Determinants of immediate family planning utilization among postpartum women in Northwestern Ethiopia

Solomon A. Adete, RM Mmusi-Phetoe

Abstract

Immediate postpartum family planning is the initiation of contraception within 48 hours after delivery and is a critical intervention for preventing unintended pregnancies and reducing short inter-birth intervals. Despite its importance, utilization remains low in many parts of Ethiopia. This study aimed to determine the magnitude of immediate postpartum family planning and identify its determinants among postpartum women in public health facilities of Assosa Zone, Northwestern Ethiopia. An institutional-based cross-sectional study was conducted from January to March 2022 among 564 postpartum women who gave birth in the nine months preceding the survey in selected public health facilities. Data were collected through face-to-face interviews using a structured questionnaire. Logistic regression was used to identify factors associated with immediate postpartum family planning utilization. Only 142(25.2%) postpartum women used immediate postpartum family planning services. Rural residence, being merchants, students, and daily laborers, having partner support, attending four or more antenatal care visits, receiving postnatal care services at the hospital or health centers, and receiving postpartum family planning counselling were significantly associated with higher utilization of immediate postpartum family planning services. The strongest predictors were partner support and receiving postnatal care at a health facility. The utilization of immediate postpartum family planning was low in the study area. Strengthening high quality, client-centered counselling during critical maternal care continuum periods, along with active partner involvement is essential to improve uptake and contribute to better maternal and child health outcomes

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References

World Health Organization. Programming strategies for postpartum family planning. 2013. From https://apps.who.int/iris/bitstream/handle/10665/93680/9789241506496_eng.pdf (Accessed May 13, 2023)

Gaffield ME, Egan S and Temmerman M. It's about time: WHO and partners release programming strategies for postpartum family planning. Global Health: Science and Practice. 2014;2(1):4-9.

Darroch JE, Sully E and Biddlecom A. Adding it up: investing in contraception and maternal and newborn health, 2017—supplementary tables. New York, NY: The Guttmacher Institute. 2017.

Sridhar A and Salcedo J. Optimizing maternal and neonatal outcomes with postpartum contraception: impact on breastfeeding and birth spacing. Maternal health, neonatology and perinatology. 2017; 3:1-0.

World Health Organization. Report of a WHO technical consultation on birth spacing: Geneva, Switzerland 13-15 June 2005. World Health Organization; 2007.

Seiber EE, Bertrand JT and Sullivan TM. Changes in contraceptive method mix in developing countries. International family planning perspectives. 2007; 117-23.

Ross JA and Winfrey WL. Contraceptive use, intention to use and unmet need during the extended postpartum period. International family planning perspectives. 2001; 20-7.

Royal College of Obstetricians and Gynaecologists. Best practice in postpartum family planning. London, UK: Royal College of Obstetricians and Gynaecologists. 2015; 2-7.

Chethan R, Anitha GS and Savitha C. Study on postpartum intrauterine contraceptive device practices and causes for discontinuation of PPIUCD at follow up in a tertiary hospital. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2018; 7(6):2299-304.

Arero W, Teka W and Jarso H. Prevalence, and pattern of LAFP use in immediate postpartum period at Jimma University Medical Center, Ethiopia [18f]. Obstetrics and Gynecology. 2018; 131:68S.

Thompson EL, Vamos CA, Logan RG, Bronson EA, Detman LA, Piepenbrink R, Daley EM and Sappenfield WM. Patients and providers’ knowledge, attitudes, and beliefs regarding immediate postpartum long-acting reversible contraception: a systematic review. Women and Health. 2020; 60(2):179-96.

Silesh M, Lemma T, Abdu S, Fenta B, Tadese M and Taye BT. Utilisation of immediate postpartum family planning among postpartum women at public hospitals of North Shoa Zone, Ethiopia: a cross-sectional study. BMJ open. 2022;12(2):e051152.

Federal Democratic Republic of Ethiopia Ministry of Health. National guideline for family planning services in Ethiopia. Third edition. Addis Ababa. 2020.

Central Statistical Agency (CSA) [Ethiopia] and ICF. 2016 Ethiopia demographic and health survey key findings. CSA and ICF. 2017.

EPHI and ICF. Ethiopia mini demographic and health survey 2019: Key indicators. Rockville, Maryland, USA: EPHI and ICF. 2019.

Rossier C and Hellen J. Traditional birth spacing practices and uptake of family planning during the postpartum period in Ouagadougou: qualitative results. International perspectives on sexual and reproductive health. 2014; 40(2):87-94.

Borda MR, Winfrey W and McKaig C. Return to sexual activity and modern family planning use in the extended postpartum period: an analysis of findings from seventeen countries. African journal of reproductive health. 2010; 14(4).

Benishangul Gumuz Regional Health Bureau. Woreda base plan. Asosa, Ethiopia: BG RHB. In press 2020.

Abraha TH, Teferra AS and Gelagay AA. Postpartum modern contraceptive use in northern Ethiopia: prevalence and associated factors. Epidemiology and health. 2017; 39.

Pasha O, Goudar SS, Patel A, Garces A, Esamai F, Chomba E, Moore JL, Kodkany BS, Saleem S, Derman RJ and Liechty EA. Postpartum contraceptive use and unmet need for family planning in five low-income countries. Reproductive health. 2015; 12(2):1-7.

Abbasi Y, Shaikh SR and Memon KN. Barriers and missed opportunities towards immediate and early post-partum family planning methods in Pakistan. The Professional Medical Journal. 2020; 27(07):1448-53.

Demissie DB and Dadi HW. Immediate postpartum modern family planning utilization and associated factors among women gave birth public health facilities, Addis Ababa. Res. Sq. 2021.

Tefera LB, Abera M, Fikru C and Tesfaye DJ. Utilization of immediate post-partum intra uterine contraceptive device and associated factors: a facility based cross sectional study among mothers delivered at public health facilities of Sidama Zone, South Ethiopia. J Preg Child Health. 2017; 4(3):1000326.

Jima GH and Garbaba WB. Postpartum family planning utilization and associated factors among women who gave birth in the last 12 months prior to the study in lode Hetosa district, South East Ethiopia. J Women’s Heal Care. 2020; 9(3).

DeSisto CL, Handler A, Haider S, Caskey R, Peacock N, Kottke M and Rankin K. Women’s informed choice and satisfaction with immediate postpartum long-acting reversible contraception in Georgia. Contraception and reproductive medicine. 2018; 3:1-0.

Shabiby MM, Karanja JG, Odawa F, Kosgei R, Kibore MW, Kiarie JN and Kinuthia J. Factors influencing uptake of contraceptive implants in the immediate postpartum period among HIV infected and uninfected women at two Kenyan District Hospitals. BMC women's health. 2015; 15:1-8.

Belay L and Birara M. Factors affecting long-term and permanent contraceptive uptake among immediate post-partum mothers at Saint Paul’s Hospital millennium medical college, Addis Ababa, Ethiopia: a cross-sectional study. Ethiopian Journal of Reproductive Health. 2018; 10(2):11-.

Kaydor VK, Adeoye IA, Olowolafe TA and Adekunle AO. Barriers to acceptance of post-partum family planning among women in Montserrado County, Liberia. Nigerian Postgraduate Medical Journal. 2018; 25(3):143-8.

Bekele D, Surur F, Nigatu B, Teklu A, Getinet T, Kassa M, Gebremedhin M, Gebremichael B and Abesha Y. Knowledge and attitude towards family planning among women of reproductive age in emerging regions of Ethiopia. Journal of Multidisciplinary Healthcare. 2020; 1463-74.

Sedlander E, Bingenheimer JB, Thiongo M, Gichangi P, Rimal RN, Edberg M and Munar W. “They destroy the reproductive system”: exploring the belief that modern contraceptive use causes infertility. Studies in family planning. 2018; 49(4):345-65.

Nugussa B, Solomon T and Tadelu H. Modern Postpartum Family Planning and Associated Factors Among Postpartum Women in a Rural District of Ethiopia, 2021: A Cross-Sectional Study. INQUIRY: The Journal of Health Care Organization, Provision, and Financing. 2023; 60:00469580231153268.

Yemane TT, Bogale GG, Egata G and Tefera TK. Postpartum family planning use and its determinants among women of the reproductive age group in low-income countries of Sub-Saharan Africa: a systematic review and meta-analysis. International Journal of Reproductive Medicine. 2021; 2021.

Mengesha ZB, Worku AG and Feleke SA. Contraceptive adoption in the extended postpartum period is low in Northwest Ethiopia. BMC pregnancy and childbirth. 2015; 15:1-6.

Tilahun T, Bekuma TT, Getachew M, Oljira R and Seme A. Barriers and determinants of postpartum family planning uptake among postpartum women in Western Ethiopia: a facility-based cross-sectional study. Archives of Public Health. 2022; 80(1):1-1.

Zimmerman LA, Yi Y, Yihdego M, Abrha S, Shiferaw S, Seme A and Ahmed S. Effect of integrating maternal health services and family planning services on postpartum family planning behavior in Ethiopia: results from a longitudinal survey. BMC Public Health. 2019; 19(1):1-9.

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