Utilisation of immediate postpartum family planning among postpartum women at public hospitals of North Shoa Zone, Ethiopia: a cross-sectional study

Silesh, Mulualem; Lemma, Tesfanesh; Abdu, Samuel; Fenta, Belete; Tadese, Mesfin; Taye, Birhan Tsegaw

doi:10.1136/bmjopen-2021-051152

Cited by 11 publications

(18 citation statements)

References 41 publications

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“…As a result, pregnant women with current unintended pregnancy were less likely to receive counselling about FP [ 31 ]. This was in line with the study conducted in Southern Ethiopia [ 22 , 32 , 33 ] where the higher odds of contraceptive utilization were observed among pregnant women with intended pregnancy. This implies that preventing unintended pregnancy could on the other hand increase utilization of postpartum modern contraceptives utilization.…”

Section: Discussionsupporting

confidence: 91%

Time to initiate postpartum modern contraceptives among pregnant women in Ambo Town, Central Ethiopia; Cox-proportional hazard regression analysis

Bekele

Roga

Gonfa

et al. 2022

Contracept Reprod Med

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Background Timing of postpartum family planning is crucial for maternal and child wellbeing by preventing unintended and closely spaced pregnancies. However, studies are limited on the time to use modern contraceptives in Ethiopia. Therefore, this study aimed to fill these gaps by assessing the time to initiate postpartum modern contraceptive and identifying its predictors among pregnant women in Ambo town, central Ethiopia. Methods An institution based cross-sectional study was conducted among 356 pregnant women in Ambo town, Central Ethiopia. The data were analysed using STATA-16 software. Kaplan–Meier estimates were performed to explain time-to- modern contraceptive use. A Cox-proportional hazard regression analysis was conducted to identify predictors. The adjusted hazard ratio (AHR) with a 95% confidence interval was considered to declare a statistically significant association. Results This study showed that the median survival time to initiate postpartum modern contraceptives was 6 months. In this study, the risk of modern contraceptive use was 2.13 times higher (AHR = 2.13; 95% CI: 1.02–4.45) among younger women, 1.44 times higher (AHR = 1.44; 95% CI: 1.09–2.66) among women with no desire for more children, and 2.25 times higher (AHR = 2.25; 95% CI: 1.02–4.95) among nulliparous women. However, it is 57% times lower (AHR = 0.57; 95% CI: 0.32–0.94) among pregnant women with current unintended pregnancy. Conclusion and recommendation The median survival time to initiate postpartum modern contraceptive was 6 months. Age of the women, desire for more children, parity and pregnancy status were found to be the significant predictors of time to initiate postpartum modern contraceptive. Therefore health care providers and concerned stakeholders should consider these factors to increase the uptake of the postpartum contraceptive methods.

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Section: Discussionsupporting

confidence: 91%

Time to initiate postpartum modern contraceptives among pregnant women in Ambo Town, Central Ethiopia; Cox-proportional hazard regression analysis

Bekele

Roga

Gonfa

et al. 2022

Contracept Reprod Med

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“…The prevalence of IPPIUCD utilization in this study was 22.1% (95% CI: 17.3 – 25.2), which was consistent with studies done in North Shoa (21.3%), 20 Sidama, (21.9%), 17 and pooled prevalence in Ethiopia (21.6%). 21 However, it was higher than the studies conducted in Uganda (16.3%), 22 Bale zone (12.4%), 23 Bahir Dar (13.3%), 24 and Debre Tabor (3.3%), Ethiopia.…”

Section: Discussionsupporting

confidence: 90%

Immediate postpartum intrauterine contraceptive device utilization and associated factors among women who gave birth in public health facilities of Adama town, Ethiopia

Aemro¹,

Abdo

Deksisa

et al. 2022

SAGE Open Medicine

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Objectives: The evidence on utilization of immediate postpartum intrauterine contraceptive devices (IPPIUCDs) and its associated factors are limited in Ethiopia. Hence, this study intended to assess IPPIUCD utilization and related factors among women who gave birth in Adama town public hospitals, Ethiopia. Method: A facility-based cross-sectional study was done among 493 postpartum mothers at selected government health facilities in Adama town from January 20 to February 20, 2021. All women who gave birth in selected government health facilities and within 48 h of postpartum were included in the study. Data were collected using an interviewer-administered questionnaire. Logistic regression models were used to identify the factors associated with IPPIUCD utilization. Adjusted odds ratios (AORs) with 95% confidence interval (CI) were calculated to measure the strength of association and statistical significance was declared at p < 0.05. Result: In this study, 22.1% (95% CI: 17.3–25.2) of the mothers used IPPIUCDs within 48 h of giving birth. Having three or more children (AOR = 4.18, 95% CI: 1.79–9.79), having no desire to have another child (AOR = 3.9, 95% CI: 1.86–8.17), counseling after delivery (AOR = 3.1 95% CI: 1.52–6.34), and having good knowledge about PPIUCD (AOR = 3.82, 95% CI: 1.94–7.49) were significantly associated with IPPIUCD utilization. Conclusion: The utilization of IPPIUCD in this study was low. Strategies to raise pregnant mothers’ awareness of IPPIUCD through mass media, and integrating standard counseling on immediate postpartum intrauterine device (IPPIUD) during antenatal care, and the immediate postpartum period are required to improve IPPIUD utilization.

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“…Though the unplanned pregnancy rate is higher in our baseline study compared with a previous study in Ethiopia (68% vs 27.2%), the plan to postpone pregnancy beyond 2 years is more or less similar (95% vs 84%). 28 According to this study the reasons why the immediate postpartum women did not use LARCs were fear of side effects in 26.9%, husband disapproval in 20.6% and taking after 6 weeks of delivery in 17.5% which is also similar to the previous study in Ethiopia. 28 Intervening in those identified gaps, through CQI; training the healthcare providers about the facts and benefits of LARCs to improve their skills in both counselling's and providing the method, availing IUD and Implants at the points of care, mobilising the hospital quality improvement teams and weekly audit and feedback, our intervention gradually increased the percentage of women using immediate postpartum LARCs at JUMC from 6.9% to 25.37% over 8 weeks.…”

Section: Discussionsupporting

confidence: 84%

“…28 According to this study the reasons why the immediate postpartum women did not use LARCs were fear of side effects in 26.9%, husband disapproval in 20.6% and taking after 6 weeks of delivery in 17.5% which is also similar to the previous study in Ethiopia. 28 Intervening in those identified gaps, through CQI; training the healthcare providers about the facts and benefits of LARCs to improve their skills in both counselling's and providing the method, availing IUD and Implants at the points of care, mobilising the hospital quality improvement teams and weekly audit and feedback, our intervention gradually increased the percentage of women using immediate postpartum LARCs at JUMC from 6.9% to 25.37% over 8 weeks. This has an important role in reducing the high maternal mortality rate in the country by preventing unplanned pregnancies, which is one of the big challenges of the hospital.…”

Section: Discussionsupporting

confidence: 84%

“…Our finding is similar with the recent study from Ethiopia about the proportions of LARCs methods use but low with regard to the immediate postpartum LARCs use, which is 21.3%. 28 Low utilisation of LARCs is also reported by the United Nations which showed, that only 15.5% of women worldwide use IUDs, and only 3.4% use subdermal implants. The common reasons for low uptake include misperceptions about the safety and efficacy of LARCs, perceived lack of consumer demand, inadequately trained providers and the relative complexity of providing LARCs compared with short-acting methods.…”

Section: Discussionmentioning

confidence: 91%

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Continuous quality improvement strategy for increasing immediate postpartum long-acting reversible contraceptive use at Jimma University Medical Center, Jimma, Ethiopia

et al. 2023

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BackgroundEven though the immediate postpartum period is a golden time and a great opportunity to provide long-acting reversible contraceptives to prevent unintended pregnancy, its utilisation is very low in Ethiopia. Quality of care in postpartum long-acting reversible contraceptive provision is thought to be an issue for this low utilisation. Thus, continuous quality improvement intervention is necessary to increase the use of postpartum long-acting reversible contraceptives at Jimma University Medical Center.MethodA quality improvement intervention to offer long-acting reversible contraceptive methods to immediate postpartum women at Jimma University Medical Center was initiated in June 2019. To study the baseline prevalence of long-acting reversible contraceptive use at Jimma Medical Centre over 8 weeks, we reviewed postpartum family planning registration logbooks and patients’ charts. Based on the baseline data, the quality gaps were identified, prioritised and change ideas were generated and tested over another 8 weeks towards achieving the immediate postpartum long-acting reversible contraceptive prevalence target set.ResultThis new intervention resulted in an average increase in immediate postpartum long-acting reversible contraceptive methods use from 6.9% to 25.4% by the end of the project intervention. The major barriers to low long-acting reversible contraceptive use were lack of attention from hospital administrative staff and quality improvement teams on the provision of long-acting reversible contraceptives, lack of training of healthcare providers on postpartum contraception and unavailability of contraception commodities at each postpartum service delivery points.Conclusion and recommendationsThe immediate postpartum long-acting reversible contraceptive use at Jimma Medical Centre was increased by training of healthcare providers, availing contraception commodities through administrative staff involvement, weekly audit and feedback on contraception use. Thus, training of the newly hired healthcare providers on postpartum contraception, involvement of hospital administrative staff, regular audits and feedback on contraception use is necessary to increase postpartum long-acting reversible contraception uptake.

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Utilisation of immediate postpartum family planning among postpartum women at public hospitals of North Shoa Zone, Ethiopia: a cross-sectional study

Cited by 11 publications

References 41 publications

Time to initiate postpartum modern contraceptives among pregnant women in Ambo Town, Central Ethiopia; Cox-proportional hazard regression analysis

Time to initiate postpartum modern contraceptives among pregnant women in Ambo Town, Central Ethiopia; Cox-proportional hazard regression analysis

Immediate postpartum intrauterine contraceptive device utilization and associated factors among women who gave birth in public health facilities of Adama town, Ethiopia

Continuous quality improvement strategy for increasing immediate postpartum long-acting reversible contraceptive use at Jimma University Medical Center, Jimma, Ethiopia

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