Family Planning in Pakistan

Corsa, Leslie

doi:10.2105/ajph.55.3.400

Cited by 12 publications

(7 citation statements)

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“…LARC usage has increased only modestly over the past decade in Pakistan, from 2.1-3% [12][13][14] . Such low uptake of LARCs appears somewhat puzzling in the context of high awareness of modern methods and LARC methods being made available through public sector facilities at subsidized costs 15,16 . This level of use is lower than in other areas of South East Asia, particularly neighboring Iran, where LARC methods are used by 8% of contraceptive users 17 .…”

Section: Introductionmentioning

confidence: 99%

Role of Social Network in Decision Making for Increasing Uptake and Continuing Use of Long Acting Reversible (LARC) Methods in Pakistan

Sarfraz

Hamid

Rawstorne

et al. 2020

Preprint

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Background: Despite evidence from recent Demographic Health Surveys that show 98% of the adult Pakistani population have an awareness of at least one modern contraceptive method, only 25% of married couples in Pakistan used a modern method of contraception. Of the modern contraceptive methods, LARC usage has increased only, from 2.1% to 3%. This low uptake is puzzling in the context of high awareness of LARC methods and its availability through public sector facilities at subsidized costs. This study aimed to understand the social influences in initiating and continuing use of an LARC methods for contraception in a rural setting in Pakistan.Methods: In-depth interviews were conducted with 27 women who were using a LARC method for contraception. Data was managed using NVivo 12 and themes were identified using a comparative content analysis approach to analyze the transcripts.Results: Four key themes, supported by sub-themes relating to a temporal model, was identified to explain women’s experiences with initiating and continuing use of a LARC. The themes were (i) Use of trusted networks for information on LARCs; (ii) Personal motivation and family support in decision to use LARC; (iii) Choice of LARC methods and access to providers; and (iv) Social and professional support instrumental in long term use of LARC. Results highlight the significant role of immediate social network of female family members in supporting the women in initiating LARCs and maintaining their use.Conclusion: This study contributes to an in depth understanding of the decision-making process of women who adopted LARC and maintained its use. Women who proceeded to use an LARC and who persisted with its use despite the experience of side effects and social pressures, were able to do so with support from other female family members and spouse.

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Section: Introductionmentioning

confidence: 99%

Role of Social Network in Decision Making for Increasing Uptake and Continuing Use of Long Acting Reversible (LARC) Methods in Pakistan

Sarfraz

Hamid

Rawstorne

et al. 2020

Preprint

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“…The present study looks at private providers' attitudes and practices related to the provision of the IUD. The IUD was first introduced into Pakistan's national family planning program in 1962, with 1,500 insertions being made by the end of 1963 [ 18 ]. Yet, in spite of its early introduction and the large number of insertions that occurred between 1965 and 1970, a much smaller number of women were using the IUD by the mid 1970s [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

“…Use of the IUD was also lower than the use of traditional methods such as rhythm (3.6%) or withdrawal (4.1%) [ 6 ]. Thus, the level of adoption of the IUD has remained much below early expectations of its role as a major contraceptive method that would reduce the birth rate in Pakistan [ 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical training alone is not sufficient for reducing barriers to IUD provision among private providers in Pakistan

Agha

Fareed²,

Keating

2011

Reprod Health

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BackgroundIUD uptake remains low in Pakistan, in spite of three major efforts to introduce the IUD since the 1960s, the most recent of these being through the private sector. This study examines barriers to IUD recommendation and provision among private providers in Pakistan.MethodsA facility-based survey was conducted among randomly selected private providers who were members of the Greenstar network and among similar providers located within 2 Kilometers. In total, 566 providers were interviewed in 54 districts of Pakistan.Logistic regression analysis was conducted to determine whether correct knowledge regarding the IUD, self-confidence in being able to insert the IUD, attitudes towards suitability of candidates for the IUD and medical safety concerns were influenced by provider type (physician vs. Lady Health Visitor), whether the provider had received clinical training in IUD insertion in the last three years, membership of the Greenstar network and experience in IUD insertion. OLS regression was used to identify predictors of provider productivity (measured by IUD insertions conducted in the month before the survey).ResultsPrivate providers consider women with children and in their peak reproductive years to be ideal candidates for the IUD. Women below age 19, above age 40 and nulliparous women are not considered suitable IUD candidates. Provider concerns about medical safety, side-effects and client satisfaction associated with the IUD are substantial. Providers' experience in terms of the number of IUDs inserted in their careers, appears to improve knowledge, self-confidence in the ability provide the IUD and to lower age-related attitudinal barriers towards IUD recommendation. Physicians have greater medical safety concerns about the IUD than Lady Health Visitors. Clinical training does not have a consistent positive effect on lowering barriers to IUD recommendation. Membership of the Greenstar network also has little effect on lowering these barriers. Providers' barriers to IUD recommendation significantly lower their monthly IUD insertions.ConclusionsTechnical training interventions do not reduce providers' attitudinal barriers towards IUD provision. Formative research is needed to better understand reasons for the high levels of provider barriers to IUD provision. "Non-training" interventions should be designed to lower these barriers.

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“…A number of affordable modern contraceptive methods can be used to achieve fertility goals. 1 Pakistan, the sixth most populous country in the world with a total fertility rate of 3.6 children per woman, 2 was among the first Asian countries to implement a national programme for FP, 3,4 and has since strived to achieve an increase in contraceptive prevalence rate (CPR). To ensure that more women and girls are able to plan their families, Pakistan recently pledged to increase its CPR to 50% to contribute towards the 2020 Family Planning commitments, 5 and announced a 30% increase (total of US$197.7 million) in annual public spending for FP services.…”

mentioning

confidence: 99%

The family planning “know–do” gap among married women of reproductive age in urban Pakistan

Yameen

Nausheen

Hussain

et al. 2021

public health action

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OBJECTIVE: To examine the prevalence and predictors of family planning (FP) know-do gaps among married women of reproductive age (MWRA) in low socio-economic urban areas of Karachi, Pakistan.DESIGN: This was a cross-sectional survey of randomly selected 7288 MWRA (16–49 years) to identify predictors of the know-do gap in FP using a logistic regression model.RESULTS: More than one third (35.5%) of MWRA had FP know-do gap, i.e., despite having a knowledge of contraceptives and desire to limit or delay childbearing, they were not using contraceptives. Women were less likely to use FP if they were getting older (25–35 years: OR 1.45, 95% CI 1.09–1.94; >35 years: OR 3.02, 95% CI 1.90–4.80), from certain ethnicities (Sindhi: OR 1.64, 95% CI 1.11–2.42; Saraiki: OR 1.66, 95% CI 1.01–2.71; other minorities: OR 2.37, 95% CI 1.63–3.44); did not receive FP counselling: OR 1.43, 95% CI 1.13–1.80; and had not made a joint decision on FP: OR 1.44, 95% CI 1.06–1.98). Conversely, women were more likely to use contraceptives if they had >10 years of schooling (OR 0.66, 95% CI 0.46–0.94), with each increasing number of a living child (OR 0.68, 95% CI 0.62–0.75) and each increasing number of contraceptive method known (OR 0.93, 95% CI 0.88–0.98).CONCLUSION: The predictors associated with the FP know-do gap among MWRA should be considered when planning future strategies to improve the contraceptive prevalence rate in Pakistan.

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Family Planning in Pakistan

Cited by 12 publications

References 0 publications

Role of Social Network in Decision Making for Increasing Uptake and Continuing Use of Long Acting Reversible (LARC) Methods in Pakistan

Role of Social Network in Decision Making for Increasing Uptake and Continuing Use of Long Acting Reversible (LARC) Methods in Pakistan

Clinical training alone is not sufficient for reducing barriers to IUD provision among private providers in Pakistan

The family planning “know–do” gap among married women of reproductive age in urban Pakistan

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