Effects of Scaling Up Family Planning on Maternal Survival in Ethiopia: Spectrum Modeling

Kasahun, Abebaw Wasie; Adane, Haimanot Abebe; Girum, Tadele; Wako, Wako Golicha

doi:10.2147/ijwh.s310103

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…In East Africa, where maternal and child mortality rates are alarmingly high, contraceptive usage remains below 30% [ 4 , 5 ]. Research conducted by Kasahun et al [ 6 ] indicates that expanding family planning services could notably contribute to achieving the SDG3 target of reducing maternal mortality. Moreover, enhancing contraceptive coverage may also play a role in alleviating poverty [ 7 ] and empowering women to make reproductive choices autonomously [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Spatial analysis of modern contraceptive use among women who need it in Ethiopia: Using geo-referenced data from performance monitoring for action

Ejigu,

Shiferaw,

Moraga

et al. 2024

PLoS ONE

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Introduction The challenge of achieving maternal and neonatal health-related goals in developing countries is significantly impacted by high fertility rates, which are partly attributed to limited access to family planning and access to the healthcare systems. The most widely used indicator to monitor family planning coverage is the proportion of women in reproductive age using contraception (CPR). However, this metric does not accurately reflect the true family planning coverage, as it fails to account for the diverse needs of women in reproductive age. Not all women in this category require contraception, including those who are pregnant, wish to become pregnant, sexually inactive, or infertile. To effectively address the contraceptive needs of those who require it, this study aims to estimate family planning coverage among this specific group. Further, we aimed to explore the geographical variation and factors influencing contraceptive uptake of contraceptive use among those who need. Method We used data from the Performance Monitoring for Action Ethiopia (PMA Ethiopia) survey of women of reproductive age and the service delivery point (SDP) survey conducted in 2019. A total of 4,390 women who need contraception were considered as the analytical sample. To account for the study design, sampling weights were considered to compute the coverage of modern contraceptive use disaggregated by socio-demographic factors. Bayesian geostatistical modeling was employed to identify potential factors associated with the uptake of modern contraception and produce spatial prediction to unsampled locations. Result The overall weighted prevalence of modern contraception use among women who need it was 44.2% (with 95% CI: 42.4%—45.9%). Across regions of Ethiopia, contraceptive use coverage varies from nearly 0% in Somali region to 52.3% in Addis Ababa. The average nearest distance from a woman’s home to the nearest SDP was high in the Afar and Somali regions. The spatial mapping shows that contraceptive coverage was lower in the eastern part of the country. At zonal administrative level, relatively high (above 55%) proportion of modern contraception use coverage were observed in Adama Liyu Zone, Ilu Ababor, Misrak Shewa, and Kefa zone and the coverage were null in majority of Afar and Somali region zones. Among modern contraceptive users, use of the injectable dominated the method-mix. The modeling result reveals that, living closer to a SDP, having discussions about family planning with the partner, following a Christian religion, no pregnancy intention, being ever pregnant and being young increases the likelihood of using modern contraceptive methods. Conclusion Areas with low contraceptive coverage and lower access to contraception because of distance should be prioritized by the government and other supporting agencies. Women who discussed family planning with their partner were more likely to use modern contraceptives unlike those without such discussion. Thus, to improve the coverage of contraceptive use, it is very important to encourage/advocate women to have discussions with their partner and establish movable health systems for the nomadic community.

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Section: Introductionmentioning

confidence: 99%

Spatial analysis of modern contraceptive use among women who need it in Ethiopia: Using geo-referenced data from performance monitoring for action

Ejigu,

Shiferaw,

Moraga

et al. 2024

PLoS ONE

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“…Family Planning (FP) is a key strategy for health, economic and population growth, and to achieve sustainable development goals (SDGs), especially SDG 3, which promotes health and well-being for all [ 1 , 2 ]. SDG target 3.7 ensures that sexual and reproductive health services, including FP, information, and education, are widely accessible, and that reproductive health is integrated into national programs and strategies [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…FP is an effective and inexpensive solution for reducing maternal mortality in high-fecundity countries [ 1 ], including developing countries. For instance, various countries have reported reductions in maternal mortality among women through FP ranging from 6 to 60% [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Perceived self-efficacy and willingness to teach family planning among nursing and midwifery faculty in higher learning institutions in Rwanda

Nkurunziza,

Mukeshimana,

Endale

et al. 2023

BMC Med Educ

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Background Promoting family planning (FP) is a key strategy for health, economic and population growth, and achieving sustainable development goals (SDGs) especially SDG 3, which promotes health and well-being for all. The quality of FP services depends on the training of competent nursing and midwifery graduates before entering the workforce. In order to ensure graduates are well-trained and capable of meeting the needs of the population, their teachers need to demonstrate high self-efficacy and willingness to teach FP. However, there is a lack of research on the capacity and willingness of nursing and midwifery faculty to teach FP at higher learning institutions (HLIs) in Rwanda. The objective is to investigate and articulate the perceived self-efficacy and willingness of the nursing and midwifery faculty to instruct HLIs students on FP. Research design/Methodology We conducted a mixed methods study using a sequential explanatory design among almost all the HLIs (n = 6, 1 institution declined) that train nurses and midwives in Rwanda. One hundred thirty-six nursing and midwifery faculty who were actively teaching FP either in class, simulation lab, or clinical practice were invited to participate in a self-administered questionnaire and four qualitative focused group discussions. Participants answered questions ranking their self-efficacy in four domains from 0 - not confident to 3 - completely confident. Scores were calculated for each domain. A semi-structured interview guide was developed based on quantitative survey findings to gain a deep understanding of the ability and willingness to teach FP. Data were analyzed using thematic analysis. Ethical approval was obtained from the University of Rwanda, College of Medicine and Health Sciences Institutional Review Board. Results A total number of 89 nursing and midwifery faculty participated in the study and only 85 completed the questionnaires fully, yielding a response rate of 95.5%. The mean age was 40.39 and there were more females (62.4%) compared to their male counterparts (37.6%). Respondents scored highest for perceived self-efficacy in course preparation (mean = 2.37), evaluation and examination (mean = 2.12) and instructor behavior and delivery (mean = 2.35). However, the score was low for clinical practices (mean = 1.79). There was a significant correlation among the four items of self-efficacy (p < 0.05). Being a female, a midwife, and having more years of experience in nursing education were each significantly associated with perceived self-efficacy to teach FP (p < 0.05). In the qualitative phase, 32 study participants participated in four focus group discussions. Four themes were identified: (a) educational background as a determinant of confidence to teach FP; (b) willingness to teach FP; (c) enabling factors of teaching FP; and (d) structural challenges. Conclusion Nursing and midwifery faculty reported inadequate self-confidence in teaching FP in clinical practice. Addressing personal and structural challenges in teaching FP should be a top priority. This requires a collective effort between nursing and midwifery faculty and HLIs to dismantle individual and systemic barriers that hinder self-efficacy and willingness to teach FP. There is a need for HLIs and different stakeholders to invest in training the nursing and midwifery faculty on FP practical skills to have a nursing and midwifery workforce providing up-to-date clinical FP services that will help Rwanda reach the SDGs.

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“…In east Africa where maternal and child mortality is very high, the coverage of contraception use is below 30% [4,5]. A study by Kasahun et al [6] showed that scaling up the coverage of family planning services would have a significant effect on meeting the SDG3 maternal mortality reduction target. Further, improving the coverage of contraception may reduce poverty [7] and promote reproductive autonomy for women [8,9].…”

Section: Introductionmentioning

confidence: 99%

Spatial Analysis of Modern Contraceptive use among women who need it in Ethiopia: Using geo-referenced data from Performance Monitoring for Action

Ejigu

Shiferaw

Moraga

et al. 2023

Preprint

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Background: One of the main challenges to achieving maternal and neonatal health-related goals in developing countries is high fertility, resulting, in part, from lower family planning coverage. In Ethiopia, the coverage of modern contraceptive use among all women under reproductive age is below 40%. To inform program efforts to effectively meet contraceptive needs, it is essential to identify factors associated with the uptake of contraception and design geographically targeted intervention mechanisms guided by up-to-date prevalence maps that show the geographic distribution of contraceptive use across different administrative areas in the country. Objective: Our objectives were to explore the spatial distribution of modern contraceptive use and identify determinant factors that affect the uptake of modern contraception among women who need it. Method: We used data from the Performance Monitoring for Action Ethiopia (PMA Ethiopia) survey of women of reproductive age and the service delivery point (SDP) survey conducted in 2019. A total of 4,390 women who need contraception was considered as the analytical sample. To account for the study design, sampling weights were considered to compute the coverage of modern contraceptive use disaggregated by socio-demographic factors. Bayesian geostatistical modeling was employed to identify potential factors associated with the uptake of modern contraception and produce spatial prediction to unsampled locations. Result: The overall weighted prevalence of modern contraception among women who need it was 44.2% (with 95% CI: 42.4% - 45.9%). Across regions of Ethiopia, contraceptive use coverage varies from 0% in Somali region to 52.3% in Addis Ababa. The average nearest distance from a woman's home to the nearest SDP was high in the Afar and Somali regions. The spatial mapping shows that contraceptive coverage was lower in the eastern part of the country. At zonal administrative level, relatively high (above 55%) proportion of modern contraception use coverage were observed in Adama Liyu Zone, Ilu Ababor, Misrak Shewa, and Kefa zone and the coverage were null in majority of Afar and Somali region zones. Among modern contraceptive users, use of the injectable dominated the method-mix. The modeling result reveals that, living closer to a SDP, having discussions about family planning with the partner, following a Christian religion, no pregnancy intention, being ever pregnant and being young increases the likelihood of using modern contraceptive methods. Conclusion: Areas with low contraceptive coverage and lower access to contraception because of distance should be prioritized by the government and other supporting agencies. Women who discussed family planning with their partner was more likely to use modern contraceptives unlike those without such discussion. Thus, to improve the coverage of contraceptive use, it is very important to encourage/advocate women to have discussions with their partner.

show abstract

Effects of Scaling Up Family Planning on Maternal Survival in Ethiopia: Spectrum Modeling

Cited by 4 publications

References 9 publications

Spatial analysis of modern contraceptive use among women who need it in Ethiopia: Using geo-referenced data from performance monitoring for action

Spatial analysis of modern contraceptive use among women who need it in Ethiopia: Using geo-referenced data from performance monitoring for action

Perceived self-efficacy and willingness to teach family planning among nursing and midwifery faculty in higher learning institutions in Rwanda

Spatial Analysis of Modern Contraceptive use among women who need it in Ethiopia: Using geo-referenced data from Performance Monitoring for Action

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