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Mruts KB, Tessema GA, Kassaw NA, Gebremedhin AT, Scott JA, Pereira G. Achieving reductions in the unmet need for contraception with postpartum family planning counselling in Ethiopia, 2019-2020: a national longitudinal study. Arch Public Health 2023; 81:79. [PMID: 37127656 PMCID: PMC10150151 DOI: 10.1186/s13690-023-01096-1] [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: 04/28/2022] [Accepted: 04/23/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND An unmet need for contraception is associated with unintended pregnancy and adverse maternal and childhood outcomes. Family planning counselling is linked with reduced unmet need for contraception. However, evidence is lacking in Ethiopia on the impact of integrated family planning counselling on the unmet need for contraception. This study aimed to examine the association between family planning counselling and the unmet need for contraception in Ethiopia. METHODS We used community-based prospective cohort study data from a nationally representative survey conducted by Performance Monitoring for Action Ethiopia between 2019 and 2020. Women who had received three maternal and child health (MCH) services (n = 769) - antenatal care (ANC), facility delivery and child immunisation - were included in this study. The primary exposure variable was family planning counselling provided during the different MCH services. A weighted modified Poisson regression model was used to estimate the adjusted relative risk (aRR) of the unmet need for contraception. RESULTS The prevalence of family planning counselling during ANC, prior to discharge, and child immunisation was 22%, 28%, and 28%, respectively. Approximately one-third (34%) of the women had an unmet need for contraception. Family planning counselling prior to discharge from the facility was associated with reductions in the unmet need for contraception (aRR 0.88; 95% CI 0.67, 1.16). The risk of unmet need for contraception was 31% (aRR 0.69; 95% CI 0.48, 0.98) less likely among women who had received family planning counselling during child immunisation services. However, family planning counselling during ANC was associated with an increased unmet need for contraception (aRR 1.24; 95% CI 0.93, 1.64). CONCLUSION Strongest evidence was observed for moderate associations between reductions in the unmet need for contraception and family planning counselling during the provision of child immunisation services in Ethiopia.
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Affiliation(s)
- Kalayu Brhane Mruts
- School of Public Health, Debre Berhan University, P.O. Box 445, Debre Berhan, Ethiopia.
- Curtin School of Population Health, Curtin University, Perth, Australia.
| | - Gizachew A Tessema
- Curtin School of Population Health, Curtin University, Perth, Australia
- School of Public Health, University of Adelaide, Adelaide, Australia
| | - Nigussie Assefa Kassaw
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Jane A Scott
- Curtin School of Population Health, Curtin University, Perth, Australia
| | - Gavin Pereira
- Curtin School of Population Health, Curtin University, Perth, Australia
- Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, Oslo, Norway
- enAble Institute, Curtin University, Perth, Australia
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Goyomsa GG, Geleta LA, Debela SA, Reshid N, Ogeto Luke A, Lamaro Abota T, Girma D, Dejene H. Quality of family planning counseling and associated factors among women attending family planning clinics at selected health centers in Akaki Kality sub-city, Addis Ababa, Ethiopia. Front Glob Womens Health 2022; 3:939783. [DOI: 10.3389/fgwh.2022.939783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 11/04/2022] [Indexed: 12/03/2022] Open
Abstract
BackgroundEthiopia has achieved a remarkable improvement in the provision of family planning. The modern contraceptive prevalence rate has shown a fivefold increment in the last two decades, yet the family planning service in the country is still deficient and characterized by poor counseling quality.ObjectiveThe aim of the study is to assess the quality of family planning counseling provided and the associated factors at selected health centers in Akaki Kality sub-city, Addis Ababa, Ethiopia.MethodA cross-sectional study was conducted among 678 randomly selected women attending family planning services at health centers in Addis Ababa, Ethiopia. Multivariable logistic regression analysis was performed to identify factors associated with the quality of family planning counseling.ResultA total of 678 women participated in the study. About 29.1% [95% confidence interval (CI): 25.7%–32.6%] of the respondents were adequately counseled. Age groups 37–49 [adjusted odds ratio (AOR) = 2.7; 95% CI: 1.1–6.6], being in marital union (AOR = 2.8; 95% CI: 1.2–6.7), attaining secondary education (AOR = 1.9; 95% CI: 1.1–3.6) or higher education (AOR = 2.2; 95% CI: 1.2–4.3), and visit status (AOR = 1.6; 95% CI: 1.1–2.4) were significantly associated with good counseling.ConclusionLess than one in three women was counseled adequately. Health professionals should give due attention to younger women, single clients, and clients with their first presentation to the health facility. It also indicates that promoting education among Ethiopian women is crucial for a positive outcome of family planning counseling.
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Guo M, Huber‐Krum S, Shah I, Canning D. The Effect of Family Planning Counseling on Incident Pregnancy in Nepal. Stud Fam Plann 2022; 53:315-338. [DOI: 10.1111/sifp.12197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Muqi Guo
- Doctoral Student Department of Global Health and Population, Harvard T.H. Chan School of Public Health Boston USA
| | - Sarah Huber‐Krum
- Research AssociateDepartment of Global Health and Population, Harvard T.H. Chan School of Public Health Boston USA
| | - Iqbal Shah
- Principal Research ScientistDepartment of Global Health and Population, Harvard T.H. Chan School of Public Health Boston USA
| | - David Canning
- Richard Saltonstall Professor of Population Sciences and Professor of Economics and International Health, Department of Global Health and Population Harvard T.H. Chan School of Public Health 655 Huntington Ave Boston, MA 02115 USA
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Byamukama O, Migisha R, Kalyebara PK, Tibaijuka L, Lugobe HM, Ngonzi J, Ahabwe OM, Garcia KRM, Mugyenyi GR, Boatin AA, Muhumuza J, Ssalongo WGM, Kayondo M, Kanyesigye H. Short interbirth interval and associated factors among women with antecedent cesarean deliveries at a tertiary hospital, Southwestern Uganda. BMC Pregnancy Childbirth 2022; 22:268. [PMID: 35354443 PMCID: PMC8969244 DOI: 10.1186/s12884-022-04611-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 03/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Women with previous cesarean deliveries, have a heightened risk of poor maternal and perinatal outcomes, associated with short interbirth intervals. We determined the prevalence of short interbirth interval, and associated factors, among women with antecedent cesarean deliveries who delivered at Mbarara Regional Referral Hospital (MRRH), in southwestern Uganda. METHODS We conducted a cross-sectional study on the postnatal ward of MRRH from November 2020 to February 2021. We enrolled women who had antecedent cesarean deliveries through consecutive sampling. We obtained participants' socio-demographic and obstetric characteristics through interviewer-administered structured questionnaires. We defined short interbirth interval as an interval between two successive births of < 33 months. Modified Poisson regression was used to identify factors associated with short interbirth intervals. RESULTS Of 440 participants enrolled, most had used postpartum family planning (PPFP) prior to the current pregnancy (67.5%), and most of the pregnancies (57.2%) were planned. The mean age of the participants was 27.6 ± 5.0 years. Of the 440 women, 147 had a short interbirth interval, for a prevalence of 33% (95%CI: 29-38%). In multivariable analysis, non-use of PPFP (adjusted prevalence ratio [aPR] = 2.24; 95%CI: 1.57-3.20, P < 0.001), delivery of a still birth at an antecedent delivery (aPR = 3.95; 95%CI: 1.43-10.9, P = 0.008), unplanned pregnancy (aPR = 3.59; 95%CI: 2.35-5.49, P < 0.001), and young maternal age (aPR = 0.25 for < 20 years vs 20-34 years; 95%CI: 0.10-0.64, P = 0.004), were the factors significantly associated with short interbirth interval. CONCLUSION One out of every three womenwith antecedent caesarean delivery had a short interbirth interval. Short interbirth intervals were more common among women with history of still births, those who did not use postpartum family planning methods, and those whose pregnancies were unplanned, compared to their counterparts. Young mothers (< 20 years) were less likely to have short interbirth intervals compared to those who were 20 years or older. Efforts should be made to strengthen and scale up child-spacing programs targeting women with previous cesarean deliveries, given the high frequency of short interbirth intervals in this study population.
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Affiliation(s)
- Onesmus Byamukama
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda.
| | - Richard Migisha
- Department of Physiology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Paul Kato Kalyebara
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Leevan Tibaijuka
- Department of Obstetrics and Gynecology, Mbarara Regional Referral Hospital, Mbarara, Uganda
| | - Henry Mark Lugobe
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Joseph Ngonzi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Onesmus Magezi Ahabwe
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Kenia Raquel Martinez Garcia
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Godfrey R Mugyenyi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Adeline Adwoa Boatin
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, USA
| | - Joy Muhumuza
- Department of Obstetrics and Gynecology, Mbarara Regional Referral Hospital, Mbarara, Uganda
| | - Wasswa G M Ssalongo
- Department of Obstetrics and Gynecology, Mbarara Regional Referral Hospital, Mbarara, Uganda
| | - Musa Kayondo
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Hamson Kanyesigye
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
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