Family planning awareness, utilization and associated factors among women of reproductive age attending psychiatric outpatient care, a cross- sectional study, Addis Ababa, Ethiopia

Zerihun, Tigist; Bekele, Delayehu; Birhanu, Elizabeth; Worku, Yoseph; Deyesa, Negussie; Tesfaye, Markos

doi:10.1371/journal.pone.0238766

Cited by 4 publications

(7 citation statements)

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“…The majority of these (n=13) focused on contraception use [28][40][43][51][53][71][74][75][2][90][94][105][106]. Four studies, which did not include a comparison, reported large proportions of women with SMI had never used contraception, had not used contraception during their most recent sexual experiences and had no intention of using contraception during sexual intercourse [87][109][71][93].…”

Section: Study Focusmentioning

confidence: 99%

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Sexual and Reproductive Health Needs of Women with Severe Mental Illness in Low- and Middle-Income Countries: A Scoping Review

Sisodia,

Hammond,

Leonardi-Bee

et al. 2024

Preprint

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BackgroundThis scoping review aimed to understand the extent and type of evidence in relation to sexual and reproductive health needs of women with severe mental illness (SMI) in low-and middle-income countries (LMIC) and to summarise those needs.MethodsInclusion criteria were 1) focus on sexual and reproductive health needs 2) women or girls with SMI, professionals, caregivers of women with SMI and community members 3) study set in a LMIC 4) peer reviewed literature (no restriction on study date or design). Studies were identified from comprehensive searches of Medline, EMBASE, CINAHL and PsycINFO (to July 2023).ResultsThe review included 100 papers. Most studies were cross-sectional and set in hospital outpatient departments. We identified studies in only 19 of 140 LMIC countries and only 15 studies were set-in low-income countries. Included studies often had multiple focus areas which were grouped into themes of HIV (prevalence, risk behaviour and knowledge), other sexually transmitted infections (STIs), sexual function, contraception use and family planning, sexual violence, fertility, pregnancy and postpartum.Included studies indicated women with SMI have worse outcomes and worse sexual and reproductive health compared to both women without SMI and men with SMI. Women with SMI were shown to have higher rates of HIV and low levels of contraception knowledge and use, with little advice offered by professionals.ConclusionsThis review highlights the need for a greater diversity of study methodology, robustness of ethical and consensual reporting when researching vulnerable populations and for further research on interventions and models of care aimed at addressing stigma, discrimination and improving the sexual and reproductive health of women with SMI. Future research should better represent the breadth of LMIC, investigate cultural adaptability of interventions and consider sexual health needs across the life course.

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Section: Study Focusmentioning

confidence: 99%

“…Fourteen studies focused on pregnancy [23][24][43][46][66][87][88][91][41][92][95][108] [109][110]. Notably, the only two case studies included in this review were based around decision-making during pregnancy in the context of medication and abortion [23][43].…”

Section: Study Focusmentioning

confidence: 99%

Sexual and Reproductive Health Needs of Women with Severe Mental Illness in Low- and Middle-Income Countries: A Scoping Review

Sisodia,

Hammond,

Leonardi-Bee

et al. 2024

Preprint

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“…10 In Ethiopia, half the women with MI used contraception, with 29.7% using oral hormonal contraception, 26.7% using injectables, and 22% using condoms. 11 Fears of drug interactions as well as a lack of knowledge influenced contraception use. 11 Barriers and facilitators to contraceptive use in women and contraceptive preferences in women with MI in the South African context are unknown.…”

Section: Introductionmentioning

confidence: 99%

“… 11 Fears of drug interactions as well as a lack of knowledge influenced contraception use. 11 Barriers and facilitators to contraceptive use in women and contraceptive preferences in women with MI in the South African context are unknown.…”

Section: Introductionmentioning

confidence: 99%

Contraceptive use in women with mental illness in Soweto, South Africa

Galvin,

Nel

2024

South African Journal of Psychiatry

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Background: The psychosocial and medical implications of unplanned pregnancy in women with mental illness (MI) are vast. International guidelines make clear recommendations about family planning for women with MI, particularly those exposed to known human teratogens; however, there is limited research related to contraceptive usage among women with MI.Aim: The aim of this study was to investigate the prevalence of consistent contraceptive use and family planning education (FPE) among a population of women of childbearing age with MI.Setting: This quantitative cross-sectional study was conducted at Chris Hani Baragwanath psychiatric unit in Soweto, South Africa.Methods: A convenience sample comprising 190 eligible women of childbearing age with MI was employed for the study. The women were invited to participate by means of a structured questionnaire which was administered by the researcher. Clinical information was obtained from the patients’ medical records.Results: Consistent contraceptive usage occurred in 44.7% of participants. Family planning education was low (26.8%). Relationship status was associated with using contraception consistently (p = 0.0229). Teratogen exposure was not associated with either contraceptive use or FPE. Family planning education was not associated with contraceptive use.Conclusion: Women with MI may have increased risk for unplanned pregnancy if they are not in a relationship because of perceived lack of need for contraception.Contribution: Family planning education must be prioritised in women with MI, especially among women prescribed teratogenic medication, highlighting the risks associated with unplanned pregnancy.

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“…Although Ethiopia has rigorous evidence on the prevalence of SMI from community studies (1.3%; 37.8% women), the impact of SMI on family planning has not been investigated in a comparative study [ 27 ]. In a study of women attending psychiatric outpatient care in Addis Ababa, Ethiopia's capital, only 68% of women with SMI were able to mention one family planning method and 38% of women expressed a low intention to use family planning in the future [ 28 ]. This is substantially lower than findings from a community study in the general population where 100% of women were aware of family planning methods, and 88% expressed favourable attitudes to using family planning [ 29 ] .…”

Section: Introductionmentioning

confidence: 99%

Family planning for women with severe mental illness in rural Ethiopia: a qualitative study

2021

Self Cite

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Background Family planning is a crucial issue for all women of reproductive age, but in women with severe mental illness (SMI), there may be particular challenges and concerns. As primary care-based mental health services are expanding in low- and middle-income countries (LMICs), there is an opportunity to improve family planning services for women with SMI. However, research exploring unmet family planning needs of women with SMI in such settings is scarce. Therefore, the present study explored the family planning experiences and preferences of women with SMI who reside in a predominantly rural area of Ethiopia. Methods A qualitative study was conducted. Women with SMI who were participating in the ongoing population-based cohort study in Butajira were selected purposively based on their responses to a quantitative survey of current family planning utilisation. In-depth interviews were conducted with 16 women with SMI who were of reproductive age. Audio files were transcribed in Amharic, translated into English and analysed thematically. Results Participants reported pervasive effects of SMI upon the intimate relationships and sexual lives of women. Although women with SMI felt that family planning was important, they had limited knowledge of family planning generally, and a lack of understanding of the specific family planning needs relevant to having SMI. None of the women with SMI in the present study had received any recommendations to use family planning services while accessing mental health care services. The participants identified ways in which primary care-based mental health services could better meet their family planning needs. Conclusions This study provided in-depth perspectives from women with SMI about the broader context of their family planning experience, needs, barriers and how integrated primary care services could better meet their needs. Empowerment of women with SMI to access information and services needs to be an important focus of future efforts to improve the reproductive experiences of this vulnerable group.

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Family planning awareness, utilization and associated factors among women of reproductive age attending psychiatric outpatient care, a cross- sectional study, Addis Ababa, Ethiopia

Cited by 4 publications

References 25 publications

Sexual and Reproductive Health Needs of Women with Severe Mental Illness in Low- and Middle-Income Countries: A Scoping Review

Sexual and Reproductive Health Needs of Women with Severe Mental Illness in Low- and Middle-Income Countries: A Scoping Review

Contraceptive use in women with mental illness in Soweto, South Africa

Family planning for women with severe mental illness in rural Ethiopia: a qualitative study

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