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Biswas M, Banerjee A. Examining the linkages between maternity services and postpartum modern contraceptive adoption among young women in India: Insights from the 2015-16 and 2019-21 National Family Health Survey. PLoS One 2023; 18:e0289701. [PMID: 37556482 PMCID: PMC10411807 DOI: 10.1371/journal.pone.0289701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 07/25/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND The adoption of maternity services and postpartum modern contraception are the two most crucial components that help in reducing maternal and infant mortality; still, India is consistently struggling with it. This paper, therefore, aimed to examine the linkages between use of maternity services and postpartum modern contraceptive adoption. DATA AND METHODS The required reproductive calendar data were extracted from the 2015-16 and 2019-21 National Family Health Survey (NFHS) datasets. The assessment was made based on a sample of currently married women aged 15-24 years who had given most recent childbirth in five years preceding the survey. For the analysis, a time-to-event approach was applied using the Kaplan-Meier survival statistic, Log-Rank Chi-square test and Cox-Proportional Hazard (Cox-PH) models. RESULTS The results revealed that the proportion of postpartum modern contraceptive uptake among young users increased by 9%, from 33% in 2015-16 to 42% in 2019-21. The Cox-PH models revealed that, in both NFHS waves, the associations between various components of maternity services and postpartum modern contraceptive uptake were strongly significant, even after controlling for selected socio-economic and demographic correlates. CONCLUSIONS The findings of this study reinforced urgent need for implementing integrated maternal-child health and family planning programmes and for boosting effective family planning counselling by health professionals to promote and motivate young women with a desire to early adoption of modern contraception in subsequent months after a recent childbirth.
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Affiliation(s)
- Monirujjaman Biswas
- Centre for the Study of Regional Development, Jawaharlal Nehru University, New Delhi, Delhi, India
| | - Anuradha Banerjee
- Centre for the Study of Regional Development, Jawaharlal Nehru University, New Delhi, Delhi, India
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Ayalew HG, Asefa KT, Liyew AM. Determinants of recommended antenatal care visits among pregnant women in Ethiopia: a generalized linear mixed-effects modeling. BMC Pregnancy Childbirth 2022; 22:867. [PMID: 36419025 PMCID: PMC9685851 DOI: 10.1186/s12884-022-05213-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 11/14/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Although antenatal care has the potential role to reduce maternal and child morbidity and mortality, utilization of a recommended number of antenatal care visits is still low in Ethiopia. Therefore, this study aimed to assess the determinants of recommended antenatal care visits in Ethiopia. METHOD Data from the 2019 mini-Ethiopian demographic and health survey (MEDHS) was used for this study. A total of 3916 women who gave birth 5 years preceding the MEDHS were included. A generalized linear mixed-effects (mixed-effects logistic regression) model was used to identify the determinants of recommended antenatal care service utilization. Finally, the adjusted odds ratio with a 95% confidence interval and random effects were reported. RESULTS In the generalized linear mixed-effects model, women with primary education (AOR = 1.55, 95%CI 1.22-2.01), secondary and above education (AOR = 5.12, 95%CI 2.80-8.16), women from the middle (AOR = 1.25, 95%CI 1.01-1.71) and rich wealth index (AOR = 1.54, 95%CI 1.12-2.25), women who were exposed to media (AOR = 1.23,95%CI 1.01-1.57) and who use contraception (AOR = 1.45 95%CI 1.25-2.03), had higher odds of recommended antenatal care service utilization. CONCLUSION In this study, factors like maternal educational status, media exposure, wealth index and history of contraceptive utilization were significantly associated with recommended ANC visits in Ethiopia. Therefore, encouraging women for contraceptive service utilization, consulting women to be exposed to media and improving women's wealth status will help to have recommended number of ANC visits by pregnant women in Ethiopia.
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Affiliation(s)
- Hiwotie Getaneh Ayalew
- grid.467130.70000 0004 0515 5212Department of midwifery, school of nursing and midwifery, college of medicine and health sciences, Wollo University, Dessie, Ethiopia
| | - Kibir Temesgen Asefa
- grid.467130.70000 0004 0515 5212Department of midwifery, school of nursing and midwifery, college of medicine and health sciences, Wollo University, Dessie, Ethiopia
| | - Alemneh Mekuriaw Liyew
- grid.59547.3a0000 0000 8539 4635Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Serván-Mori E, Cerecero-García D, Morales-Vazquez M, Sosa-Rubí S, Heredia-Pi I, Hernández-Serrato M. The Role of Effective Knowledge on Contraceptive Methods Use in the Replication of Mother-Daughter Adolescent Pregnancy in Mexico. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:4035-4046. [PMID: 36036869 DOI: 10.1007/s10508-021-02272-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 12/16/2021] [Accepted: 12/20/2021] [Indexed: 06/15/2023]
Abstract
An important gap in the literature is the analysis of the role of effective knowledge concerning use of contraceptive methods in the intergenerational reproduction of adolescent pregnancy in low- and middle-income countries. Using data from the 2014 Mexico National Survey of Demographic Dynamics, we conducted a retrospective cohort and complete case analysis of women aged ≤ 19 years cohabitating with their mothers and who self-reported having had sexual intercourse at the moment of the survey (n = 5143). We estimated instrumental variable probit models (IV-probit) to assess the association between effective knowledge concerning the use of contraceptive methods and adolescent pregnancy. We stratified our models according to parental history of adolescent pregnancy. Adolescent pregnancy prevalence in our sample was 58.7%. The IV-probit model showed that mothers with a history of adolescent pregnancy were 12.1 percentage points more likely to have daughters who experience adolescent pregnancy. In addition, daughters with effective knowledge concerning the use of contraceptive methods were 1.3 percentage points less likely to experience an adolescent pregnancy. Our findings carry relevant implications for policies seeking to reduce adolescent pregnancy. They highlight the need for policies and programs that tackle the intergenerational transmission of sexual and reproductive behaviors by increasing the information available to adolescents and enhancing their effective knowledge about the use of contraceptive methods. Identifying population groups at higher risk of adolescent pregnancy can contribute to the design of successful reproductive health policies in Mexico and other low- and middle-income countries.
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Affiliation(s)
- Edson Serván-Mori
- Center for Health Systems Research, National Institute of Public Health, Mexico, Universidad No. 655 Colonia Santa Maria Ahuacatitlan, Cerrada Los Pinos y Caminera, 62100, Cuernavaca, Morelos, México
| | - Diego Cerecero-García
- Center for Health Systems Research, National Institute of Public Health, Mexico, Universidad No. 655 Colonia Santa Maria Ahuacatitlan, Cerrada Los Pinos y Caminera, 62100, Cuernavaca, Morelos, México.
| | - Mariana Morales-Vazquez
- Center for Health Systems Research, National Institute of Public Health, Mexico, Universidad No. 655 Colonia Santa Maria Ahuacatitlan, Cerrada Los Pinos y Caminera, 62100, Cuernavaca, Morelos, México
| | - Sandra Sosa-Rubí
- Center for Health Systems Research, National Institute of Public Health, Mexico, Universidad No. 655 Colonia Santa Maria Ahuacatitlan, Cerrada Los Pinos y Caminera, 62100, Cuernavaca, Morelos, México
| | - Ileana Heredia-Pi
- Center for Health Systems Research, National Institute of Public Health, Mexico, Universidad No. 655 Colonia Santa Maria Ahuacatitlan, Cerrada Los Pinos y Caminera, 62100, Cuernavaca, Morelos, México
| | - María Hernández-Serrato
- Center of Information for Public Health Decisions, National Institute of Public Health, Mexico, Universidad No. 655 Colonia Santa Maria Ahuacatitlan, Cerrada Los Pinos y Caminera, 62100, Cuernavaca, Morelos, México
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Bansal A, Shirisha P, Mahapatra B, Dwivedi LK. Role of maternal and child health services on the uptake of contraceptive use in India: A reproductive calendar approach. PLoS One 2022; 17:e0269170. [PMID: 35704629 PMCID: PMC9200305 DOI: 10.1371/journal.pone.0269170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 05/16/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND According to the latest round of National Family Health Survey-4 (NFHS (2015-16)) maternal and child health care (MCH) services improved drastically compared to NFHS-3. Previous studies have established that the uptake of MCH services increases the likelihood of early adoption of contraceptives among women. So, our study aims to examine if the early initiation of contraceptive has proportionately improved with the recent increase in MCH services. METHODS This study used the reproductive calendar of NFHS-4, 2015-16, to evaluate contraceptive initiation within 12 months after the last birth among 1,36,962 currently married women in India. A complementary log-log regression model was created to examine the link between the time of initiation of contraception and MCH care at the national level. RESULTS It was found that only a quarter of women within 12 months from last birth have adopted the modern contraceptive method. Among those majority of the females adopted sterilization mostly at the time of birth. The multivariable model identified, that the period of initiation of contraceptive depends on the gender composition of children and access to MCH services. It was found that the odds of early initiation of contraceptive use was higher when a women have only son (AOR = 1.15,95% CI- 1.22, 1.18) compared to women with only daughter. Also, it was found that women who have availed MCH services were more likely to adopt contraceptives earlier. CONCLUSION The number of women availing MCH services has increased in India, but it did not result in a proportional increase in initiation of contraception after childbirth. Facilitating family planning services alongside MCH services will be beneficial in low-resource settings. It is a golden opportunity to educate and encourage women for early adoption of contraceptive.
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Affiliation(s)
- Anjali Bansal
- International Institute for Population Sciences, Govandi East, Mumbai, India
| | - P. Shirisha
- Department of Humanities and Social Sciences, Humanities and Science Block, IIT Madras, Chennai, Tamil Nadu, India
| | | | - Laxmi Kant Dwivedi
- International Institute for Population Sciences, Govandi East, Mumbai, India
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Do family planning advice and maternal health care utilization changes course in contraception usage? A study based on Bihar, India. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Nabirye J, Matovu JKB, Bwanika JB, Makumbi F, Wanyenze RK. Missed opportunities for family planning counselling among HIV-positive women receiving HIV Care in Uganda. BMC WOMENS HEALTH 2020; 20:91. [PMID: 32370797 PMCID: PMC7201557 DOI: 10.1186/s12905-020-00942-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 04/12/2020] [Indexed: 11/23/2022]
Abstract
Introduction HIV-positive women who are still in the reproductive years need adequate sexual and reproductive health information to make informed reproductive health choices. However, many HIV-positive women who interface with the health system continue to miss out on this information. We sought to: a) determine the proportion of HIV-positive women enrolled in HIV care who missed family planning (FP) counselling; and b) assess if any association existed between receipt of FP counselling and current use of modern contraception to inform programming. Methods Data were drawn from a quantitative national cross-sectional survey of 5198 HIV-positive women receiving HIV care at 245 HIV clinics in Uganda; conducted between August and November 2016. Family planning counselling was defined as provision of FP information (i.e. available FP methods and choices) to an HIV-positive woman by a health provider during ANC, at the time of delivery or at the PNC visit. Analyses on receipt of FP counselling were done on 2760 HIV-positive women aged 15–49 years who were not currently pregnant and did not intend to have children in the future. We used a modified Poisson regression model to determine the Prevalence Ratio (PR) as a measure of association between receipt of any FP counselling and current use of modern contraception, controlling for potential confounders. Analyses were performed using STATA statistical software, version 14.1. Results Overall, 2104 (76.2%) HIV-positive women reported that they received FP counselling at any of the three critical time-points. Of the 24% (n = 656) who did not, 37.9% missed FP counselling at ANC; 41% missed FP counselling during delivery; while 54% missed FP counselling at the post-natal care visit. HIV-positive women who received any FP counselling were significantly more likely to report current use of modern contraception than those who did not (adjusted PR [adj. PR] = 1.21; 95% Confidence Interval [CI]: 1.10, 1.33). Conclusion Nearly one-quarter of HIV-positive women did not receive any form of FP counselling when they interfaced with the healthcare system. This presents a missed opportunity for prevention of unintended pregnancies, and suggests a need for the integration of FP counselling into HIV care at all critical time-points.
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Affiliation(s)
- Juliet Nabirye
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, P.O. Box 7072, Kampala, Uganda
| | - Joseph K B Matovu
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, P.O. Box 7072, Kampala, Uganda. .,Busitema University Faculty of Health Sciences, Mbale, Uganda.
| | - John Baptist Bwanika
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, P.O. Box 7072, Kampala, Uganda
| | - Fredrick Makumbi
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, P.O. Box 7072, Kampala, Uganda
| | - Rhoda K Wanyenze
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, P.O. Box 7072, Kampala, Uganda
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Ugwu IA, Itua I. Utilization of Maternity Services and Its Relationship with Postpartum Use of Modern Contraceptives Among Women of Reproductive Age Group in Nigeria. Open Access J Contracept 2020; 11:1-13. [PMID: 32021499 PMCID: PMC6955809 DOI: 10.2147/oajc.s215619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 11/21/2019] [Indexed: 11/23/2022] Open
Abstract
Background Utilization of maternity services (UMS) exposes mothers to family planning (FP) counseling and other FP promotional activities. Uptake of postpartum modern contraceptives (PPMC) reduces both infant and maternal mortalities by reducing unwanted pregnancies and promoting good child spacing. Understanding the relationship between UMS and uptake of PPMC was therefore very important. Purpose To determine the association between UMS and uptake of PPMC among women of the reproductive age group in Nigeria taking into consideration the influence of the place of access to the maternity services. Patients and Methods This study was a descriptive epidemiological study design. Secondary data obtained from the 2013 Nigerian Demographic Health Survey (NDHS) was analyzed to achieve the above aim. The uptake of PPMC was the dependent variable (DV). The independent variables (IDV) selected were the number of antenatal care (ANC) visits, place of access of ANC, place of delivery, timing of postnatal care (PNC) and place of access of PNC. Other control variables include socio-demographic factors. Descriptive statistics, chi-square testing, and logistic regression analyses were conducted to determine the association between the PPMC uptake and the IDV/other control variables. Statistical significance was claimed at p<0.05. Results Utilization of maternity services was associated with higher uptake of PPMC among the women (>/= 4 ANC visits OR = 2.08, 95% CI=1.65–2.62, P<0.001; public facility delivery OR= 1.80, 95% CI= 1.54–2.10, P< 0.001; private facility delivery OR =1.54, 95% CI 1.28–1.85, P< 0.001; PNC OR=1.21, 95% CI= 1.02–1.43, P=0.029). Accessing postnatal care in private health facilities was associated with increased uptake of PPMC (OR= 1.46, 95% CI =1.05–2.02, P= 0.024). The number of children alive, educational attainment, wealth index and having information about FP remained significant predictors of PPMC uptake. Conclusion The utilization of maternity services was positively associated with postpartum use of modern contraceptives among women of reproductive age in Nigeria. There was increased uptake of PPMC among women who utilized maternity service compared to their counterparts who did not. Regarding the place of access, accessing antenatal care as well as delivering in either private or public health facilities was not a significant predictor of PPMC use. However, accessing postnatal care in private facilities was associated with higher uptake of PPMC.
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Affiliation(s)
- Innocent Anayochukwu Ugwu
- Department of Obstetrics & Gynecology, College of Medicine, Enugu State University of Science & Technology (ESUT) and ESUT Teaching Hospital, Enugu, Nigeria
| | - Imose Itua
- Department of Public Health and Healthcare Management, University of Liverpool/Laureate Online Education, Liverpool, UK
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Escamilla V, Calhoun L, Odero N, Speizer IS. Access to public transportation and health facilities offering long-acting reversible contraceptives among residents of formal and informal settlements in two cities in Kenya. Reprod Health 2019; 16:161. [PMID: 31703700 PMCID: PMC6839122 DOI: 10.1186/s12978-019-0828-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 10/18/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite improved health facility access relative to rural areas, distance and transportation remain barriers in some urban areas. Using household and facility data linked to residential and transportation geographic information we describe availability of health facilities offering long-acting reversible contraceptive (LARC) methods and measure access via matatus (privately owned mid-size vehicles providing public transport) in urban Kenya. METHODS Study data were collected by the Measurement, Learning and Evaluation (MLE) Project. Location information for clusters (2010) representative of city-level population were used to identify formal and informal settlement residents. We measured straight-line distances between clusters and facilities that participated in facility audits (2014) and offered LARCs. In Kisumu, we created a geographic database of matatu routes using Google Earth. In Nairobi, matatu route data were publicly available via the Digital Matatus Project. We measured straight-line distance between clusters and matatu stops on 'direct' routes (matatu routes with stop(s) ≤1 km from health facility offering LARCs). Facility and matatu access were compared by settlement status using descriptive statistics. We then used client exit interview data from a subset of facilities in Nairobi (N = 56) and Kisumu (N = 37) Kenya (2014) to examine the frequency of matatu use for facility visits. RESULTS There were 141 (Informal = 71; Formal = 70) study clusters in Nairoibi and 73 (Informal = 37; Formal = 36) in Kisumu. On average, residential clusters in both cities were located ≤1 km from a facility offering LARCs and ≤ 1 km from approximately three or more matatu stops on direct routes regardless of settlement status. Client exit interview data in Nairobi (N = 1602) and Kisumu (N = 1158) suggest that about 25% of women use matatus to visit health facilities. On average, women who utilized matatus travelled 30 min to the facility, with 5% travelling more than 1 hour. Matatu use increased with greater household wealth. CONCLUSIONS Overall, formal and informal settlement clusters were within walking distance of a facility offering LARCs, and multiple matatu stops were accessible to get to further away facilities. This level of access will be beneficial as efforts to increase LARC use expand, but the role of wealth and transportation costs on access should be considered, especially among urban poor.
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Affiliation(s)
- Veronica Escamilla
- Carolina Population Center, University of North Carolina (UNC), Chapel Hill, USA.
| | - Lisa Calhoun
- Carolina Population Center, University of North Carolina (UNC), Chapel Hill, USA
| | - Norbert Odero
- Duke Global Health Institute, Duke University, Durham, USA
| | - Ilene S Speizer
- Carolina Population Center, University of North Carolina (UNC), Chapel Hill, USA.,Gillings School of Global Public Health, Department of Maternal and Child Health, UNC, Chapel Hill, USA
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Do M, Micah A, Brondi L, Campbell H, Marchant T, Eisele T, Munos M. Linking household and facility data for better coverage measures in reproductive, maternal, newborn, and child health care: systematic review. J Glob Health 2016; 6:020501. [PMID: 27606060 PMCID: PMC5012234 DOI: 10.7189/jogh.06.020501] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Currently many measures of intervention coverage obtained from household surveys do not measure actual health intervention/service delivery, resulting in a need for linking reports of care-seeking with assessments of the service environment in order to improve measurements. This systematic review aims to identify evidence of different methods used to link household surveys and service provision assessments, with a focus on reproductive, maternal, newborn and child health care, in low- and middle-income countries. METHODS Using pre-defined search terms, articles published in peer-reviewed journals and the grey literature after 1990 were identified, their reference lists scanned and linking methods synthesized. FINDINGS A total of 59 articles and conference presentations were carefully reviewed and categorized into two groups based on the linking method used: 1) indirect/ecological linking that included studies in which health care-seeking behavior was linked to all or the nearest facilities or providers of certain types within a geographical area, and 2) direct linking/exact matching where individuals were linked with the exact provider or facility where they sought care. The former approach was employed in 51 of 59 included studies, and was particularly common among studies that were based on independent sources of household and facility data that were nationally representative. Only eight of the 59 reviewed studies employed direct linking methods, which were typically done at the sub-national level (eg, district level) and often in rural areas, where the number of providers was more limited compared to urban areas. CONCLUSIONS Different linking methods have been reported in the literature, each category has its own set of advantages and limitations, in terms of both methodology and practicality for scale-up. Future studies that link household and provider/facility data should also take into account factors such as sources of data, the timing of surveys, the temporality of data points, the type of services and interventions, and the scale of the study in order to produce valid and reliable results.
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Affiliation(s)
- Mai Do
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, Tulane, LA, USA
| | - Angela Micah
- Department of Global Health Management and Policy, Tulane University School of Public Health and Tropical Medicine, Tulane, LA, USA
| | - Luciana Brondi
- Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, Scotland, UK
| | - Harry Campbell
- Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, Scotland, UK
| | - Tanya Marchant
- Faculty of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London, UK
| | - Thomas Eisele
- Center for Applied Malaria Research and Evaluation, Department of Tropical Medicine, Tulane University School of Tropical Medicine, Tulane, LA, USA
| | - Melinda Munos
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Agha S, Williams E. Does the antenatal care visit represent a missed opportunity for increasing contraceptive use in Pakistan? An analysis of household survey data from Sindh province. Health Policy Plan 2016; 31:325-31. [PMID: 26208505 PMCID: PMC4779145 DOI: 10.1093/heapol/czv065] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2015] [Indexed: 11/30/2022] Open
Abstract
During the last two decades, the use of maternal health services has increased dramatically in Pakistan, with nearly 80% of Pakistani women making an antenatal care (ANC) visit during their pregnancy. Yet, this increase in use of modern health services has not translated into significant increases in the adoption of contraception. Even though Pakistan has had a national family planning programme and policies since the 1950s, contraceptive use has increased slowly to reach only 35% in 2012-13. No evidence is currently available to demonstrate whether the utilization of maternal health services is associated with contraceptive adoption in Pakistan. This study uses data from a large-scale survey conducted in Sindh province in 2013 to examine whether ANC utilization is a significant predictor of subsequent contraceptive use among women. In an analysis which controls for a range of variables known to be important for family planning adoption, the findings show that ANC is the strongest predictor of subsequent family planning use among women in Sindh. The antenatal visit represents an enormous opportunity to promote the adoption of family planning in Pakistan. The family planning programme should ensure that high-quality family planning counselling is provided to women during their ANC visits. This approach has the potential for contributing to substantial increases in contraceptive use in Pakistan.
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Affiliation(s)
- Sohail Agha
- Department of Monitoring and Evaluation, Jhpiego, D-66, Block 2, Clifton, Karachi, Pakistan and
| | - Emma Williams
- Department of Monitoring, Evaluation and Research, Jhpiego
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Cleland J, Shah IH, Daniele M. Interventions to Improve Postpartum Family Planning in Low- and Middle-Income Countries: Program Implications and Research Priorities. Stud Fam Plann 2015; 46:423-41. [DOI: 10.1111/j.1728-4465.2015.00041.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- John Cleland
- Emeritus Professor of Medical Demography, Department of Population Health; London School of Hygiene & Tropical Medicine; Keppel Street London WC1E 7HT United Kingdom
| | - Iqbal H. Shah
- Doctoral student, Faculty of Epidemiology and Population Health, Department of Population Health; London School of Hygiene & Tropical Medicine; Keppel Street London WC1E 7HT United Kingdom
| | - Marina Daniele
- Principal Research Scientist, Department of Global Health and Population; Harvard T.H. Chan School of Public Health; Boston Massachusetts
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Yadav D, Dhillon P. Assessing the impact of family planning advice on unmet need and contraceptive use among currently married women in Uttar Pradesh, India. PLoS One 2015; 10:e0118584. [PMID: 25738707 PMCID: PMC4349805 DOI: 10.1371/journal.pone.0118584] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 01/21/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Counseling/advice is one of the key interventions to promote family planning (FP) in developing countries, including India. It helps to improve the quality of care and reduce maternal deaths. This paper investigates the continuity of maternal health (MH) service utilization from antenatal care to post-natal care and the impact this service utilization has on contraceptive use and on meeting the demand for family planning among currently married women in rural Uttar Pradesh, India. METHODS AND FINDINGS The study assesses the impact of FP advice on unmet need and contraceptive use by adopting the propensity score matching method. It uses data from the District Level Household Survey (DLHS) (2007-08) that covered 76,147 currently married women (CMW) in the age group 15-44 years in Uttar Pradesh. Results show that the utilization of MH services [Antenatal care (ANC), institutional delivery, Postnatal care (PNC)] and FP advice during ANC and PNC has led to increase in current use of contraception by 3.7% (p<.01), 7.3% (p<.01) and 6.8% (p<.01), respectively. However, a greater utilization of these services has not translated into a reduction of unmet need for contraception at a similar manner. CONCLUSION MH service utilization including FP advice is more effective in increasing current use of spacing methods as compared to limiting methods. Findings support the need for "effective FP advice" interventions to reduce unintended births and unmet need. However, women from Scheduled Caste/Scheduled Tribe communities are less likely to receive MH services. Thus, efforts are required to ensure that currently married women across socio-economic backgrounds have equal opportunity to receive MH services and information on contraceptive use to meet the demand for family planning methods.
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Affiliation(s)
- Diwakar Yadav
- Population Services International, Lucknow, Uttar Pradesh, India
- * E-mail:
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Hong R, Montana L, Mishra V. Family planning services quality as a determinant of use of IUD in Egypt. BMC Health Serv Res 2006; 6:79. [PMID: 16792810 PMCID: PMC1553443 DOI: 10.1186/1472-6963-6-79] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2005] [Accepted: 06/22/2006] [Indexed: 11/28/2022] Open
Abstract
Background Both availability and quality of family planning services are believed to have contributed to increasing contraceptive use and declining fertility rates in developing countries. Yet, there is limited empirical evidence to show the relationship between the quality of family planning services and the population based prevalence of contraceptive methods. This study examined the relationship between quality of family planning services and use of intrauterine devices (IUD) in Egypt. Methods The analysis used data from the 2003 Egypt Interim Demographic and Health Survey (EIDHS) that included 8,445 married women aged 15–49, and the 2002 Egypt Service Provision Assessment (ESPA) survey that included 602 facilities offering family planning services. The EIDHS collected latitude and longitude coordinates of all sampled clusters, and the ESPA collected these coordinates for all sampled facilities. Using Geographic Information System (GIS) methods, individual women were linked to a facility located within 10 km of their community. A facility-level index was constructed to reflect the quality of family planning services. Four dimensions of quality of care were examined: counseling, examination room, supply of contraceptive methods, and management. Effects of quality of family planning services on the use of IUD and other contraceptive methods were estimated using multinomial logistic regression. Results are presented as relative risk ratios (RRR) with significance levels (p-values). Results IUD use among women who obtained their method from public sources was significantly positively associated with quality of family planning services (RRR = 1.36, p < 0.01), independent of distance to the facility, facility type, age, number of living children, education level, household wealth status, and residence. Quality of services related to counseling and examination room had strong positive effects on use of IUD (RRR = 1.61 for counseling and RRR = 1.46 for examination room). Obtaining IUD from a private source or using other contraceptive methods was not associated with quality of services. Conclusion This study is one among the few that used geographic information to link data from a population-based survey with an independently sampled health facility survey. The findings demonstrate that service quality is an important determinant of use of clinical contraceptive methods in Egypt. Improving quality of family planning services may help further increase use of clinical contraceptive methods and reduce fertility.
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Affiliation(s)
- Rathavuth Hong
- Demographic and Health Research Division, ORC Macro, 11785 Beltsville Drive, Calverton, MD 20705, USA.
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