Identifying Factors Associated With the Use of a Scaled-Up Postpartum Family Planning Project Implemented in Punjab, Pakistan

Abstract

Pakistan has one of the highest unmet needs for family planning among low and middle-income countries. Postpartum family planning (PPFP) is considered to have the potential of significantly improving the contraceptive prevalence rate and reducing the unmet need for family planning. Jhpiego (John Hopkins Affiliate) implemented a PPFP pilot project in the district headquarter hospital of Mandi Bahauddin. The key interventions of the Jhpiego pilot were to improve services pertinent to PPFP. Based on the successes of the pilot, the interventions were scaled up to other health facilities. The present study aims to identify the factors associated with the utilization of the postpartum family planning health project implemented in the health facilities once the scale-up activities ended and comparing it with the pilot facility. A cross-sectional survey with a sample of 410 women using postpartum care services in the facilities was conducted using a structured questionnaire. The findings indicated that the complete set of interventions were not present in the facilities. Postpartum family planning method uptake was low (26%) along with the shortage of contraceptives supplies. Multivariate logistic regression was conducted to identify the predictors for the current use of postpartum family planning. The predictors identified that women with the age of 25 years and above with 3 or more children, who attended antenatal care visits and were counselled on PPFP were more likely to adopt/use PPFP in the postpartum period. The findings indicated scale-up was limited and the interventions were not sustained once the donor support ended.

Predictors of voluntary uptake of modern contraceptive methods in rural Sindh, Pakistan

“…In addition to this, family planning exposure was seen to be associated with subsequent antenatal care visits, a higher number of deliveries performed by skilled professionals, and a greater chance of delivery at a health facility [ 41 ]. Earlier studies have shown a positive relationship between the delivery of high-quality antenatal family planning counseling services and increased contraceptive use [ 4 , 42 ].…”

Predictors of voluntary uptake of modern contraceptive methods in rural Sindh, Pakistan

“…Another study conducted in a similar setting as our study sites, concluded that in communities where a higher proportion of women received quality antenatal care with an explanation of the importance of postpartum family planning and where discussion of birth spacing was more common, there was significantly higher contraceptive use particularly LARC. [36, 37]. These studies were short-term funded programs highlighting the need for sustainable programs and scaling up existing resources.…”