Factors influencing the likelihood of acceptance of postpartum intrauterine devices across four countries: India, Nepal, Sri Lanka, and Tanzania

Makins, Anita; Taghinejadi, Neda; Sethi, Maya; Machiyama, Kazuyo; Thapa, Kusum; Perera, Gamini; Munganyizi, Projestine S.; Bhardwaj, Ajey; Arulkumaran, Sabaratnam

doi:10.1002/ijgo.12599

Cited by 37 publications

(65 citation statements)

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“…[1][2][3] The increasing institutional deliveries in Nepal provides a one-stop approach to provide maternity and PPFP service at the same time. 4 However, the data on postpartum family planning service coverage from the health facilities in Nepal remains limited.…”

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confidence: 99%

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

et al. 2020

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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.

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Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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“…In low and middle-income countries (LMICs) such as Nepal, not all women attend health facilities to give birth, and among those who do deliver in health facilities, return for follow-up remains a challenge [1].…”

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confidence: 99%

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

Dhital¹,

Siwal²,

Pokhrel

et al. 2020

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Background This is a 1-year post-intervention study following an initiative to provide orientation to female community health volunteers (FCHVs) on postpartum family planning (PPFP) in Nepal implemented in December 2018. Despite positive results in the earlier post-intervention study, this study was designed to provide a more long-term perspective on sustainability by assessing the effect at 1-year post-intervention. Methods This mixed-methods study was conducted in January 2020 in Morang district, Nepal. We collected quantitative data from a knowledge assessment of FCHVs who had participated in the intervention on PPFP; data on their community-based counseling coverage and through interviews with postpartum mothers in two selected hospitals. Qualitative data was collected through six key informant interviews with health providers working on PPFP and four focus group discussions with FCHVs involved in the intervention. We performed descriptive and multivariable analyses for quantitative data and thematic analysis for qualitative data. Results of 1-year post-intervention were compared with pre-intervention and earlier evaluation study results. Results In total, 206 FCHVs participated in the 1-year post-intervention knowledge assessment with a 15-fold [adjusted odds ratio (AOR) = 14.9, p < 0.001] increase in knowledge when compared with the pre-intervention phase. A 20-fold increase in knowledge (AOR = 20.4, P < 0.001) had been reported in the post-test conducted immediately after the orientation. The FCHVs counseled 71% of the pregnant women within their communities at 1-year post-intervention. The postpartum mothers in hospitals had 2 times higher odds than in pre-intervention phase of being counseled by FCHVs during their pregnancy at 1-year post-intervention (AOR = 1.9, P = 0.036) as compared to a 3-fold higher odds of being counseled at 2-months post-intervention (AOR = 2.9, P < 0.001). The qualitative findings suggested a positive impression regarding the FCHV's involvement in PPFP counseling in the communities, however, supervision and monitoring over the longer term was identified as a key challenge and may influence sustainability of community-based and hospital-based PPFP services. Conclusion The FCHVs’ knowledge and community-based activities on PPFP remained higher than in the pre-intervention phase. They had however declined when compared to the 2-months post-intervention period. We propose regular supervision and monitoring of the work of the FCHVs in order to sustain progress.

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“…Esto refleja la gran variedad de factores que intervienen en algunas culturas en las que la mujer no es la que toma las decisiones sobre su propia salud sexual y reproductiva. El análisis de los factores relacionados con el asesoramiento en estos cuatro países puso de manifiesto el papel determinante que juega el contexto en la aceptación de la anticoncepción (y, en particular, del DIUPP) por parte de las mujeres 15 . Como resultado de esta iniciativa, el gobierno de Sri Lanka ha convertido la anticoncepción posparto en la base de su política y ha incluido tanto el DIUPP como los implantes hormonales entre las opciones que las mujeres pueden elegir 16 .…”

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Institucionalización de los dispositivos intrauterinos posparto

2019

Intl J Gynecology & Obste

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Factors influencing the likelihood of acceptance of postpartum intrauterine devices across four countries: India, Nepal, Sri Lanka, and Tanzania

Abstract: Consent for contraception, specifically PPIUD, is such a culturally specific topic and generalization across countries is not possible. When planning contraceptive policy changes, it is important to have an understanding of the sociocultural factors at play.

Cited by 37 publications

References 13 publications

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

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

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

Institucionalización de los dispositivos intrauterinos posparto

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