Family Planning Uptake in Kagera and Mara Regions in Tanzania: A Cross-Sectional Community Survey

Abstract

In Tanzania, 27.1% of all women of reproductive age are currently using modern contraception and 16.8% have an unmet need for family planning. We therefore examined factors associated with family planning uptake after giving birth in two regions of Tanzania. The survey, which collected information beyond that collected in the Tanzania Demographic Health Survey, used a two-stage, stratified-cluster sampling design, conducted in April 2016 in Mara and Kagera regions in Tanzania. A total of 1184 women aged 15–49 years, who had given birth less than two years prior to the survey were included. Logistic regression mixed effect modelling was used to examine factors associated with family planning uptake. A total of 393 (33.2%) women used family planning methods and 929 (79%) required prior approval from their partners. Participation of men in utilization of maternal health care was low, where 680 (57.8%) women responded that their partners accompanied them to at least one antenatal care (ANC) counselling visit and 120 (10%) responded that their partners participated in family planning counselling. Women who did not want to disclose whether they had discussed family planning with their partners, strikingly had the highest percentage of using family planning methods after birth. Factors independently associated with family planning uptake included: having discussed family planning with the partner (aOR 3.22; 95% CI 1.99–5.21), having been counselled on family planning during antenatal care (aOR 2.68; 95% CI 1.78–4.05), having discussed family planning with a community health worker (CHW) (aOR 4.59; 95% CI 2.53–8.33) and with a facility health care worker (aOR 1.93; 95% CI 1.29–2.90), having primary or higher educational level (aOR 1.66; 95% CI 1.01–2.273), and being in union (aOR 1.86; 95% CI 1.02–3.42). Educational interaction with community and facility health workers, as well as having a supportive partner as facilitator increased uptake of family planning. This needs to be prioritized in regions with similar socio-cultural norms in Tanzania and beyond.

Pooled prevalence and determinants of informed choice of contraceptive methods among reproductive age women in Sub-Saharan Africa: A multilevel analysis

“…Women who utilized IUD, injectable, and implants had higher odds of having an informed choice of contraceptive methods than women who utilized pill-type contraceptive methods, respectively. The possible explanation could be that healthcare workers might be given more attention to provide good information to those long-acting contraceptive users to promote its coverage because healthcare workers have a major role in contraceptive method uptake ( 23 , 34 ).…”

A Qualitative Analysis of the Barriers to Healthcare and Education for Adolescent Girls in Tanzania

“…Steps are certainly being taken towards this direction in Tanzania, as shown by a significant rise in contraception usage, from 23% in 2004 to 34.3% in 2016 [ 3 ]. This improvement is attributed to increased partner education levels and home visits by family planning workers [ 12 ]. The Zanzibar Ministry of Health (MoH) approved an annual action plan in June 2019 to increase access to long-acting and permanent contraceptive methods (LAPMs) in nine hospitals on the Unguja and Pemba islands.…”

“…Despite these remarkable efforts, this was not reflected in teenage childbearing rates, rating from 23% in 2010 to 27% in 2016 and stabilizing at 22% recently [ 3 , 7 ]. Moreover, Zanzibar has the lowest modern contraceptive prevalence rate of all the zones in Tanzania [ 12 ]. Only 27% of sexually active women aged 15 to 49, who need family planning use modern methods of contraception, compared to about half of sexually active women in mainland Tanzania [ 13 ].…”

“They call me the ‘Great Queen’”: implementing the Malkia Klabu program to improve access to HIV self-testing and contraception for adolescent girls and young women in Tanzania

“…Product availability at community drug shops enabled AGYW to avoid potentially stigmatizing treatment at hospital clinics, and providing different opportunities for learning, engagement, and understanding of FPRH information and products within drug shops facilitated knowledge and uptake while also benefiting shops’ marketing. Few other interventions have specifically targeted the needs of AGYW who may not have children or be in long term relationships, and for whom the stigma of seeking HIV testing or FPRH services is highest; many previously described programs relied upon hospital or health centers, settings in which AGYW may experience heightened public scrutiny [ 2 , 12 , 13 ]. This study builds on promising results showing that ADDOs are a common first source for healthcare needs for people in Tanzania [ 5 ] and that they can expand access to testing and treatment for other conditions (e.g., malaria) [ 14 ].…”