Barriers to contraceptive use in South Tarawa, Kiribati

2016 ◽  
Vol 1 (4) ◽  
Author(s):  
Jacob Daube ◽  
Viktoria Chamberman ◽  
Eliza Raymond

<p><strong>Background</strong>: Improving access to family planning in the Pacific region has been slow, especially for those living in remote and rural areas. Pacific countries consistently report contraceptive prevalence rates well below the United Nations’ global averages for ‘less developed’ regions.  The most recent data available on family planning usage in Kiribati from 2009 reported that the modern contraceptive prevalence rate was just 18.0% and total contraceptive prevalence rate just 22.3%.</p><div><p>The aim of the study was to investigate knowledge and use of family planning and identify barriers to contraceptive uptake for men and women of reproductive age in South Tarawa, Kiribati, to inform future approaches aimed at increasing access to family planning.</p><p><strong>Methods:</strong> A mixed methods approach was used. A community survey of men and women of reproductive age (15-49 years) (n=500) was carried out to identify current levels of knowledge, contraceptive use and barriers to use. Focus groups (n=4) of target populations (men 15-24, men 25-49, women 15-24, women 25-49) were undertaken and in-depth interviews (n=14) were conducted with health professionals and government officials to interpret survey results, further investigate barriers and generate ideas for improving service delivery.</p><p><strong>Findings:</strong> Considerable barriers to family planning use were observed in the community survey and explored in the interviews and focus groups. They can be categorised into four thematic groups: disinterest in family planning; knowledge gaps; personal, family and social objections; and unsuitable service delivery.<strong><em></em></strong></p></div><p><strong>Conclusion:</strong> A broad range of solutions were identified and fourteen service delivery recommendations were made for family planning service providers in South Tarawa. The recommendations may also hold relevance to other Pacific countries, however we encourage service providers to consider their country context before initiating any recommendations provided in this study. </p>

2018 ◽  
Vol 8 (2) ◽  
pp. 63-69
Author(s):  
Khola Noreen ◽  
Kausar Aftab Khan ◽  
Naeem Khan ◽  
Shahzad Ali Khan ◽  
Nadia Khalid

Background: Family planning includes knowledge, services, attitude, policies and practices which enable individuals to decide whether they want to have child and allow them to avoid unwanted pregnancy. Pakistan with population of 195.390 million with estimated population growth rate as 1.89 is the sixth most populous country in the world. Our objectives were to assess the total demand of family planning, contraceptive prevalence rate, unmet need for family planning and factors associated with unmet need of family planning among women of reproductive age group. Methods: We conducted this cross-sectional study on 355 females of reproductive age attending the out-patient department as patient or attendant. Data were collected using structured questionnaire after the participants' verbal consent. Results: The prevalence of unmet need was 34%. The proportion of unmet need for spacing was 63.6% and for limiters it was found to be 36.3%. Contraceptive prevalence rate was 57%. Total demand for family planning was 92.1%.Almost all study participant had knowledge regarding at least one method of contraception. Unmet need of family planning was found to be significantly associated with age and education status of women. High unmet need was there in women with low education status (p=0.047) and older age group (p=0.003). Main reasons for not using contraceptive was family opposition both family and husband (66.9), and fear of side effects (17.3%). Conclusion: More than one third females had unmet need which strongly points towards the strong influence of various socio demographic factors contributing towards the unmet need.


Author(s):  
Anita Thakur ◽  
Anmol K. Gupta ◽  
Tripti Chauhan ◽  
Nidhi Chauhan

Background: The utilization of family planning services has improved over the decade, but still the SDG’s health target to ensure universal access to sexual and reproductive health care services is yet to be achieved.Methods: A cross-sectional study was undertaken in the rural field practice area of Department of Community Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India, from September to December 2019, with sample size of 316. The eligible participants were administered a predesigned, pretested, semi-structured and anonymous interview schedule after taking consent.Results: The mean age of the participants was 30.2±6.1 years. The modern contraceptive prevalence rate (mCPR) was found to be 67.7% among women of reproductive age group 15-49 years. Male condom 36%, followed by female sterilization 30% were the most common methods preferred.Conclusions: Besides male condoms and female sterilisation, other methods of contraception were adopted by meagre number of women. Though, the unmet need for family planning was lesser in this study, still, efforts are needed to plunge it, for ameliorating the contraceptive prevalence rate. Also, the availability of basket of contraceptive choices in government sector need sheer assiduity.


2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Delayehu Bekele ◽  
Feiruz Surur ◽  
Balkachew Nigatu ◽  
Alula Teklu ◽  
Tewodros Getinet ◽  
...  

Abstract Background Ethiopia is the second most populous country in Africa, known for its high fertility and low contraceptive use. The magnitude of contraceptive use in the emerging regions of the country is below the national average. However, there is a paucity of evidence regarding the reasons for low contraceptive use in these regions. Therefore, this study aimed to assess contraceptive use and associated factors in the emerging regions of Ethiopia. Methods For the quantitative part, a community based cross-sectional study was conducted among 2891 reproductive age women who were selected by multistage sampling technique. Data were collected face to face using an open data kit software, and STATA version 14 was used for data analysis. Frequencies, percentages, summary measures and tables were used to summarize and present the data. Bivariable and multivariable logistic regression analyses were performed to identify factors associated with contraceptive use, by computing odds ratio with 95% confidence interval. Level of significance was considered at p-value < 0.05. For the qualitative part, phenomenological study was conducted among 252 health care workers and community members who were selected purposely. The data were collected by focused group discussions, in-depth interviews and key informant interviews. The data were audio-recorded in the local languages, and then translated to English verbatim. NVivo version 11 was used to analyze the data through a thematic analysis method. Results The overall contraceptive prevalence rate was 22.2%; with 11.7, 38.6, 25.5 and 8.8% for Afar, Benshangul Gumuz, Gambela and Somali Regions, respectively. Age, religion, education, marital status, family size, ideal children, knowledge and attitude were significantly associated with contraceptive use. Additionally, the qualitative study identified three themes as barriers to contraceptive use: individual, health care system and sociocultural factors. Conclusions Contraceptive prevalence rate was low in this study compared to the national average. Age, religion, education, marital status, family size, ideal children, knowledge and attitude were significantly associated with contraceptive use. From the qualitative aspect, individual, health care system and sociocultural factors were identified as barriers to contraceptive use. Therefore, the emerging regions of Ethiopia need special focus in increasing contraceptive use through behavioral influence/change.


2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Violeta Alarcão ◽  
Miodraga Stefanovska-Petkovska ◽  
Ana Virgolino ◽  
Osvaldo Santos ◽  
Sofia Ribeiro ◽  
...  

Abstract Background The existing knowledge on the interplay between reproductive and sexual health, migration and acculturation is recent and inconsistent, particularly on the sociocultural motives and constraints regarding fertility. Therefore, sexual and reproductive health (SRH) surveys are needed to provide accurate and comparable indicators to identify and address SRH inequalities, with specific focus on under researched aspects, such as the interrelation between migration and gender. FEMINA (FErtility, MIgratioN and Acculturation) aims to investigate intersectional SRH inequalities among Cape Verdean immigrant and Portuguese native families and how they impact on fertility in Portugal. This study will use a comprehensive approach exploring simultaneously the components of SRH, namely regarding identities, perceptions and practices of both women and men among lay people and relevant experts and stakeholders. The project has three main goals: 1) to identify social determinants of SRH among Cape Verdean immigrant and Portuguese native men and women of reproductive age; 2) to gain understanding of the diversity of the sexual and reproductive experiences and expectations of Cape Verdean immigrant and Portuguese native men and women of reproductive age, considering the singularities of their migratory, social and family dynamics; and 3) to produce recommendations for policy makers, employers and service providers on how to better address the SRH needs of Portuguese-born and immigrant populations. Methods The study will address these goals using a mixed methods approach, including: a cross-sectional telephone survey with a probabilistic sample of 600 Cape Verdean immigrant and 600 Portuguese native women and men (women aged 18 to 49 and men aged 18 to 54), residents of the Greater Lisbon Area; a qualitative research through in-depth interviews with a subsample of 30 Cape Verdean immigrants and 30 Portuguese native men and women; and a Delphi technique for finding consensus on good practices in SRH for the entire population with a special emphasis on immigrants, namely extra-EU migrants. Discussion Data will be used to produce a comprehensive set of indicators to monitor SRH in Portugal, to foster a greater understanding of its specificities and challenges to policy and decision makers, and to provide targeted recommendations to promote inclusive and migrant sensitive SRH services.


Author(s):  
Nidhi Chauhan ◽  
Saurabh Rattan

Background: The utilization of family planning services has improved over the decade, but still the SDG’s health target to ensure universal access to sexual and reproductive health care services is yet to be achieved, unmet need being one of the  imperative component.Methods: A cross-sectional study was undertaken in the rural field practice area of Department of Community Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India, from July 2018 to June 2019. Total sample size calculated was 316. Random sampling was used to select eligible couple to whom a predesigned, pretested, semi-structured and anonymous interview schedule was administered after taking consent.Results: The mean age of the participants was 30.2±6.1 years. The modern contraceptive prevalence rate (mCPR) was found to be 67.7% among women of reproductive age group (15-49 years). Male condom (36%), followed by female sterilisation (30%) were the most common methods preferred. Unmet need of family planning was found to be 10.4%.Conclusions: Besides male condoms and female sterilisation, other methods of contraception were adopted by meagre number of women. Though, the unmet need for family planning was lesser in this study, still, efforts are needed to plunge it, for ameliorating the contraceptive prevalence rate. Also, the availability of basket of contraceptive choices in government sector need sheer assiduity.


2014 ◽  
Vol 9 (4) ◽  
pp. 24-29
Author(s):  
N Bhandari ◽  
GK Shrestha ◽  
PC Thakuri

Background The use of contraception can prevent pregnancies related complication and helps in improving the women’s health and quality of their lives. Objective To explore reproductive characteristics among married women of reproductive age. To find out method of contraceptive use and side effects among married women of reproductive age. To uncover factors related to contraceptive use among married women of reproductive age. Methods This cross-sectional was carried out among (369) married couples of reproductive age group in ward number 5, 6 and 7 of Dhulikhel Municipality using purposive sampling. Those who fell in between the age group of (14-49 years) and willing to participate were included and pregnant women were excluded from the study. Questionnaire was used to obtain informations. Results Among 369(81.3%) of the respondents of reproductive age were using a modern contraceptive method. Regarding education 331(89.5%) of women’s and 352(95.1%) of husbands were literate and 275(91.6%) of women were found to be involved in decision making and had good inter-spousal communication that is 280(93.3%). Among the temporary method of family planning, Depo-Provera was the choice 150(54.5%) of contraceptive method. Conclusion The present study put more emphasis on increase in women’s literacy, women’s involvement in decision making and inter-spousal communication which helps to promote the effective use of contraceptive methods. As women play an important role in the decision making, women should be included in all aspects of reproductive health and family planning programs. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-4, 24-29 DOI: http://dx.doi.org/10.3126/jcmsn.v9i4.10233


2021 ◽  
Vol 4 ◽  
pp. 160
Author(s):  
Kristin Bietsch ◽  
Ali Arbaji ◽  
Jennifer Mason ◽  
Rebecca Rosenberg ◽  
Malak Al Ouri

Background: Between the two most recent Population and Family Health Surveys, Jordan saw a dramatic decline in the Total Fertility Rate (TFR) from 3.5 to 2.7 in 5.5 years.  Over the same period, modern contraceptive use also declined, from 61.2% to 51.8% among married women.  This decrease in both TFR and the contraceptive prevalence rate (CPR) diverges from the typical relationship seen between these two factors whereby historically as CPR increases, TFR decreases.  This paper explores this unique pattern using multiple methodologies.  Methods: First, we validate the survey data using nationally collected data on fertility and contraceptive distribution.  Second, we look to changes that have historically influenced changes in CPR and TFR, including changes in ideal family size and wanted fertility rates. Third, we explore proximate determinants and other influences on fertility and changes in contraception, examining the changes in the method mix and unmet need; marriage patterns, including the demographics of the married population, spousal separation, and time since last sex; postpartum insusceptibility; infecundity, both primary and secondary; and abortion, to see if any have shifted significantly enough to allow for fertility to decline with less contraceptive use. Results: We find that the decline in fertility in Jordan was driven by a reduction in mistimed or unwanted pregnancies and there was a significant increase in the share of reproductive aged women who are infecund. We also concluded that the changes in fertility and contraceptive use are driven by changes in Jordanian nationals, not by the growing Syrian refugee population. Conclusions: Jordan is not the only country to be experiencing a shift in the typical relationship between CPR and TFR.  Results can inform both future approaches for family planning programs and our expectations regarding what kind of change our family planning investments might buy.


PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0250988
Author(s):  
Caroline Amour ◽  
Rachel N. Manongi ◽  
Michael J. Mahande ◽  
Bilikisu Elewonibi ◽  
Amina Farah ◽  
...  

Introduction Adequate sexual and reproductive health information is vital to women of reproductive age (WRA) 15 to 49 years, for making informed choices on their reproductive health including family planning (FP). However, many women who interact with the health system continue to miss out this vital service. The study aimed to identify the extent of provision of FP counselling at service delivery points and associated behavioral factors among women of reproductive age in two districts of Arusha region. It also determined the association between receipt of FP counselling and contraceptive usage. Methods Data were drawn from a cross-sectional survey of 5,208 WRA residing in two districts of Arusha region in Tanzania; conducted between January and May 2018. Multistage sampling technique was employed to select the WRA for the face-to-face interviews. FP counseling was defined as receipt of FP information by a woman during any visit at the health facility for antenatal care (ANC), or for post-natal care (PNC). Analyses on receipt of FP counseling were done on 3,116 WRA, aged 16–44 years who were in contact with health facilities in the past two years. A modified Poisson regression model was used to determine the Prevalence Ratio (PR) as a measure of association between receipt of any FP counseling and current use of modern contraception, controlling for potential confounders. Results Among the women that visited the health facility for any health-related visit in the past two years, 1,256 (40%) reported that they received FP counselling. Among the women who had had births in the last 30 months; 1,389 and 1,409 women had contact with the service delivery points for ANC and PNC visits respectively. Of these 31% and 26% had a missed FP counseling at ANC and PNC visit respectively. Women who were not formally employed were more likely to receive FP counselling during facility visit than others. WRA who received any FP counseling at PNC were significantly more likely to report current use of modern contraception than those who did not (adjusted PR [adj. PR] = 1.28; 95% Confidence Interval [CI]: 1.09, 1.49). Conclusion Overall, only 40% women reported that they received any form of FP counseling when they interfaced with the healthcare system in the past two years. Informally employed women were more likely to receive FP counselling, and women who received FP counselling during PNC visits were significantly more likely to use contraceptive in comparison to the women who did not receive FP counselling. This presents a missed opportunity for prevention of unintended pregnancies and suggests a need for further integration of FP counseling into the ANC and PNC visits.


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