A scoping review on determinants of unmet need for family planning among women of reproductive age in low and middle income countries

Abstract

BackgroundPoor access and low contraceptive prevalence are common to many Low- and Middle-Income Countries (LMICs). Unmet need for family planning (FP), defined as the proportion of women wishing to limit or postpone child birth, but not using contraception, has been central to reproductive health efforts for decades and still remains relevant for most policy makers and FP programs in LMICs. There is still a lag in contraceptive uptake across regions resulting in high unmet need due to various socioeconomic and cultural factors. In this mixed method scoping review we analyzed quantitative, qualitative and mixed method studies to summarize those factors influencing unmet need among women in LMICs.MethodsWe conducted our scoping review by employing mixed method approach. We included studies applying quantitative and qualitative methods retrieved from online data bases (PubMed, JSTOR, and Google Scholar). We also reviewed the indexes of journals specific to the field of reproductive health by using a set of keywords related to unmet contraception need, and non-contraception use in LMICs.ResultsWe retrieved 283 articles and retained 34 articles meeting our inclusion criteria. Of these, 26 were quantitative studies and 8 qualitative studies. We found unmet need for FP to range between 20 % and 58 % in most studies. Woman’s age was negatively associated with total unmet need for FP, meaning as women get older the unmet need for FP decreases. The number of children was found to be a positively associated determinant for a woman’s total unmet need. Also, woman’s level of education was negatively associated – as a woman’s education improves, her total unmet need decreases. Frequently reported reasons for non-contraception use were opposition from husband or husbands fear of infidelity, as well as woman’s fear of side effects or other health concerns related to contraceptive methods.ConclusionFactors associated with unmet need for FP and non-contraception use were common across different LMIC settings. This suggests that women in LMICs face similar barriers to FP and that it is still necessary for reproductive health programs to identify FP interventions that more specifically tackle unmet need.Electronic supplementary materialThe online version of this article (doi:10.1186/s12905-015-0281-3) contains supplementary material, which is available to authorized users.

Factors Influencing Contraceptives Use among Women in the Juba City of South Sudan

“…The finding that the level of education of the respondent was positively correlated with contraceptive use in the last three months supports existing evidence which indicates direct relationship between education level and use of family planning methods [17,26]. Also the results provide a clear picture of the settings where the study was conducted, that is, urban settings with two-thirds of the participants having secondary level of education.…”

“…The association demonstrated in this study between contraceptive use and parity is also reported elsewhere [17,18,27]. This finding may not be a new finding in the family planning domain but may have different implications in the conflict afflicted settings.…”

“…The drivers of family planning uptake are a set of multiple factors that may be complex and difficult to address in real world settings, specifically so in conflict afflicted zones where things happen in an emergency situation [17,18]. These factors range from individual and social factors, cultural factors, availability, and access factors to factors related to the attributes of the contraceptive methods such as fear of side effects [12,18,19].…”

Planejamento Familiar e Papéis Parentais: o Tradicional, a Mudança e os Novos Desafios

“…No entanto, pode-se pensar que os serviços de saúde ainda não conseguem cumprir com esse papel de transformação, visto que a oferta de ações em saúde em planejamento familiar, principalmente no âmbito da atenção básica, se dá prioritariamente às mulheres. Isto pode estar a serviço de reforçar a ideia de que a responsabilidade de planejar a família é exclusiva das mulheres, uma vez que exclui de antemão os homens destas iniciativas (Ferreira et al, 2014;Wulifan, Brenner, Jahn, & De Allegri, 2016).…”

“…Ademais, entende-se que o direcionamento das ações de planejamento familiar tanto para mulheres quanto para homens e casais, através de informação, educação e comunicação, pode ser uma abordagem mais eficaz para superar as necessidades não satisfeitas em planejamento familiar, as quais ainda são presentes nos países com população que apresenta renda baixa e média (Wulifan et al, 2016).…”