Trend and determinants of quality of family planning counseling in Ethiopia: Evidence from repeated PMA cross-sectional surveys, (2014–2019)

Ejigu, Bedilu Alamirie; Seme, Assefa; Zimmerman, Linnea; Shiferaw, Solomon

doi:10.1371/journal.pone.0267944

Cited by 14 publications

(14 citation statements)

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“…Adolescent girls and young women who were employed (currently working) as well as those having primary, secondary, or higher education were more likely to receive quality contraceptive counselling relative to the unemployed and those with no formal education. Similar findings were reported in previous studies [ 30 , 43 ]. Education and employment have been identified as major empowerment tools in women’s autonomy and decision-making capacity towards contraception practices [ 44 – 46 ] such as accessing contraceptive counselling.…”

Section: Discussionsupporting

confidence: 93%

Access to quality contraceptive counselling among adolescent girls and young women in sub-Saharan Africa

Mohammed,

Donkoh,

Aboagye

et al. 2024

Contracept Reprod Med

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Background Improving women’s access to and use of modern contraceptives is a key global strategy for improving the sexual and reproductive health of women. However, the use of modern contraceptives among adolescent girls and young women in sub-Saharan Africa (SSA) remains relatively low, despite the numerous interventions to increase patronage. This study examined adolescent girls and young women’s receipt of quality contraceptive counselling and its associated factors in SSA. Methods Data for the study were extracted from the recent Demographic and Health Surveys of 20 countries in SSA, spanning from 2015 to 2021. A sample of 19,398 adolescent girls and young women aged 15 to 24 years was included in the study. We presented the proportion of adolescent girls and young women who received quality contraceptive counselling using a spatial map. Multilevel binary logistic regression analysis was carried out to examine the factors associated with the receipt of quality contraceptive counselling. Results Overall, 33.2% of adolescent girls and young women had access to quality contraceptive counselling, ranging from 13.0% in Cameroon to 67.0% in Sierra Leone. The odds of receiving quality contraceptive counselling was higher among adolescent girls and young women aged 20–24 (AOR = 1.48, CI: 1.32–1.67), those with primary (AOR = 1.32, CI: 1.11–1.57) and secondary or higher education (AOR = 1.31, CI: 1.09–1.58), and those married (AOR = 1.32, CI: 1.15–1.52), cohabiting (AOR = 1.47, CI: 1.23–1.76), and previously married (AOR = 1.48, CI: 1.20–1.83) compared to their counterparts in the reference groups. Adolescent girls and young women who were currently working (AOR = 1.22, CI: 1.09–1.37), those who heard of family planning from radio in the last few months (AOR = 1.34, CI:1.21–1.50), those who visited the health facility in the last 12 months (AOR = 1.69, CI: 1.52–1.88), and those residing in the Southern (AOR = 5.01, CI: 3.86–6.51), Eastern (AOR = 2.54, CI: 1.96–3.30), and Western (AOR = 4.09, CI: 3.19–5.25) SSA were more likely to receive quality contraceptive counselling compared to their counterparts in the reference groups. Conversely, adolescent girls and young women who used the internet, those who had problem getting permission to seek medical help, those facing problem in seeking medical help for not wanting to go alone, those from the middle and richest wealth indices, and those from the rural areas were less likely to receive quality contraceptive counselling compared to their counterparts in the reference groups. Conclusion Receipt of quality contraceptive counselling among adolescent girls and young women was low. Considering the importance of quality contraceptive counselling on the uptake and continuation of contraception, policymakers need to institute measures that improve adolescent girls and young women’s access to quality contraceptive counselling in SSA, especially in countries like Cameroon, Angola, Madagascar, Mauritania, and Guinea, taking into consideration the factors identified in the study. Increasing adolescent girls and young women’s access to quality contraceptive counselling could greatly minimize the risk of unintended pregnancies and its associated maternal and child health burden in SSA and subsequently contribute to the attainment of the Sustainable Development Goal 3, target 3.7.

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Section: Discussionsupporting

confidence: 93%

Access to quality contraceptive counselling among adolescent girls and young women in sub-Saharan Africa

Mohammed,

Donkoh,

Aboagye

et al. 2024

Contracept Reprod Med

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“…While most studies to date show the effect of quality of care on contraceptive initiation, discontinuation or continuation, unique to this study is its use of validated measures to assess changes in quality of care over time within a program setting. Several studies have used secondary data sources like the DHS surveys and the PMA surveys to assess changes in the method information index (MII) over time ( 24 , 25 ), none has used primary data to assess quality of care at two time points.…”

Section: Discussionmentioning

confidence: 99%

Changes in clients' perceptions of family planning quality of care in Kaduna and Lagos States, Nigeria: A mixed methods study

Akomolafe

OlaOlorun

Okafor

et al. 2022

Front. Glob. Womens Health

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Community Pharmacists (CPs) and Patent and Proprietary Medicine Vendors (PPMVs) are crucial to improving access to family planning (FP) services in Nigeria. Although the private sector is preferred for convenience, availability of commodity, privacy, and timeliness, less well known is the quality of care received by clients who obtain FP services from CPs and PPMVs. This paper seeks to explore the use of validated quality of care measures for programming in Kaduna and Lagos States and to assess how these measures worked in capturing changes in quality of care using client exit interviews implemented at two time points. Using validated measures of quality of care, 598 and 236 exit interviews in rounds 1 and 2 were conducted with FP clients aged 18–49 years old. The quality of care domains were assessed using 22 questions. A weighted additive quality score was created, and scores were grouped into three: low, medium, and high quality. Changes in quality of care received were examined using χ2 test. A subset of 53 clients were selected for in-depth interviews. Deductive and inductive approaches were used for coding, and data analysis was thematic. In Lagos, we observed increases in 16 out of 22 items while in Kaduna increases were only observed in 8 items. For instance, increases were observed in the proportion of women who experienced visual privacy between rounds 1 and 2 in Lagos (74%–89%) and Kaduna (66%–82%). The quality of care received by clients changed over time. Women who reported high quality care in Lagos increased from 42% to 63%, whereas women who reported high quality care in Kaduna decreased from 35% to 21%. In both states, in-depth interviews revealed that women felt they were treated respectfully, that their sessions with providers were visually private, that they could ask questions, and that they were asked about their preferred method. This study demonstrates that clients received high quality of care services from providers (CPs and PPMVs) especially in Lagos, and such services can be improved over time. Continuous support may be required to maintain and prevent reduction in quality of FP counseling and services, particularly in Kaduna.

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“…Despite a number of similar targets made by the government and other donor agencies in the last few decades to improve family planning (FP) coverage in Ethiopia, however, the coverage has not progressed as targeted [12]. Additionally, while the government holds the principle of equitable access to safe, effective, and affordable contraception and family planning services across the country, there is marked geographical disparity in the use of modern contraceptive methods [13][14][15], which may explain recent survey findings that use of family planning has not increased since 2018 [16,17]. Hence, identifying factors linked with the uptake of modern contraceptive methods and exploring geographical disparities in use will be helpful for policy makers to plan and implement geographically targeted intervention mechanisms.…”

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.

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Trend and determinants of quality of family planning counseling in Ethiopia: Evidence from repeated PMA cross-sectional surveys, (2014–2019)

Cited by 14 publications

References 29 publications

Access to quality contraceptive counselling among adolescent girls and young women in sub-Saharan Africa

Access to quality contraceptive counselling among adolescent girls and young women in sub-Saharan Africa

Changes in clients' perceptions of family planning quality of care in Kaduna and Lagos States, Nigeria: A mixed methods study

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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