Prevalence of Postpartum Family Planning Service Coverage in Selected Referral Facilities of Nepal

Abstract

Introduction: Nepal Society of Obstetricians and Gynecologists jointly with the Nepalese governmentand with the support from the International Federation of Obstetrics and Gynecology hasimplemented an initiative to institutionalize postpartum family planning services in selected majorreferral facilities of Nepal to address the gap of low uptake of postpartum family planning in Nepal.The aim of the study is to find the prevalence of the service coverage of postpartum contraception inthe selected facilities.
 Methods: A descriptive cross-sectional study was conducted in seven major referral facilities acrossNepal. Data were collected from the hospital records of all women who delivered in these facilitiesbetween October 2018 and March 2019. Ethical approval for this study was obtained from NepalHealth Research Council. Data analysis was done with SPSS version 23.
 Results: Among the 29,072 deliveries from all the facilities, postpartum family planning counselingcoverage was 27,301 (93.9%). The prevalence of uptake of Postpartum Intrauterine Device is 1581(5.4%) and female sterilization is 1830 (6.3%). In total 11387 mothers (52.2%) had the intention tochoose a postpartum family planning method. However, 36% of mothers neither used nor had theintention to choose a postpartum family planning method.
 Conclusions: The coverage of Postpartum Intrauterine Device counseling service coverage in Nepal ishigher in 2018 as compared to 2016-2017 and in other countries implementing Postpartum IntrauterineDevice initiatives. However, the prevalence of service coverage of immediate Postpartum FamilyPlanning methods, mainly Postpartum Intrauterine Device in 2018 is lower in Nepal as compared to2016-2017, and other countries implementing Postpartum Intrauterine Device initiative. More effortsare needed to encourage mothers delivering in the facilities to use the postpartum family planningmethod.

Evaluating the impact of female community health volunteer involvement in a postpartum family planning intervention in Nepal: A mixed-methods study at one-year post-intervention

“…Postpartum family planning is the family planning method available for women for the first 12 months of the postpartum period [ 4 ]. The family planning methods available after six weeks of childbirth in Nepal for breastfeeding mothers include progesterone-only contraceptives such as oral contraceptive pills, implants, and injectable, non-hormonal methods such as copper intrauterine device (IUD), and female sterilization [ 5 ]. The options available for men include condoms and male sterilization throughout the women’s postpartum period [ 5 ].…”

“…The family planning methods available after six weeks of childbirth in Nepal for breastfeeding mothers include progesterone-only contraceptives such as oral contraceptive pills, implants, and injectable, non-hormonal methods such as copper intrauterine device (IUD), and female sterilization [ 5 ]. The options available for men include condoms and male sterilization throughout the women’s postpartum period [ 5 ]. The contraceptive methods available only six weeks after childbirth limit the choices for women who may resume their sexual activities sooner, and the options available for their male partners might not be reliable when women lack autonomy [ 5 , 6 ].…”

“…The options available for men include condoms and male sterilization throughout the women’s postpartum period [ 5 ]. The contraceptive methods available only six weeks after childbirth limit the choices for women who may resume their sexual activities sooner, and the options available for their male partners might not be reliable when women lack autonomy [ 5 , 6 ]. Moreover, for a country with low postnatal care coverage, it limits women’s options for family planning, especially when the women are less likely to return to the facilities [ 1 ].…”

“…Moreover, for a country with low postnatal care coverage, it limits women’s options for family planning, especially when the women are less likely to return to the facilities [ 1 ]. Therefore, postpartum family planning options available immediately after childbirth provide a one-stop solution for those giving birth in the health facilities [ 1 , 5 , 6 ]. The immediate postpartum family planning services available for women in Nepal include female sterilization and postpartum IUD (PPIUD) [ 5 ].…”

Evaluating the long-term impact of Female Community Health Volunteer involvement in a postpartum family planning intervention in Nepal: a mixed-method study at 1 year post-intervention

“…The intervention for FCHV was conducted for the rst time in Nepal in December 2018 as a pilot in Morang district [6]. This intervention was part of a larger PPFP/PPIUD project that was implemented between 2015 and 2019 in different referral hospitals across Nepal [6,[9][10][11]. The FCHV intervention was conducted towards the end of the project, running for six months, between December 2018 and June…”