Youths’ perceptions of community health workers’ delivery of family planning services: a cross-sectional, mixed-methods study in Nakaseke District, Uganda

Background High rates of unintended adolescent pregnancy are a significant health problem in Uganda. To improve access to family planning (FP) services, community-based Village Health Teams (VHTs) are widely employed in Uganda to deliver education and services. However, evaluations of FP programs suggest that mainly older, married women use VHT FP services. Methods To better understand youth reluctance to use VHTs, we collected quantitative FP and contraceptive-seeking behavior data from a survey of 250 youths aged 15–25 in randomly selected households in Nakaseke District, which we triangulated with data from 3 focus group discussions (FGDs) (n = 15). Results Most respondents received FP services from the formal health sector, not VHTs. Only half had talked to a VHT, but 65% knew that VHTs provide free FP services, and most (82%) felt comfortable talking to VHTs about FP. The main reasons for discomfort were fear that VHTs would violate privacy (mentioned by 60% of those not comfortable), that VHTs would talk to parents (33%), shyness (mentioned by 42% of those ≤18), and fear of being judged (14%). Concern about side effects was the most common reason for not using FP methods. Survey respondents said having VHTs of the same sex was important, particularly those in the youngest age group (OR = 4.45; 95%CI: 1.24, 16.00) and those who were unmarried (OR = 5.02; 95%CI: 2.42, 10.39). However, FGD participants (who were older than survey respondents on average) often preferred older VHTs of the opposite sex, whom they viewed as more professional and trustworthy. Respondents said the primary deciding factors for using VHTs were whether privacy would be respected, the proximity of care, and the respectfulness of care. Conclusions VHTs are a known source of FP services but not widely used by youth due to privacy and quality of care concerns. VHT messaging and training should increase focus on ensuring privacy, protecting confidentiality, providing respectful care, and addressing concerns about contraceptive side effects. Preferences for VHTs of similar age and sex may be more important for younger adolescents than older youths for whom quality concerns predominate.

Determinants of unmet need for family planning among married women in Zambia

Unmet need for family planning remains a major family planning problem in most countries around the world. It presents serious consequences for the women, their families and society at large. This study was undertaken to establish the factors that affect total unmet need for family planning and its components in Zambia. This study used the 2013/14 Zambia Demographic Health Survey (ZDHS) dataset focusing on currently married women aged 15 to 49. Data analysis took the form of descriptive, binary logistic and multinomial logistic regressions. The study shows that although there has been a substantial increase in contraceptive use, combined unmet need for family planning has only decreased slightly over time and currently stand at 21%, made up of 14% limiters and 7% spacers. Various factors were identified as determinants of unmet need for spacing, limiting or total unmet need for family planning. These included age, partner’s level of education, contraceptive side effects, husband opposition to contraceptives and number of living children. To enhance utilization, policy should not be blind to the respective factors that influence combined unmet, unmet need for spacing and limiting.

Acceptability and feasibility of a school-based contraceptive clinic in a low-income community in South Africa

AimTo investigate how acceptable and feasible a school-based contraceptive clinic (SBCC) would be in a low-income South African community.BackgroundTeenage pregnancy is an important issue in South Africa, with significant health and social consequences. Issues regarding lack of confidentiality in an intimate community, unwelcoming health workers, long distances to clinics and perceptions of contraceptive side effects may all inhibit contraceptive use by adolescents. Although SBCC has been initiated and investigated in other countries, this approach is inadequately researched in South Africa.MethodsA mixed method study was conducted to assess the attitudes of one community towards establishment of an SBCC in their area. Methods of data collection included: focus group discussions (FGDs) with teenage girls from a local high school; a key informant interview with the school principal; a structured survey, including open-ended questionnaires with randomly selected parents of teenage girls from the same community; and a documentary analysis to explore relevant legal and policy considerations.FindingsTeenage girls, the school principal and parents with teenage daughters largely supported the idea of an SBCC, but with concerns about confidentiality, the possibility of increased promiscuity and contraceptive side effects. While legal statutes and policies in South Africa do not pose any barriers to the establishment of an SBCC, some logistical barriers remain.

Barriers to Pregnancy Spacing in Women Living with HIV: A Series of Informational Interviews

For reproductive-age women living with HIV, birth spacing allows for optimization of maternal health and viral suppression to prevent mother-to-child transmission of HIV. We conducted semi-structured informational interviews to explore use of contraception for birth spacing. Interviews were transcribed and analyzed. Audio files were reviewed to capture non-explicit data. We interviewed 18 multiparous HIV positive women. All described experiences with at least one contraceptive method. Six themes emerged: Burden of contraception, Failure of birth control, Impact of youth and lack of life experience, Community beliefs about birth control, Lack of partner cooperation, and Altruism. Women viewed birth spacing favorably. Young age at first delivery, contraceptive side effects, non-adherence to short-acting methods, lack of partner cooperation, and prior contraceptive failure were identified as barriers to ideal birth spacing. Additional outreach is needed in women living with HIV to overcome barriers to planned pregnancy and birth spacing.

Tingkat Pemahaman Aseptor KB tentang Penggunaan Alat Kontrasepsi Hormonal

The results of interviews conducted on mothers of hormonal contraceptive users in Lapulu Village working area of Abeli Care Center that they do not know what hormonal contraceptives are and do not know about the contraceptive methods they use in terms of Hormonal Contraceptives, Hormonal Contraceptive Advantages and Disadvantages, Indications and Contraindications of hormonal contraceptives. All they know is just how to delay pregnancy so that the distance of pregnancy is not too close to the low cost. This goal is to obtain a general overview of Family Planning Acceptance Knowledge about the use of hormonal contraceptives in Lapulu Village, Abeli Health Centre, Kendari. This type of research is a descriptive study with a sample of 49 people. The results of this study obtained respondents knowledge about the benefits of hormonal contraceptives obtained results as many as 23 people (46.94%) knowledge while knowledge is less than 26 people (53.06%) while respondents' knowledge of hormonal contraceptive side effects was 16 people (32.65%) knowledge is good while knowledge is less than 33 people (67.35%). Catatan PenerbitPolekkes Kemenkes Kendari menyatakan tetap netral sehubungan dengan klaim dari perspektif atau buah pikiran yang diterbitkan dan dari afiliasi institusional manapun.