of 1650 women who gave birth during the 12 months and had contact with service delivery points during the 12 months preceding the survey.Primary outcomeA weighted modified Poisson regression model was used to estimate an adjusted relative risk (RR) of postpartum modern contraceptives.ResultsApproximately half (48%) of the women have missed the opportunity to receive family planning counselling at the health service contact points during the 12 months preceding the survey. The postpartum modern contraceptive uptake was 27%. Two hundred forty-two (30%) and 204 (24%) of the counselled and not counselled women used postpartum modern contraceptive methods, respectively. Compared with women who did not receive counselling for family planning, women who received counselling had higher contraceptive uptake (RR 1.32, 95% CI 1.04 to 1.67).ConclusionSignificant numbers of women have missed the opportunity of receiving family planning counselling during contact with health service delivery points. Modern contraceptive uptake among postpartum women was low in Ethiopia. Despite this, our findings revealed that family planning counselling was associated with improved postpartum modern contraceptive uptake.
| S-EPMC9092163 | biostudies-literature
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.
| S-EPMC6258500 | biostudies-literature
Project description:BackgroundMaternal health outcomes in Tanzania had continued to be of great concern. According the Tanzania Demographic and Health surveys, maternal mortality is still unacceptable higher. Effective use of family planning is reported to prevent maternal deaths by more than 30%. However, the prevalence of family planning uptake is still lower especially in rural areas of this country despite the fact that family planning services are provided freely and at a subsidized cost in all public and private health care facilities respectively.Objective of the studyThe broad objective is to assess the determinants of family planning uptake among women of reproductive age in rural settings, Morogoro Region, Tanzania.MethodsThis study will be a cross-sectional study that will be conducted in rural areas of Morogoro Region. Study population will be women of reproductive age. Qualitative and quantitative approaches will be used to collect the data. Sampling techniques will involve stratification of urban and rural wards, simple and systematic random sampling for selection wards and households respectively and kish selection table for the selection one participant from a household. Purposive sampling will be applied to get participants for qualitative data. Data collection will be done by using semi-structured questionnaire and interview guide. Frequencies, percentages, chi-square test and logistic regression will be used to analyze the quantitative data whereas codes and themes formation will be used to analyze the qualitative data.
| S-EPMC9012382 | biostudies-literature
Project description:Fertility among rural women in Uganda continues to decline. Studies on fertility in Uganda have focused on the overall fertility in the country. In this study, we focus on determinants of change in fertility among rural women in Uganda using a multivariate Poisson decomposition technique to quantify the contribution of changes in the socioeconomic and demographic composition of women which we also refer to as the characteristic effects and changes in their fertility behavior (the coefficients' effects or risk of childbearing) to the overall reduction in fertility among women in rural areas during the 2006-2016 period. The "characteristics effects" are used to mean the effect of changing composition of women by the socioeconomic and demographic characteristics between 2006 and 2016. On the other hand, fertility behavior also presented as coefficients' effects mean changes in the risk or likelihood of giving birth to children by the rural women between the two survey years. Our findings indicate that the mean number of children ever born (MCEB) reduced from 4.5 to 3.9 in 2006 and this reduction was associated with both the changes in composition of women and fertility behavior. The composition of women contributed to 42% while the fertility behavior contributed to 58% of the observed reduction. The education level attained and the age at first sex showed significant contributions on both components of the decomposition. The observed decline in fertility is largely associated with the variation in the risk of childbearing among the rural women. The variation in the risk of childbearing by education and age at first sex of the rural women showed to be the biggest contribution to the observed change in fertility. Continued improvements in access, attendance, and completion of secondary schools by women in rural areas will be the key drivers to Uganda's overall transition to low fertility. Furthermore, with improved access to mass media in the rural areas, there can be changes in attitudes and large family size preferences which can create a conducive environment for the utilization of family planning services in the rural communities. Efforts should therefore focus on applying appropriate methods to deliver packaged family planning messages to these communities.
| S-EPMC6942859 | biostudies-literature
Project description:Introduction: Interventions informed by behavioural economics, such as planning prompts, have the potential to increase HIV testing at minimal or no cost. Planning prompts have not been previously evaluated for HIV testing uptake. We conducted a randomised clinical trial to evaluate the effectiveness of low-cost planning prompts to promote HIV testing among men.Methods: We randomised adult men in rural Ugandan parishes to receive a calendar planning prompt that gave them the opportunity to make a plan to get tested for HIV at health campaigns held in their communities. Participants received either a calendar showing the dates when the community health campaign would be held (control group) or a calendar showing the dates and prompting them to select a date and time when they planned to attend (planning prompt group). Participants were not required to select a date and time or to share their selection with study staff. The primary outcome was HIV testing uptake at the community health campaign.Results: Among 2362 participants, 1796 (76%) participants tested for HIV. Men who received a planning prompt were 2.2 percentage points more likely to test than the control group, although the difference was not statistically significant (77.1% vs 74.9%; 95%?CI -1.2 to 5.7?percentage points, p=0.20). The planning prompt was more effective among men enrolled ?40 days before the campaigns (3.6?percentage-point increase in testing; 95%?CI -2.9 to 10.1, p=0.27) than among men enrolled >40 days before the campaigns (1.8?percentage-point increase; 95%?CI -2.3 to 5.8, p=0.39), although the effects within the subgroups were not significant.Conclusion: These findings suggest that planning prompts may be an effective behavioural intervention to promote HIV testing at minimal or no cost. Large-scale studies should further assess the impact and cost-effectiveness of such interventions.
| S-EPMC7705572 | biostudies-literature
Project description:Comprehensive HIV treatment and care makes it safer for women living with HIV (WLWH) to have the children they desire, partly through provision and appropriate use of effective contraception. However, nearly one third of WLWH in-care in a large Ugandan cohort became pregnant within 3 years of initiating ART and half of these incident pregnancies (45%) were unplanned. We therefore describe future pregnancy plans and associated factors among postpartum WLWH in rural southwestern Uganda in order to inform interventions promoting postpartum contraceptive uptake. This analysis includes baseline data collected from adult WLWH enrolled into a randomized controlled trial to evaluate the effect of family planning support versus standard of care at 12 months postpartum in southwestern Uganda. Enrolled postpartum WLWH completed an interviewer-administered questionnaire at enrolment. Among 320 enrolled women, mean age, CD4 count, and duration on ART was 28.9 (standard deviation [SD] 5.8) years, 395 cells/mm3 (SD = 62) and 4.6 years (SD = 3.9), respectively. One-hundred and eighty nine (59%) of women reported either personal (175, 55%) or partner (186, 58%) desire for more children in the next 2 years. Intentions to have more children was strongly associated with partner's desire for more children (AOR = 31.36; P < 0.000), referent pregnancy planned (AOR = 2.69; P = 0.050) and higher household income > 150,000 Shs per month (AOR = 1.37; P = 0.010). Previous use of modern contraception (AOR = 0.07; P = 0.001), increasing age (AOR = 0.34; P = 0.012), having > 2 own children living in a household (AOR = 0.42; P = 0.021) and parity > 2 (AOR = 0.59; P = 0.015) were associated with reduced odds of pregnancy intention. Our findings highlight the role male partners play in influencing pregnancy intentions postpartum and the importance of engaging men in sexual and reproductive health counselling about child spacing for the health of women, children, and families. This should be addressed alongside key individual-level social, demographic, economic and structural factors within which couples can understand risks of unplanned pregnancies and access effective contraceptive methods when they need or want them.
| S-EPMC6486443 | biostudies-literature
Project description:BackgroundUnwanted pregnancies remain a burden for women living with HIV (WLWH). Family planning prevents unplanned pregnancies while promoting longer birth intervals, key strategies to eliminate perinatal transmission of HIV and promote maternal and child health. We evaluated the effect of a family planning voucher, inclusive of immediate postpartum counseling, on uptake, early initiation, and continuation of modern contraceptive methods among recently postpartum WLWH delivering at a publicly funded regional referral hospital in rural, southwestern Uganda.Methods and findingsWe performed a randomized controlled trial between October, 2016 and June, 2018 at a referral hospital in southwestern Uganda. This interim analysis includes adult WLWH randomized and enrolled equally to receive a family planning voucher or standard of care (control). Enrolled postpartum WLWH completed an interviewer-administered questionnaire at enrollment and 6 months postpartum. Our primary outcome of interest for this analysis is initiation of a modern family planning method within 8 weeks postpartum. Secondary outcomes included family planning initiation at 12, 14, 16, and 20 weeks postpartum, family planning discontinuation and/or change, pregnancy incidence, and mean time without contraception. The trial was registered with clinicaltrials.gov (NCT02964169). At enrollment, half of the women in both the voucher (N = 87, 55%) and control (N = 86, 54%) groups wanted to have a child in 2 years postpartum. Over 80% of referent pregnancies in the voucher (N = 136, 86%) and control (N = 128, 81%) groups were planned. All women were accessing ART. The mean CD4 count was 396 cells/mm3 (SD = 61) for those enrolled in the control group versus 393 cells/mm3 (SD = 64) in the family planning voucher group. By 8 weeks postpartum, family planning was initiated in 144 (91%) participants in the voucher group and 83 (52%) participants in the control group (odds ratio [OR] 9.42; CI 4.67-13.97, P < 0.001). We also found high family planning uptake rates for both groups, with higher rates among the intervention group at 12 weeks (OR 5.66; CI 2.65-12.12, P < 0.001), 14 weeks (OR 2.51; CI 1.31-4.79, P < 0.001), 16 weeks (OR 4.02; CI 1.66-9.77, P = 0.001), and 20 weeks (OR 3.65; CI 1.40-9.47, P = 0.004) postpartum. The average time to family planning initiation was reduced to 5.9 weeks (SD = 2.4) for those in the voucher group compared to 9.3 weeks (SD = 5) in the control (P < 0.001). One pregnancy was recorded in the group receiving standard of care; none were reported in the voucher group. Method mix did not differ by group: injectables were selected by most women (N = 150, 50%), and 52% of this proportion were in the experimental arm, with <10% in each arm selecting condoms, oral contraception, or intrauterine devices (IUDs). Similar proportions of women changed contraceptive methods over the 6-month follow-up in the voucher and control groups (N = 8, 5% versus N = 5, 4%; P = 0.467). More women in the control group discontinued contraception for 1 to 2 weeks (N = 19, 13% versus N = 7, 5%; P = 0.008) or more than 4 weeks (N = 15, 10% versus N = 3, 2%; P = 0.002) compared to those given a family planning voucher. The main limitation of this study is that its findings may not be generalized to settings without improved availability of contraceptives in publicly funded facilities.ConclusionThese findings indicate that a well-structured, time-bound family planning voucher program appeared to increase early postpartum contraceptive uptake and continuation in a setting in which users are faced with financial, knowledge, and structural barriers to contraceptive services. Further work should clarify the role of vouchers in empowering WLWH to avoid unintended pregnancies over time.Trial registrationClinicalTrials.gov NCT02964169.
| S-EPMC6588214 | biostudies-literature
Project description:BackgroundDemand for family planning is predominantly for birth limiting rather than birth spacing in India. Despite several family planning programmes in India, the use of reversible contraception for limiting family planning has been stagnant and largely depends on female sterilization. Though many researchers have examined patterns and determinants of using modern contraception for total family planning, studies on patterns and determinants of contraceptive use for birth limiting are limited in India. This paper examines the patterns of contraceptive use for liming demand and its determinants in India.MethodsThe National Family Health Survey-4, 2015-16 data was used. Bivariate chi-square significant test and multivariate binary logistic regression model used to accomplish the study objectives.ResultsMajority of women (86.5%) satisfied limiting demand (SLD) in India; the SLD was found significantly low among the women's age 15-19 years (53.1%) and parity 0 (42%). The satisfied limiting demand by modern reversible contraception (mrSLD) was found significantly high in age group 15-19 years (49.1%), Muslims (30.6%) and North-east region (45.4%). The satisfied limiting demand by traditional contraception (tSLD) was almost three times higher in North-east region (26.1%) than national average of India (8.7%). The women's years of schooling, wealth status, religion and presence of son child found to be significant determinants of mrSLD. The likelihood of tSLD was found significantly high among the women who had no son child (AOR = 1.41; 95% CI:1.34, 1.48), Muslim (AOR = 1.78; 95% CI:1.70, 1.87). A considerable regional variability in levels of SLD, mrSLD and tSLD was found in India.ConclusionPublic investment in family planning is required to promote and provide subsidized modern reversible contraception (MRC) services, especially to women from North-east region, Muslim, Scheduled tribe, poor household and who had no son child. Improving the quality and availability of MRC services in public health centre will be helpful to increase SLD among the above mentioned women. Besides, the promotion of MRC will be supportive to overcome the issues of sterilization regrets in India.
| S-EPMC9020013 | biostudies-literature