1
|
Sileo KM, Muhumuza C, Wanyenze RK, Kershaw TS, Ellerbe B, Muñoz S, Sekamatte S, Lule H, Kiene SM. Effects of a community-based, multi-level family planning intervention on theoretically grounded intermediate outcomes for couples in rural Uganda: Results from a mixed methods pilot evaluation. Br J Health Psychol 2024; 29:551-575. [PMID: 38242837 PMCID: PMC11258211 DOI: 10.1111/bjhp.12713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 12/18/2023] [Indexed: 01/21/2024]
Abstract
OBJECTIVES This study tested the theoretically grounded conceptual model of a multi-level intervention, Family Health = Family Wealth (FH = FW), by examining FH = FW's effect on intermediate outcomes among couples in rural Uganda. FH = FW is grounded in the social-ecological model and the social psychological theory of transformative communication. DESIGN A pilot quasi-experimental controlled trial. METHODS Two matched clusters (communities) were randomly allocated to receive the FH = FW intervention or an attention/time-matched water, sanitation and hygiene intervention (N = 140, 35 couples per arm). Quantitative outcomes were collected through interviewer-administered questionnaires at baseline, 7-months and 10-months follow-up. Focus group discussions (n = 39) and semi-structured interviews (n = 27) were conducted with subsets of FH = FW participants after data collection. Generalized estimated equations tested intervention effects on quantitative outcomes, and qualitative data were analysed through thematic analysis-these data were mixed and are presented by level of the social-ecological model. RESULTS The findings demonstrated an intervention effect on family planning determinants across social-ecological levels. Improved individual-level family planning knowledge, attitudes and intentions, and reduced inequitable gender attitudes, were observed in intervention versus comparator, corroborated by the qualitative findings. Interpersonal-level changes included improved communication, shared decision-making and equitable relationship dynamics. At the community level, FH = FW increased perceived acceptance of family planning among others (norms), and the qualitative findings highlighted how FH = FW's transformative communication approach reshaped definitions of a successful family to better align with family planning. CONCLUSIONS This mixed methods pilot evaluation supports FH = FW's theoretically grounded conceptual model and ability to affect multi-level drivers of a high unmet need for family planning.
Collapse
Affiliation(s)
- Katelyn M Sileo
- Department of Public Health, The University of Texas at San Antonio, San Antonio, Texas, USA
| | - Christine Muhumuza
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Rhoda K Wanyenze
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda
| | - Trace S Kershaw
- Department of Social and Behavior Science, Yale School of Public Health, New Haven, Connecticut, USA
| | - Brooke Ellerbe
- Department of Public Health, The University of Texas at San Antonio, San Antonio, Texas, USA
| | - Suyapa Muñoz
- Department of Public Health, The University of Texas at San Antonio, San Antonio, Texas, USA
| | | | - Haruna Lule
- Global Centre of Excellence in Health (GLoCEH), Kampala, Uganda
| | - Susan M Kiene
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda
- Division of Epidemiology and Biostatistics, San Diego State University (SDSU) School of Public Health, San Diego, California, USA
| |
Collapse
|
2
|
Klu D, Odame ML, Asante PY, Dansu CA. Determinants of men's perspectives on women contraceptive use in Ghana: an analysis of the 2022 Ghana demographic and health survey. Contracept Reprod Med 2024; 9:35. [PMID: 39049061 PMCID: PMC11271215 DOI: 10.1186/s40834-024-00300-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 07/22/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Male dominance in reproductive health decision-making, specifically regarding family planning and contraceptive use among women, has been argued to have a significant influence on Africa's fertility transition. However, there is a paucity of research evidence on the extent to which men influence contraceptive adoption and the factors shaping their perspectives on contraceptive use among women in Ghana. This study aims to examine the factors influencing men's perspectives on women's contraceptive use in Ghana. METHODS Data for this study was obtained from the 2022 Ghana Demographic and Health Survey (GDHS) conducted between October 17, 2022 and January 14, 2023. A total weighted sample of 7,044 men aged 15-59 was extracted from the men's data file. Data was analyzed with SPSS version 27, employing both descriptive and binary logistics regression modeling. Statistical significance was set at p < 0.05. RESULTS The results indicate that 63% of men disagreed with the opinion that contraception is solely a woman's concern, while 59% agreed with the view that contraceptive use encourages promiscuity among women. With factors that significantly influence men's opinion on contraception being solely a woman's concern, men with secondary (aOR = 0.69; C.I: 0.57-0.82) and higher education, residing in urban areas, belonging to other Christian faiths, Ga/Dangme, Ewe, and Mole-Dagbani men were less likely to agree with such opinions. Conversely, men dwelling in the Coastal zones were more likely to agree with that view. Men exposure to FP messages on radio and during community durbars had higher odds of agreeing with that opinion. Regarding the factors influencing men's perspective on the perception that contraceptive use by women encourages promiscuity, men who are 20-24 (aOR = 1.51; C.I:1.12-2.03) and 35-39 years in Coastal and Middle Belt zones, cohabiting and formerly married men were more likely to agree with such opinions. Conversely, men with higher educational levels, in urban areas and unemployed had lower odds to agreeing with such perception. CONCLUSIONS The study underscores the importance of men's socio-demographic characteristics and their exposure to FP messages in shaping their perspectives on women's contraceptive use. Policy implications highlight the need to involve men in promoting safe sexual and reproductive health practices.
Collapse
Affiliation(s)
- Desmond Klu
- Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana.
| | - Michael Larbi Odame
- Department of Sustainable Development and Policy, University of Environment and Sustainable Development, Somanya, Ghana
| | - Paapa Yaw Asante
- Mental Health Unit, Family and Community Health Department, University of Health and Allied Sciences, Ho, Ghana
| | | |
Collapse
|
3
|
Oppong Asante K, Ampaw S, Gyan SE. Consistent condom use among sexually active young adults in Ghana: an analysis of prevalence and associated factors. Glob Health Promot 2024; 31:75-84. [PMID: 37933812 DOI: 10.1177/17579759231205850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
Consistent and proper condom use offers a safer, economically cheap and practically effective means of preventing HIV infection. Using the 2014 Ghana Demographic and Health Survey with a sample of 2779 sexually active youth (males = 682 and females = 2,097) in the age range 15-24, this study explored the prevalence of, and factors associated with consistent condom use among sexually active young adults in Ghana. Multivariate logistic regression was used to analyse the data. Our results showed that approximately 11% of the respondents reported consistent condom use in their previous sexual activity. Females were more likely than males to have used a condom consistently. The logistic regression results showed that females who had tested for HIV were less likely to use a condom consistently. However, those who have obtained family planning information from print media and those from the northern part of Ghana were more likely to practise consistent condom use. Furthermore, males who professed the Traditional African religion were less likely to use a condom consistently. In contrast, males in the rich wealth category were more likely to use a condom consistently. These findings underscore the need for behavioural change campaigns targeting young adults, particularly those who are sexually active, to encourage consistent condom use. These interventions should target young adults with less family planning knowledge, those who know their HIV status and those who profess the Traditional African religion.
Collapse
Affiliation(s)
- Kwaku Oppong Asante
- Department of Psychology, University of Ghana, Ghana
- Department of Psychology, University of the Free State, South Africa
| | - Samuel Ampaw
- School of Economics, University of Nottingham Ningbo China, People's Republic of China
| | | |
Collapse
|
4
|
Omona K, Mahoro RM. Factors associated with men’s participation in postpartum family planning: a study of Kiswa Health Centre III, Kampala, Uganda. J OBSTET GYNAECOL 2023; 43. [DOI: https:/doi.org/10.1080/01443615.2022.2158321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 12/09/2022] [Indexed: 02/17/2024]
Affiliation(s)
- Kizito Omona
- Faculty of Health Sciences, Uganda Martyrs University, Kampala, Uganda
| | - Rose Mary Mahoro
- Department of Communication and Policy, Marie Stopes Uganda, Kampala, Uganda
| |
Collapse
|
5
|
Hylkema R, Ilozumba O. Male engagement in family planning: the role of faith leaders in urban West Africa. J Public Health (Oxf) 2023; 45:1056-1059. [PMID: 37460406 PMCID: PMC10687861 DOI: 10.1093/pubmed/fdad112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 05/31/2023] [Accepted: 06/23/2023] [Indexed: 12/02/2023] Open
Abstract
Sustainable Development Goal 3 aims to improve access to modern contraceptives and inform and educate people on family planning (FP). However, contraceptive use among women of reproductive age in West Africa is low at approximately 20%. One related factor is the limited engagement of males in FP decision-making. Addressing this issue requires a multiplicity of approaches, including the engagement of faith leaders. Faith leaders are often trusted by their congregants and could be an avenue to promoting male involvement in FP. In this report, we discuss the role of faith leaders in two West African countries, Nigeria and Ghana. We conducted 11 in-depth interviews with faith leaders in Nigeria and Ghana. Our exploratory findings indicate that faith leaders seem to have adequate knowledge and a positive perspective on male engagement and FP. In addition, the relationship of trust faith leaders maintain with their congregants is valuable in educating or counselling congregants on male engagement and FP.
Collapse
Affiliation(s)
- Renske Hylkema
- Athena Institute, Vrije Universiteit, Amsterdam, 1081 HV, the Netherlands
| | - Onaedo Ilozumba
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| |
Collapse
|
6
|
Bizuneh FK, Bizuneh TK, Masresha SA, Yayeh BM. Individual and community level factors for modern contraceptives utilization among reproductive aged women in Amhara region, Mixed effect multi-level modeling, Data from Mini-EDHS, 2019. Contracept Reprod Med 2023; 8:56. [PMID: 38012780 PMCID: PMC10683182 DOI: 10.1186/s40834-023-00256-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 11/18/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Modern contraceptive has been identified as a key strategy to control unintended pregnancy, protect the health of the mother and child, and promote women wellbeing. Despite this and increasingly wider availability of modern contraceptives, however, there are still high levels of unmet need for birth interspacing and contraceptive use in Amhara regions. This study aimed to identify factors associated with the enhancing of modern contraceptives utilization among reproductive aged women in Amhara region, using a mixed effects multilevel modeling data from mini-EDHS 2019. METHODS A community-based cross-sectional study was conducted among 711(wt = 100%) samples of reproductive-aged women. The data were interviewed by trained data collectors using a semi-structured questionnaire for the final mini-EDHS 2019 data set. A multilevel binary logistic regression model was fitted to identify the enhancing factors for modern contraceptive utilization Adjusted Odds Ratio (AOR) with 95% Confidence Intervals (CI) was used to identify factors associated with utilization. RESULT The median age of the participants was 31 with (IQR ± 13) years. The overall modern contraceptive utilization was 42.3% (95%CI: 38.7; 46.1). Individual and community factors accounted for 21.4% of the variation in modern contraceptive utilization at the cluster level. Being age 25 years (AOR = 12.99; 95%CI: 4.5-37.2), 26-35 years (AOR = 8.8, 95%CI: 3.25- 24), 36-45 years (AOR = 5.6, 95%CI: 2.2-16.2), being married (AOR = 4.2, 95%CI: 2.21-6.97), educated women (AOR = 11.6, 95%CI: 3.22-40.4), and being middle-economic class (AOR = 3.03; 95%CI: 1.87-4.91) were identified as individual enhancing factors. Whereas, being urban resident (AOR = 5.19; 95%CI: 5.19: 41.7) and having media exposure (AOR = 1.5; 95%CI: 1.58-3.7) were community-level enhancing factors for modern contraceptive utilization. CONCLUSION Compared to earlier studies, in Amhara region, a lower prevalence rate of modern contraceptive utilization was reported. The variation in utilization at the cluster level, 21.4%, was attributed to individual and community-level factors. Healthcare providers should prioritize raising awareness about contraceptive side effects to encourage new users and decrease the number of individuals who discontinue contraceptive methods.
Collapse
Affiliation(s)
- Fassikaw Kebede Bizuneh
- School of public health, College of health science, Woldia University, North East, Ethiopia.
| | - Tsehay Kebede Bizuneh
- Department of Geography, Faculty of social science, Bahir Dare University, Bahir Dar, Ethiopia
| | | | - Berihun Mulu Yayeh
- School of public health, College of health science, Woldia University, North East, Ethiopia
| |
Collapse
|
7
|
Nabhan A, Kabra R, Ashraf A, Elghamry F, Kiarie J. Implementation strategies, facilitators, and barriers to scaling up and sustaining demand generation in family planning, a mixed-methods systematic review. BMC Womens Health 2023; 23:574. [PMID: 37932747 PMCID: PMC10629088 DOI: 10.1186/s12905-023-02735-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 10/26/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Demand generation aims to increase clients' desire to use family planning. The aim of this work was to systematically summarize strategies, facilitators, and barriers to scaling up and sustaining demand generation in family planning. METHODS We searched electronic bibliographic databases from inception to October 2022. We included quantitative, qualitative, and mixed methods reports on demand generation strategies in family planning, regardless of country, language, publication status, or methodological limitations. We assessed abstracts, titles and full-text papers according to the inclusion criteria, extracted data, and assessed methodological quality of included reports. We used the convergent integrated approach and a deductive thematic synthesis to summarize demand generation themes and subthemes. We used the health system building blocks to synthesize the factors affecting implementation (barriers and facilitators). We used GRADE-CERQual to assess our confidence in the findings. RESULTS Forty-six studies (published 1990-2022) were included: forty-one quantitative, one qualitative, and four mixed methods). Three were from one high-income country, and forty three from LMIC settings. Half of reports were judged to be of unclear risk of bias. There were unique yet interrelated strategies of scaling-up demand generation for family planning. Interpersonal communication strategies increase adoption and coverage of modern contraceptive methods, but the effect on sustainability is uncertain. Mass media exposure increases knowledge and positive attitudes and may increase the intention to use modern contraceptive methods. Demand-side financing approaches probably increase awareness of contraceptives and the use of modern contraceptive methods among poor clients. Multifaceted Demand generation approaches probably improve adoption, coverage and sustainability of modern methods use. Factors that influence the success of implementing these strategies include users knowledge about family planning methods, the availability of modern methods, and the accessibility to services. CONCLUSIONS Demand generation strategies may function independently or supplement each other. The myriad of techniques of the different demand generation strategies, the complexities of family planning services, and human interactions defy simplistic conclusions on how a specific strategy or a bundle of strategies may succeed in increasing and sustaining family planning utilization. TRIAL REGISTRATION Systematic review registration: Center for Open Science, osf.io/286j5.
Collapse
Affiliation(s)
- Ashraf Nabhan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Ramses Street, Cairo, Egypt.
| | - Rita Kabra
- Department of Sexual and Reproductive Health including UNDP/UNFPA/ UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
| | - Alyaa Ashraf
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - James Kiarie
- Department of Sexual and Reproductive Health including UNDP/UNFPA/ UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
| |
Collapse
|
8
|
Montt-Maray E, Adamjee L, Horanieh N, Witt A, González-Capella T, Zinke-Allmang A, Cislaghi B. Understanding ethical challenges of family planning interventions in sub-Saharan Africa: a scoping review. Front Glob Womens Health 2023; 4:1149632. [PMID: 37674903 PMCID: PMC10478786 DOI: 10.3389/fgwh.2023.1149632] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 08/10/2023] [Indexed: 09/08/2023] Open
Abstract
Background Improving the design of family planning (FP) interventions is essential to advancing gender equality, maternal health outcomes, and reproductive autonomy for both men and women. While progress has been made towards applying a rights-based approach to FP interventions in sub-Saharan Africa, the ethical implications of FP interventions has been underreported and underexplored. Several ethical challenges persist related to measuring success, choice, and target population. Methods We conducted a scoping review to understand if and how FP interventions published between 2000 and 2020 within sub-Saharan Africa address the ethical challenges raised within the literature. We identified a total of 1,652 papers, of which 40 were included in the review. Results Our review demonstrated that the majority of family planning interventions in sub-Saharan Africa place a strong emphasis, on measuring success through quantitative indicators such as uptake of modern contraception methods among women, specifically those that are married and visiting healthcare centres. They also tend to bias the provision of family planning by promoting long-acting reversible contraception over other forms of contraception methods potentially undermining individuals' autonomy and choice. The interventions in our review also found most interventions exclusively target women, not recognising the importance of gender norms and social networks on women's choice in using contraception and the need for more equitable FP services. Conclusion The results of this review highlight how FP interventions measured success through quantitative indicators that focus on uptake of modern contraception methods among women. Utilising these measures makes it difficult to break away from the legacy of FP as a tool for population control as they limit the ability to incorporate autonomy, choice, and rights. Our results are meant to encourage members of the global family planning community to think critically about the ethical implications of their existing interventions and how they may be improved. More public health and policy research is required to assess the effect of applying the new indicators with the FP community as well as explicitly outlining monitoring and evaluation strategies for new interventions to allow for programme improvement and the dissemination of lessons learned.
Collapse
Affiliation(s)
- Eloisa Montt-Maray
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Lamiah Adamjee
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Nour Horanieh
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Alice Witt
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Thaïs González-Capella
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Anja Zinke-Allmang
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Beniamino Cislaghi
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| |
Collapse
|
9
|
Amoak D, Konkor I, Mohammed K, Saaka SA, Antabe R. Exposure to mass media family planning messages among men in Nigeria: analysis of the Demographic and Health Survey data. PeerJ 2023; 11:e15391. [PMID: 37273544 PMCID: PMC10237178 DOI: 10.7717/peerj.15391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/19/2023] [Indexed: 06/06/2023] Open
Abstract
Background Family planning (FP) is essential for improving health and achieving reproductive goals. Although men are important participants in FP decision-making within households in Nigeria, a country with one of the highest rates of maternal mortality, we know very little about their exposure to mass media FP messages. Methods Drawing theoretical insights from the structural influence model of health communication and using the 2018 Nigeria Demographic and Health Survey (n = 13,294), and applying logistic regression analysis, we explored the factors associated with men's exposure to mass media FP messages in Nigeria. Results A range of socioeconomic, locational, and demographic factors were associated with men's exposure to mass media FP messages. For example, wealthier, more educated, and employed men were more likely to be exposed to mass media FP messages than their poorer, less educated, and unemployed counterparts. In addition, compared to those in rural areas and other regions, men in urban areas as well as South East Region, were more likely to be exposed to mass media FP messages. Finally, younger men and those who belong to the traditional religion were less likely to be exposed to mass media FP messages, compared to their older and Christian counterparts. Conclusions Based on these findings, we discuss implications and recommendations for policymakers as well as directions for future research.
Collapse
Affiliation(s)
- Daniel Amoak
- University of Western Ontario, London, Ontario, Canada
| | | | | | | | - Roger Antabe
- University of Toronto, Scarborough, Ontario, Canada
| |
Collapse
|
10
|
Shabanikiya H, Darman A, Ghavami V, Moghri J, Varmaghani M, Noughabi JJ, KokabiSaghi F. Men's involvement in family planning programs and associated factors from the perspective of women in Afghanistan; a case study. Midwifery 2023; 117:103575. [PMID: 36527771 DOI: 10.1016/j.midw.2022.103575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 10/31/2022] [Accepted: 12/05/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Family planning is a cornerstone to the achievement of Sustainable Development Goals. However, men's involvement in family planning has been a challenge in many countries. This study aimed to investigate the participation of men in the family planning programs and related factors from the perspective of women referring to family planning organizations in Herat, Afghanistan 2021. METHODS The study had a cross-sectional design. The participants of the study consisted of 544 married women aged 15-49 years selected by simple random sampling. The data collection tool was a valid and reliable questionnaire to assess the participation of men in family planning programs. To analyze the data, descriptive statistics and analytical methods including Mann-Whitney and Pearson Chi-Square tests were applied in SPSS 21. The answers to the open-end questions were analyzed, coded and classified in two main categories. RESULTS The average age of study participants was 28(±10) years and a significant proportion of them were illiterate (48.5%). Most of the participants were housewives (83.6%) and their husbands were non-professional workers (39.9%). The husbands participated in family planning programs by choosing the type of contraception (29.2%), provision of contraceptives (29.6%) and supporting their wives using them (49.3%). There were statistically significant relationships between women's and their husband's education level, and husband's employment status with the type of participation in family planning. The main incentives for Afghan men to participate family planning were the increased attention of families to the education and needs of children and the health and welfare of the wives. However, cultural norms supporting larger families, the desire for having boy children, the fear of contraception's side effects and religious prohibitions discourage them in using family planning methods. CONCLUSION A large number of the respondents stated that their spouse participated in family planning programs. It shows the importance and success of family planning centers in promoting sexual and reproductive health and family planning. Study showed that various factors affected men's participation in family planning programs. Recognition of these factors can help policy makers in designing behavioral interventions based on social marketing, and enhancing the effectiveness of these programs.
Collapse
Affiliation(s)
- Hamidreza Shabanikiya
- Department of Management Sciences and Health Economics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Vahid Ghavami
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Javad Moghri
- Department of Management Sciences and Health Economics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehdi Varmaghani
- Department of Management Sciences and Health Economics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Javad Javan Noughabi
- Department of Management Sciences and Health Economics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh KokabiSaghi
- Department of Management Sciences and Health Economics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
| |
Collapse
|
11
|
Baynes C, Steyn P, Soi C, Dinis A, Tembe S, Mehrtash H, Narasimhan M, Kiarie J, Sherr K. Use of implementation science to advance family planning programs in low- and middle-income countries: A systematic review. Front Glob Womens Health 2022; 3:1038297. [PMID: 36561275 PMCID: PMC9763469 DOI: 10.3389/fgwh.2022.1038297] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/11/2022] [Indexed: 12/12/2022] Open
Abstract
Objective As environmental and economic pressures converge with demands to achieve sustainability development goals, low- and middle-income countries (LMIC) increasingly require strategies to strengthen and scale-up evidence-based practices (EBP) related to family planning (FP). Implementation science (IS) can help these efforts. The purpose of this article is to elucidate patterns in the use of IS in FP research and identify ways to maximize the potential of IS to advance FP in LMIC. Design and methods We conducted a systematic review that describes how IS concepts and principles have been operationalized in LMIC FP research published from 2007-2021. We searched six databases for implementation studies of LMIC FP interventions. Our review synthesizes the characteristics of implementation strategies and research efforts used to enhance the performance of FP-related EBP in these settings, identifying gaps, strengths and lessons learned. Results Four-hundred and seventy-two studies were eligible for full-text review. Ninety-two percent of studies were carried out in one region only, whereas 8 percent were multi-country studies that took place across multiple regions. 37 percent of studies were conducted in East Africa, 21 percent in West and Central Africa, 19 percent in Southern Africa and South Asia, respectively, and fewer than 5 percent in other Asian countries, Latin America and Middle East and North Africa, respectively. Fifty-four percent were on strategies that promoted individuals' uptake of FP. Far fewer were on strategies to enhance the coverage, implementation, spread or sustainability of FP programs. Most studies used quantitative methods only and evaluated user-level outcomes over implementation outcomes. Thirty percent measured processes and outcomes of strategies, 15 percent measured changes in implementation outcomes, and 31 percent report on the effect of contextual factors. Eighteen percent reported that they were situated within decision-making processes to address locally identified implementation issues. Fourteen percent of studies described measures to involve stakeholders in the research process. Only 7 percent of studies reported that implementation was led by LMIC delivery systems or implementation partners. Conclusions IS has potential to further advance LMIC FP programs, although its impact will be limited unless its concepts and principles are incorporated more systematically. To support this, stakeholders must focus on strategies that address a wider range of implementation outcomes; adapt research designs and blend methods to evaluate outcomes and processes; and establish collaborative research efforts across implementation, policy, and research domains. Doing so will expand opportunities for learning and applying new knowledge in pragmatic research paradigms where research is embedded in usual implementation conditions and addresses critical issues such as scale up and sustainability of evidence-informed FP interventions.Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier: CRD42020199353.
Collapse
Affiliation(s)
- Colin Baynes
- Department of Global Health, University of Washington, Seattle, WA, United States,Correspondence: Colin Baynes
| | - Petrus Steyn
- Department of Sexual and Reproductive Health and Research, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Geneva, Switzerland
| | - Caroline Soi
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Aneth Dinis
- Department of Global Health, University of Washington, Seattle, WA, United States,The National Directorate of Public Health, Ministry of Health of Mozambique, Maputo, Mozambique
| | - Stelio Tembe
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Hedieh Mehrtash
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Manjulaa Narasimhan
- Department of Sexual and Reproductive Health and Research, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Geneva, Switzerland
| | - James Kiarie
- Department of Sexual and Reproductive Health and Research, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Geneva, Switzerland
| | - Kenneth Sherr
- Department of Global Health, University of Washington, Seattle, WA, United States,Department of Epidemiology, University of Washington, Seattle, WA, United States,Department of Industrial and Systems Engineering, University of Washington, Seattle, WA, United States
| |
Collapse
|
12
|
Zinke-Allmang A, Hassan R, Bhatia A, Gorur K, Shipow A, Ogolla C, Shirley S, Keizer K, Cislaghi B. Use of digital media for family planning information by women and their social networks in Kenya: A qualitative study in peri-urban Nairobi. FRONTIERS IN SOCIOLOGY 2022; 7:886548. [PMID: 35992509 PMCID: PMC9385981 DOI: 10.3389/fsoc.2022.886548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 07/15/2022] [Indexed: 06/15/2023]
Abstract
Access to information about family planning (FP) continues to have financial, physical and social barriers among young women living in Kenya. This paper draws on social norms theory to explore how young women and their social networks access FP information on digital media (e.g., WhatsApp, websites). Qualitative phone interviews were conducted with 40 participants - young women, their partners and key influencers - in seven peri-urban wards in Nairobi, Kenya. Data were analyzed using thematic analysis. Findings suggested that young women, their partners and key influencers predominately accessed FP information online through their informal networks, but identified healthcare workers as the most trusted sources of FP information. In digital spaces, participants described being more comfortable sharing FP information as digital spaces allowed for greater privacy and reduced stigma to talk about FP openly. Our findings highlight the importance of digital media in disseminating FP information among young women and their networks, the differences in norms governing the acceptability to talk about FP online vs. in-person and the significance of targeting misinformation about FP in digital media spaces.
Collapse
Affiliation(s)
- Anja Zinke-Allmang
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Rahma Hassan
- Institute for Development Studies, University of Nairobi, Nairobi, Kenya
| | - Amiya Bhatia
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Amy Shipow
- Busara Center for Behavioral Economics, Nairobi, Kenya
| | | | - Sarah Shirley
- Harvard College, Harvard University, Cambridge, MA, United States
| | - Kees Keizer
- Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, Netherlands
| | - Beniamino Cislaghi
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| |
Collapse
|
13
|
Lotfi R, Azin SA, Hatefnia E, Amiri M, Simbar M, Ramezani Tehrani F. How Do Iranian Men Perceive Their Sexual and Reproductive Health Situation? A Qualitative Content Analysis. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2022; 10:197-209. [PMID: 35855387 PMCID: PMC9287571 DOI: 10.30476/ijcbnm.2022.92155.1831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 01/24/2022] [Accepted: 02/26/2022] [Indexed: 11/19/2022]
Abstract
Background Males' viewpoint about sexual and reproductive health (SRH) and their situation are essential components of men's and women's health in the community. Men have been overlooked in reproduction health, especially with reproductive issues such as contraception, sexually transmitted infections (STIs), infertility, and sexual function. This study aimed to investigate the males' perceptions of their SRH situation in Iran. Methods A qualitative study was conducted from May 2016 to April 2017 on data retrieved through semi-structured interviews with 19 adult males aged 18 to 59 years. The participants were purposefully recruited from among populations of health centers in Alborz province, Iran. Conventional content analysis in OneNote software version 2016 was used for data analysis. Results Three main themes and nine categories emerged including 1) Perceived SRH needs, including "need to increase men's awareness about SRH", "need to have an accessibility to SRH services", and "need to have a high-quality sexual relationship"; 2) perceived SRH responsibilities, including "health-seeking behaviors", "sexual skills", "childbearing responsibilities", and "ethical commitment", and 3) Men' perception of trends of social and cultural norms, including "changing SRH priorities" and "changing marital prototype". Conclusion In this study, men perceived SRH as an important issue due to the changes in social and cultural trends, and many of their SRH needs have not yet been addressed. Hence, along with socio-economic changes, the policymakers of the health system should develop strategies and interventions to meet these needs.
Collapse
Affiliation(s)
- Razieh Lotfi
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Seyed Ali Azin
- Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Effat Hatefnia
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Mina Amiri
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Simbar
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
14
|
Noormal AS, Winkler V, Eshraqi AM, Deckert A, Sadaat I, Dambach P. Factors influencing the uptake of short-term contraceptives among women in Afghanistan. Sci Rep 2022; 12:6632. [PMID: 35459773 PMCID: PMC9033810 DOI: 10.1038/s41598-022-10535-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 04/05/2022] [Indexed: 11/08/2022] Open
Abstract
The aim of this study is to assess factors that influence the uptake of short-term contraceptives among married women aged between 15 and 49 years in Afghanistan. The cross-sectional Afghanistan 2015 Demographic and Health Survey provided the dataset for this analysis. We included 22,974 women and applied multivariable logistic regression to investigate the influencing factors for the uptake of short-term contraceptives. 92% of Afghan women knew at least one type of short-term contraception but only 17% were using short term contraceptives. Short term contraceptive use was most prevalent among women in the age group between 30 and 40 who were educated, employed, and rich. Most of the users were living in the western parts of Afghanistan and women from the Balooch and Pashtun ethnic groups were most likely to use short-term contraceptives. Media exposure and women empowerment were also positively associated with the use of short-term contraceptives. We did not find an association with living in urban or rural settings. Contraception promotion in Afghanistan requires multisectoral efforts, tailored to the needs of women from low and middle socioeconomic strata. Health promotion activities, empowering women, strengthening education, and training of service providers on effective counseling are options that should be considered to improve the current situation.
Collapse
Affiliation(s)
- Ahmad Siyar Noormal
- Heidelberg Institute of Global Health, Im Neunheimer Feld 365, 69120, Heidelberg, Germany.
| | - Volker Winkler
- Heidelberg Institute of Global Health, Im Neunheimer Feld 365, 69120, Heidelberg, Germany
| | | | - Andreas Deckert
- Heidelberg Institute of Global Health, Im Neunheimer Feld 365, 69120, Heidelberg, Germany
| | | | - Peter Dambach
- Heidelberg Institute of Global Health, Im Neunheimer Feld 365, 69120, Heidelberg, Germany
| |
Collapse
|
15
|
Mutumba M. Mass media influences on family planning knowledge, attitudes and method choice among sexually active men in sub-Saharan Africa. PLoS One 2022; 17:e0261068. [PMID: 35085245 PMCID: PMC8794141 DOI: 10.1371/journal.pone.0261068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 11/23/2021] [Indexed: 11/18/2022] Open
Abstract
Men are underrepresented in family planning (FP) research, and despite the widespread promotion of FP through mass media, there is no systematic evaluation on how mass media exposure influences their FP knowledge, attitudes and behavior. Using Demographic and Health Survey (DHS) data from 31 countries in Sub-Saharan Africa (SSA), collected between 2010 and 2019, this paper examines the associations between three types of traditional mass media (radio, television and print) with FP knowledge, attitudes and method choices among reproductive age men in SSA, relative to other socio-cultural factors. Estimates to quantify the relative contribution of each type of mass media, relative to other evidence-based socio-cultural influences on FP outcomes, were derived using the Shorrocks-Shapley decomposition. Radio exposure had the largest impact on FP knowledge, attitudes and method choice, accounting for 26.1% of the variance in FP knowledge, followed by Television (21.4%) and education attainment (20.7%). Mass media exposure had relatively minimal impact on FP method choice, and between the three types of mass media, television (8%) had the largest influence on FP method choice. Print media had comparatively lesser impact on FP knowledge (8%), attitudes (6.2%) and method choice (3.2%). Findings suggest that mass media exposure has positive influences on FP knowledge, attitudes and method choice but its influence on FP knowledge, attitudes and method choice is smaller relative to other socio-cultural factors such as education, household wealth and marital status. As such, efforts to increase FP uptake in Sub-Saharan Africa should take into consideration the impact of these socio-cultural economic factors.
Collapse
Affiliation(s)
- Massy Mutumba
- Department of Health Behavior & Biological Sciences, University of Michigan School of Nursing, Ann Arbor, Michigan, United States of America
- * E-mail:
| |
Collapse
|
16
|
Akoth C, Oguta JO, Kyololo OM, Nyamu M, Ndirangu MN, Gatimu SM. Factors Associated With the Utilisation and Unmet Need for Modern Contraceptives Among Urban Women in Kenya: A Cross-Sectional Study. Front Glob Womens Health 2022; 2:669760. [PMID: 34977861 PMCID: PMC8716368 DOI: 10.3389/fgwh.2021.669760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 11/17/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Family planning (FP) is a key intervention in improving maternal and child health. Hence, we assessed the factors associated with utilisation and unmet need for modern contraceptives among urban women in Kenya. Methods: The study used pooled data on 10,474 women 15–49 years from the seven rounds of the performance monitoring for accountability surveys collected between 2014 and 2018. The surveys were conducted in 11 of the 47 counties of Kenya using a multistage cluster design. Sample characteristics were described using frequencies and percentages while factors associated with utilisation and unmet need for modern contraceptives were assessed using multivariable logistic regressions. Results: The prevalence of modern contraceptives use and unmet need for FP among urban women in Kenya was 53.7% [95% confidence interval (CI) 52.1–55.3%] and 16.9% (15.8–18.1%), respectively. The use of modern contraceptive was associated with the county of residence, age, marital status, parity, education, household wealth quintile, exposure to media, and survey year. Teenagers, poorest urban women, women with no formal or primary level of education and those who seek services at a dispensary or health centres had higher odds of unmet need for FP while women who resided in Kitui and Nyamira counties had reduced odds of unmet need for FP. The odds of unmet need decreased with the survey year while that of modern contraceptive use had an inverse trend. Conclusion: Overall modern contraceptive use in urban areas is lower than the national average while the unmet need for FP is higher than national average, highlighting a potential urban-rural disparity in FP indicators in Kenya. Individual sociodemographic and socioeconomic and contextual factors are associated with the use of modern contraceptive and unmet need for FP among urban women in Kenya. Urban family planning policies and programmes in Kenya need to focus on strengthening urban healthcare systems to provide equal and accessible FP services, especially targeted towards teenagers and young women and those of low socioeconomic status.
Collapse
Affiliation(s)
- Catherine Akoth
- Institute of Tropical and Infectious Diseases, Faculty of Health Sciences, University of Nairobi, Nairobi, Kenya
| | - James Odhiambo Oguta
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom.,Health Section, UNICEF, Eastern and Southern Africa Regional Office, Nairobi, Kenya
| | | | - Martin Nyamu
- Institute of Tropical and Infectious Diseases, Faculty of Health Sciences, University of Nairobi, Nairobi, Kenya
| | | | - Samwel Maina Gatimu
- School of Economics, University of Nairobi, Nairobi, Kenya.,Diabetic Foot Foundation of Kenya, Nairobi, Kenya
| |
Collapse
|
17
|
Birabwa C, Chemonges D, Tetui M, Baroudi M, Namatovu F, Akuze J, Makumbi F, Ssekamatte T, Atuyambe L, Hernandez A, Sewe MO. Knowledge and Information Exposure About Family Planning Among Women of Reproductive Age in Informal Settlements of Kira Municipality, Wakiso District, Uganda. Front Glob Womens Health 2021; 2:650538. [PMID: 34816206 PMCID: PMC8594013 DOI: 10.3389/fgwh.2021.650538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 04/07/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction: A high unmet need for family planning (FP) prevails in sub-Saharan Africa. Knowledge, awareness creation, and ensuring accessibility are frequently used to increase FP uptake. However, evidence on knowledge or information dissemination about FP among marginalized populations in urban settings in Africa is limited. This study explored the knowledge of FP methods, media exposure, and contact with FP providers among women from an informal settlement in Uganda. Methods: Using a cross-sectional study design, we interviewed 626 women aged 15–49 years living in informal settlements of Kira municipality, selected through multistage sampling. Using a standard questionnaire, data was collected on socioeconomic characteristics, knowledge of FP methods, and access to media FP messages among others. Binomial log-linear regression was used to assess disparities in exposure to media FP messages or provider information. Data were analyzed using STATA version 14, at a 5% level of statistical significance. Results: Nearly all women in the survey were aware of FP methods (99.7%). On average, each woman was aware of 10 FP methods. The most commonly known methods were male condoms (98.2%), injectables (97.4%), and the oral contraceptive pill (95.2%). Use of any contraceptive was found among 42.7% of respondents. Exposure to media was found in 70.6% of the respondents, mostly through television (58.5%) and radio (58.3%). Discussing FP with a provider was significantly associated with media exposure (aPR 1.4, 95% CI: 1.24–1.56). Less than 50% of women who were not using FP had contact with an FP provider. Women in union (aPR 1.6, 95% CI: 1.01–2.68) and those with access to media messages (aPR 2.5, 95% CI: 1.37–4.54) were more likely to have contact with a provider to discuss FP. Conclusion: There is high general awareness about FP methods and media exposure, but method use was low. Further exploration of women's understanding of FP methods and the fit between existing education programs and FP knowledge needs in this urban setting should be conducted. The potential for mobile health solutions in this urban population should be explored. Future studies should focus on the knowledge and understanding of FP among unmarried and nulliparous women and those with no access to media information.
Collapse
Affiliation(s)
- Catherine Birabwa
- Department of Health Policy, Planning and Management, Makerere University School of Public Health, New Mulago Hospital Complex, Kampala, Uganda
| | - Dennis Chemonges
- Department of Programs, Population Services International Uganda, Kampala, Uganda.,Department of Epidemiology and Biostatistics, Makerere University School of Public Health, New Mulago Hospital Complex, Kampala, Uganda
| | - Moses Tetui
- Department of Health Policy, Planning and Management, Makerere University School of Public Health, New Mulago Hospital Complex, Kampala, Uganda.,School of Pharmacy, Waterloo University, Waterloo, ON, Canada.,Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Mazen Baroudi
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Fredinah Namatovu
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Joseph Akuze
- Department of Health Policy, Planning and Management, Makerere University School of Public Health, New Mulago Hospital Complex, Kampala, Uganda.,Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Fredrick Makumbi
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, New Mulago Hospital Complex, Kampala, Uganda
| | - Tonny Ssekamatte
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, New Mulago Hospital Complex, Kampala, Uganda
| | - Lynn Atuyambe
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, New Mulago Hospital Complex, Kampala, Uganda
| | - Alison Hernandez
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Maquins Odhiambo Sewe
- Department of Public Health and Clinical Medicine, Sustainable Health Section, Umeå University, Umeå, Sweden
| |
Collapse
|
18
|
Ahinkorah BO, Hagan JE, Seidu AA, Budu E, Mensah GY, Adu C, Schack T. Understanding the association between exposure to family planning messages and consistent condom use among never married men in Ghana. PLoS One 2021; 16:e0255325. [PMID: 34428211 PMCID: PMC8384178 DOI: 10.1371/journal.pone.0255325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 07/14/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Despite considerable efforts to promote condom use, sexually active people in sub-Sahara Africa still engage in risky sexual behaviours, with condom use relatively low. With this high vulnerability of these persons to HIV and sexually transmitted infections, research related to exposure to family planning messages to help curb this trend remains sparse. This study examined how exposure to family planning messages in the midst of some socio-demographic factors is associated with consistent condom use among sexually active never married men in Ghana. METHODS Data were obtained from the 2014 Demographic and Health Survey (DHS) of Ghana. Only never married men (15-64 years) who have had sexual experience in the last 12 months were included in the analysis (N = 971). Frequencies, percentages, chi-square tests and binary logistic regression analyses were carried out. Results of the binary logistic regression analysis were presented using crude odds ratios (cOR) and adjusted odds ratios (aOR). RESULTS The results showed that only 26.15% of sexually active never married men in Ghana consistently used condom during sex. Men who were exposed to family planning messages were 51% more likely use condom consistently compared to those who are not exposed [aOR = 1.51, CI = 1.04-2.18]. In terms of the covariates, the likelihood of consistent condom use among men in Ghana was lower among those aged 35 years and above compared to those aged 15-24 [aOR = 0.46 CI = 0.21-0.99]. The odds of consistent condom use among men increased with level of education, with men with higher level of education having the highest odds of consistent condom use compared to those with no formal education [aOR = 9.98, CI = 2.05-48.46]. Men of the richest wealth quintile were more likely to use condom consistently compared to those of the poorest wealth quintile [aOR = 2.62, CI = 1.30-5.27]. Higher odds of consistent condom use was found among men who dwelled in the Central, Northern, and Upper East regions compared to those of the Western region. CONCLUSION Our findings have established a strong association between exposure to family planning messages alongside age, educational level, wealth, and region of residence and consistent condom use. Men exposed to family planning messages were more likely to use condoms consistently. Designed programs should use intervention strategies that focus on interactive and participatory educational activities to improve sexually active men's interpersonal communication on family planning messages, especially on consistent condom use with their sexual partners.
Collapse
Affiliation(s)
- Bright Opoku Ahinkorah
- Faculty of Health, School of Public Health, University of Technology Sydney, Sydney, Australia
| | - John Elvis Hagan
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
- Faculty of Psychology and Sport Sciences, Neurocognition and Action-Biomechanics-Research Group, Bielefeld University, Bielefeld, Germany
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Douglas, Australia
- Department of Estate Management, Takoradi Technical University, Takoradi, Ghana
| | - Eugene Budu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Georgina Yaa Mensah
- Faculty of Health, Department of Communication Studies, University of Cape Coast, Cape Coast, Ghana
| | - Collins Adu
- Department of Health Promotion and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Thomas Schack
- Faculty of Psychology and Sport Sciences, Neurocognition and Action-Biomechanics-Research Group, Bielefeld University, Bielefeld, Germany
| |
Collapse
|
19
|
Ghosh R, Mozumdar A, Chattopadhyay A, Acharya R. Mass media exposure and use of reversible modern contraceptives among married women in India: An analysis of the NFHS 2015-16 data. PLoS One 2021; 16:e0254400. [PMID: 34255787 PMCID: PMC8277022 DOI: 10.1371/journal.pone.0254400] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 06/28/2021] [Indexed: 11/18/2022] Open
Abstract
Since the inception of the National Programme for Family Planning, messages on family planning (FP) have been promoted across India using different mass media platforms. Mass media plays an important role in disseminating important information among the masses, such as how reversible modern methods give women more reproductive choices than opting for permanent methods that limit their child-bearing capacity. Mass media can provide a continuous flow of information and motivation to deter women from discontinuing the methods they have opted for. However, very few studies have been conducted on this issue, especially using recently available data. This study particularly focuses on exposure to mass media and the use of reversible modern methods of family planning among married women in India. The data for this study was obtained from the National Family Health Survey (2015–16) on currently married women aged 15–49 years. The association of reversible modern method use with media exposure variables was examined, controlling for a set of independent variables from multiple levels—individual, district, state, and region. The findings from this study showed that television was the most important medium for disseminating information on FP among married women in India. Spatial analysis revealed that some districts in the north, parts of the northeast, and Kerala in South India lacked any television exposure. The results from the decomposition analysis showed that mass media exposure was associated with a 14% increase in the use of reversible modern methods. Results from the multilevel analyses showed that exposure to TV along with other media (AOR 1.57 95% CI 1.49–1.65) and exposure to FP messages through different media (AOR 1.22 95% CI 1.12–1.32) had a significant positive effect on the use of reversible modern methods even when various individual, district, state, and regional-level factors were controlled. The findings of this paper provide evidence supporting the use of mass media to promote and increase awareness of voluntary contraceptive use in India. An increase in mass media exposure coupled with improvement in coverage and services of the FP program can significantly increase the use of reversible modern methods in a cost-effective yet efficient manner among women in need of FP services.
Collapse
Affiliation(s)
- Ranjita Ghosh
- Department of Development Studies, International Institute for Population Sciences, Mumbai, India
| | - Arupendra Mozumdar
- Reproductive Health Division, Population Council, New Delhi, India
- * E-mail:
| | - Aparajita Chattopadhyay
- Department of Development Studies, International Institute for Population Sciences, Mumbai, India
| | - Rajib Acharya
- Reproductive Health Division, Population Council, New Delhi, India
| |
Collapse
|
20
|
Factors Influencing Choice of Contraceptives among Women of Reproductive Age Attending Lagos State University Teaching Hospital, Nigeria. JOURNAL OF RESEARCH DEVELOPMENT IN NURSING AND MIDWIFERY 2021. [DOI: 10.52547/jgbfnm.18.2.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
|
21
|
Tuyisenge G, Crooks VA, Berry NS. "He lets me go although he does not go with me.": Rwandan women's perceptions of men's roles in maternal health. Glob Health Res Policy 2021; 6:2. [PMID: 33431064 PMCID: PMC7802268 DOI: 10.1186/s41256-020-00185-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 12/26/2020] [Indexed: 11/10/2022] Open
Abstract
Background Increasing men’s involvement in their pregnant partners’ wellness has been reported as one of the ways to improve access to and utilization of maternal health services, including birth preparedness and complication readiness. Men can play meaningful roles in the support systems that pregnant women need to achieve better maternal health outcomes. In Rwanda, the roles that men take vary, resulting in diverse expectations and responsibilities to support the health of women during this critical time. In this study, we aimed to examine the views, perspectives, and experiences of women on men’s involvement in maternal health and how this impacts access and utilization of maternal health services. Methods We conducted 21 interviews with pregnant and recently-pregnant women to gain an understanding of their views on men’s involvement in facilitating their partners’ health during pregnancy. Interviews were conducted across five Rwandan districts in both rural and urban settings of the country. Data analysis was guided by a thematic analysis approach. This started with independent transcript review by the investigators, after which a meeting was held to discuss emergent themes and to identify potential codes. A coding scheme was created and transcripts were coded in NVIVO™ software according to conceptual and practical topics that formed an understanding of men’s involvement in maternal care. Results Three key themes emerged during the analytic process that categorize the specific roles that men play in maternal health: 1) facilitating access to maternal health services, which involves assisting women with getting and or attending appointments jointly with men; 2) supporting women’s decisions, wherein men can support the decisions women make with regard to their maternal healthcare in a number of ways; and 3) evaluating information, including gathering information from multiple sources, especially from community health workers, to assist women with making informed decisions. Conclusion Rwandan men take on three types of roles in supporting women’s maternal health, and their responsibilities are experienced differently by women. Interventions involving men are encouraged to increase their understanding of the implications of their involvement in maternal health without compromising women’s autonomy in decision-making and to promote positive maternal health outcomes.
Collapse
Affiliation(s)
- Germaine Tuyisenge
- Department of Geography, Simon Fraser University, 8888 University Dr, Burnaby, BC, V5A 1S6, Canada. .,Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada.
| | - Valorie A Crooks
- Department of Geography, Simon Fraser University, 8888 University Dr, Burnaby, BC, V5A 1S6, Canada
| | - Nicole S Berry
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| |
Collapse
|
22
|
Do M, Hutchinson P, Omoluabi E, Akinyemi A, Akano B. Partner Discussion as a Mediator of the Effects of Mass Media Exposure to FP on Contraceptive Use among Young Nigerians: Evidence from 3 Urban Cities. JOURNAL OF HEALTH COMMUNICATION 2020; 25:115-125. [PMID: 31964316 DOI: 10.1080/10810730.2020.1716279] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Evidence suggests that despite high knowledge of family planning (FP), unwanted pregnancies and birth rates remain high among young Nigerians. There is a critical gap in understanding the nexus between exposure to FP information and contraception practices among this population. This study aimed to fill this gap and tested a pathway of the impact of media exposure to FP messages on modern contraceptive use. Data came from a 2018 cross-sectional baseline survey of young people aged 15-24 in three urban centers in Nigeria - Lagos, Kaduna, and Kano. This was part of an impact evaluation of a television-based drama designed to improve contraceptive use among young individuals. The study was limited to 777 young men and women who were sexually active. We found evidence of the mediation effect of media exposure to FP messages on partner discussion about FP, which in turn was associated with an increased likelihood of modern contraceptive use. Contraceptive self-efficacy also had positive associations with contraception. Our study elucidated a potential pathway through which media communication programs can significantly contribute to increased modern contraceptive use and underlined the importance of providing young people in Nigeria with opportunities to learn and practice obtaining and using contraception.
Collapse
Affiliation(s)
- Mai Do
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, USA
| | - Paul Hutchinson
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, USA
| | - Elizabeth Omoluabi
- Centre for Research, Evaluation Resources and Development (CRERD), Ile-Ife, Nigeria
| | - Akanni Akinyemi
- Centre for Research, Evaluation Resources and Development (CRERD), Ile-Ife, Nigeria
- Demography and Social Statistics Department, Obafemi Awolowo University, Ilesa, Nigeria
| | - Babatunde Akano
- Centre for Research, Evaluation Resources and Development (CRERD), Ile-Ife, Nigeria
| |
Collapse
|
23
|
Safieh J, Schuster T, McKinnon B, Booth A, Bergevin Y. Reported evidence on the effectiveness of mass media interventions in increasing knowledge and use of family planning in low and middle-income countries: a systematic mixed methods review. J Glob Health 2019; 9:020420. [PMID: 33282226 PMCID: PMC7686646 DOI: 10.7189/jogh.09.020420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND An estimated 200 million women and girls in low and middle-income countries (LMICs) wish to delay, space or avoid becoming pregnant, yet are not using contraceptives. This study seeks to investigate the effectiveness of mass media interventions for increasing knowledge and use of contraceptives, and to identify barriers to program implementation. METHODS Using a mixed-methods systematic approach, we searched five electronic databases using pre-determined search strategies and hand-searching of articles of any study design published from 1994 to 2017 of mass media interventions for family planning education. Two reviewers independently applied clearly defined eligibility criteria to the search results, quality appraisal, data extraction from published reports, and data analysis (using meta-analysis and thematic analysis) following PRISMA guidelines. RESULTS We identified 59 eligible studies. Although the majority of studies suggest a positive association between media interventions and family planning outcomes, the pooled results are still consistent with possibly null intervention effects. The reported prevalence ratios (PR) for media interventions association with increased contraceptive knowledge range from 0.97 to 1.41, while the PRs for contraceptive use range from 0.54 to 3.23. The qualitative analysis indicates that there are barriers to contraceptive uptake at the level of individual knowledge (including demographic factors and preconceived notions), access (including issues relating to mobility and financing), and programming (including lack of participatory approaches). CONCLUSIONS There is a need for rigorous impact evaluation, including randomised controlled trials, of mass media interventions on knowledge and uptake of family planning in LMIC settings. Interventions should be better tailored to cultural and socio-demographic characteristics of the target populations, while access to resources should continue to remain a priority and be improved, where possible.
Collapse
Affiliation(s)
- Jacqueline Safieh
- Department of Family Medicine, McGill University, Montréal, Quebec, Canada
| | - Tibor Schuster
- Department of Family Medicine, McGill University, Montréal, Quebec, Canada
| | - Britt McKinnon
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | - Amy Booth
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Yves Bergevin
- Department of Family Medicine, McGill University, Montréal, Quebec, Canada
| |
Collapse
|
24
|
Costenbader E, Zissette S, Martinez A, LeMasters K, Dagadu NA, Deepan P, Shaw B. Getting to intent: Are social norms influencing intentions to use modern contraception in the DRC? PLoS One 2019; 14:e0219617. [PMID: 31310641 PMCID: PMC6634398 DOI: 10.1371/journal.pone.0219617] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 06/27/2019] [Indexed: 12/02/2022] Open
Abstract
Meeting the reproductive health needs of women in post-conflict settings is a global health priority. In the Democratic Republic of the Congo, social norms perpetuate gender-based violence and contribute to low contraceptive use and high fertility. The Masculinité, Famille, et Foi (MFF) intervention is working with communities in Kinshasa to create normative environments supportive of modern contraception access and use. Our analysis uses survey data collected from 900 men and women in 17 community groups prior to the MFF intervention. We aimed to measure the extent to which social norms influence intentions to use modern contraception. Using multiple items to assess social norms and reference groups related to family planning and gender equity, we identified four distinct social norms constructs through factor analysis. Through structural equation modeling, we found that social norms influence intentions to use modern contraception overall, but that normative influence varies by gender.
Collapse
Affiliation(s)
| | | | | | - Katherine LeMasters
- FHI 360, Durham, NC, United States of America
- University of North Carolina Gillings School of Public Health, Chapel Hill, NC, United States of America
| | - Nana Apenem Dagadu
- Institute of Reproductive Health at Georgetown University, Washington, DC, United States of America
| | | | - Bryan Shaw
- Institute of Reproductive Health at Georgetown University, Washington, DC, United States of America
| |
Collapse
|
25
|
Kriel Y, Milford C, Cordero J, Suleman F, Beksinska M, Steyn P, Smit JA. Male partner influence on family planning and contraceptive use: perspectives from community members and healthcare providers in KwaZulu-Natal, South Africa. Reprod Health 2019; 16:89. [PMID: 31238960 PMCID: PMC6593556 DOI: 10.1186/s12978-019-0749-y] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 06/05/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND South Africa faces numerous reproductive challenges that include high rates of unplanned and adolescent pregnancies. The uptake and utilization of family planning services and modern contraception methods depend on numerous factors. The male partner plays a key role in reproductive health but data on this topic are outdated or have a predominant HIV prevention focus. The purpose of this paper is to explore the influence of male partners on family planning and contraceptive (FP/C) uptake and use within the contemporary South African setting, and to identify further areas of exploration. METHODS This qualitative study was conducted in a community and healthcare provision setting in the eThekwini District in KwaZulu-Natal province, South Africa. Data were collected from twelve community-based focus group discussions (n = 103), two healthcare providers focus group discussions (n = 16), and eight key informant individual in-depth interviews. Following a constructionist paradigm and using the health utilization behaviour model, data were analysed using thematic analysis, allowing a robust and holistic exploration of the data. RESULTS The data from this study revealed the complex and evolving role that male partners play in FP/C uptake and use within this setting. Key themes from the data elucidated the dual nature of male involvement in FP/C use. Culturally influenced gender dynamics and adequate understanding of FP/C information were highlighted as key factors that influenced male attitudes and perceptions about contraceptive use, whether positively or negatively. Male opposition was attributed to limited understanding; misunderstandings about side-effects; male dominance in relationships; and physical abuse. These factors contributed to covert or discontinued use by female partners. Pathways identified through which male partners positively influenced FP/C uptake and access include: social support, adequate information, and shared responsibility. CONCLUSIONS Understanding the role that male partners play in FP/C uptake and use is important in preventing unintended pregnancies and improving family planning policy and service delivery programmes. By identifying the barriers that male partners present, appropriate strategies can be implemented. Equally important is identifying how male partners facilitate and promote adherence and use, and how these positive strategies can be incorporated into policy to improve the uptake and use of FP/C.
Collapse
Affiliation(s)
- Yolandie Kriel
- MatCH Research Unit (Maternal, Adolescent and Child Health Research Unit), Department of Obstetrics and Gynaecology, Faculty of Health Science, University of the Witwatersrand, Durban, South Africa. .,School of Public Health and Nursing, College of Health Science, University of KwaZulu-Natal, Durban, South Africa.
| | - Cecilia Milford
- MatCH Research Unit (Maternal, Adolescent and Child Health Research Unit), Department of Obstetrics and Gynaecology, Faculty of Health Science, University of the Witwatersrand, Durban, South Africa
| | - Joanna Cordero
- Department of Reproductive Health and Research, World Health Organisation (WHO), Geneva, Switzerland
| | - Fatima Suleman
- Discipline of Pharmaceutical Science, College of Health Science, University of KwaZulu-Natal, Durban, South Africa
| | - Mags Beksinska
- MatCH Research Unit (Maternal, Adolescent and Child Health Research Unit), Department of Obstetrics and Gynaecology, Faculty of Health Science, University of the Witwatersrand, Durban, South Africa
| | - Petrus Steyn
- Department of Reproductive Health and Research, World Health Organisation (WHO), Geneva, Switzerland
| | - Jennifer Ann Smit
- MatCH Research Unit (Maternal, Adolescent and Child Health Research Unit), Department of Obstetrics and Gynaecology, Faculty of Health Science, University of the Witwatersrand, Durban, South Africa
| |
Collapse
|
26
|
Chima V, Alawode OA. Modern contraceptive use among female adolescents in rural Nigeria: Does exposure to family planning messages matter? A cross-sectional study. Gates Open Res 2019. [DOI: 10.12688/gatesopenres.12904.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: The world currently has the highest number of adolescents in all of history. Africa is home to quite a number of them, with most of these adolescents in Africa live in rural areas where they are more disadvantaged and their reproductive decisions could have telling impacts on their lives, family planning (contraception) has been identified as important to avoid such impacts. Factors associated with the use of modern contraceptives among female adolescents have been extensively researched but the importance of mass media family planning messages on modern contraceptives use among female adolescents in rural Nigeria is under-researched, hence this study. Method: This paper uses the 2013 Nigeria Demographic and Health Survey (NDHS) data with a weighted sample size (n=4473) to examine the association between exposure to family planning messages and use of modern contraceptives among female adolescents in rural Nigeria. Results: Findings indicated that exposure to family planning messages on radio and television were significantly associated with modern contraceptive use, however, educational attainment and region of residence were other factors that influenced modern contraceptive use.. Conclusion: The study concludes that family planning messages through mass media especially radio and television are associated with modern contraceptives use among rural adolescents. The continued use of mass media would enhance opportunities to achieve more results, however, other interventions addressing education with objectives of closing the rural-urban socio-economic gap should be encouraged also, as these factors play critical roles in improving uptake of family planning among rural adolescents. Further, messages on modern contraceptive use should be sensitive to regional divides in terms of content and delivery.
Collapse
|
27
|
Kim TY, Haider M, Hancock GR, Boudreaux MH. The Role of Health Literacy in Family Planning Use among Senegalese Women. JOURNAL OF HEALTH COMMUNICATION 2019; 24:244-261. [PMID: 30958224 DOI: 10.1080/10810730.2019.1601299] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Health communication has contributed to an increase in family planning use through education and mass media as a means to increase health literacy. In this research, we investigate health literacy as an auxiliary component of health communication. We test the validity of the Health Literacy Skills Framework by examining the correlation of health literacy indicators to family planning use among Senegalese women in the 2014 Demographic Health Survey. We found that increased family planning use was most strongly associated with hearing family planning messages through television and radio. Other health literacy indicators, including access to printed family planning messaging, textual literacy, and knowledge of ovulatory cycles did not strengthen family planning use, even when performing a subgroup analysis of women who could read. The implications are that the Health Literacy Skills framework can measure health literacy's ability (assessed through proxy indicators of health literacy) to predict modern family planning use among Senegalese women and that audio and visual health literacy measures are most strongly associated with increased family planning use.
Collapse
Affiliation(s)
- Theresa Y Kim
- a Clinical Effectiveness & Decision Science , Patient-Centered Outcomes Research Institute , Washington , DC , USA
| | - Muhiuddin Haider
- b Maryland Institute for Applied Environmental Health , University of Maryland , College Park , MD , USA
| | - Gregory R Hancock
- c Department of Human Development and Quantitative Methodology , University of Maryland , College Park , MD , USA
| | - Michel H Boudreaux
- d Department of Health Services Administration , University of Maryland , College Park , MD , USA
| |
Collapse
|
28
|
Assaf S, Davis LM. Women’s modern contraceptive use in sub-Saharan Africa: does men’s involvement matter? JOURNAL OF GLOBAL HEALTH REPORTS 2019. [DOI: 10.29392/joghr.3.e2019013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
|
29
|
Chima V, Alawode OA. Modern contraceptive use among female adolescents in rural Nigeria: Does exposure to family planning messages matter? A cross-sectional study. Gates Open Res 2019. [DOI: 10.12688/gatesopenres.12904.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: The world currently has the highest number of adolescents in all of history. Africa is home to quite a number of them, with most of these adolescents in Africa live in rural areas where they are more disadvantaged and their reproductive decisions could have telling impacts on their lives, family planning (contraception) has been identified as important to avoid such impacts. Factors associated with the use of modern contraceptives among female adolescents have been extensively researched but the importance of mass media family planning messages on modern contraceptives use among female adolescents in rural Nigeria is under-researched, hence this study. Method: This paper uses the 2013 Nigeria Demographic and Health Survey (NDHS) data with a weighted sample size (n=4473) to examine the association between exposure to family planning messages and use of modern contraceptives among female adolescents in rural Nigeria. Results: Findings indicated that exposure to family planning messages on radio and television were significantly associated with use, however, educational attainment and region of residence were other factors that influenced contraceptive use. Therefore, family planning messages through traditional media (radio and television) is associated with the use of modern contraceptives among female rural adolescents in Nigeria. Conclusion: The study concludes that family planning messages through mass media especially radio and televisions are associated with modern contraceptives use among rural adolescents. The continued use of mass media could create opportunities to achieve more results in family planning although the messages should be resident-specific and targeted to various cadres of people with consideration for the level of education to ensure efficiency of the message.
Collapse
|
30
|
Oluwasanu MM, John-Akinola YO, Desmennu AT, Oladunni O, Adebowale AS. Access to Information on Family Planning and Use of Modern Contraceptives Among Married Igbo Women in Southeast, Nigeria. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2019; 39:233-243. [PMID: 30600774 DOI: 10.1177/0272684x18821300] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study was conducted among married Igbo women in Nigeria who have the lowest median birth interval coupled with a culture of sex preference and low use of modern contraceptives. We examined the relationship between access to information on family planning and sex preference on the use of modern contraceptive (MC). The 2013 Nigeria Demographic and Health Survey data were used. The data of 1,661 women of reproductive age were analyzed in this study. Access to information on family planning was low, and almost half (48.6%) of the women had a score of zero. Controlling for possible confounding variables, the data show that women who have good (odds ratio [ OR]= 3.92; CI [2.28, 6.75], p < .001) and poor ( OR = 2.56; CI [1.85, 3.56], p < .001) access to information on family planning were more likely to use MC than those with no access to information on family planning. Sex preference showed no relationship with the use of MC. Families where husbands want more children than their wives inhibit ( OR = 0.62, CI [0.42, 0.90], p < .05) the use of MC compared with those families where husbands and wives fertility desire is the same. Public health programs by government and donors should intensify interventions to increase access to family planning information to promote the use of MC among married Igbo women.
Collapse
Affiliation(s)
- Mojisola M Oluwasanu
- 1 Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Yetunde O John-Akinola
- 1 Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Adeyimika T Desmennu
- 1 Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Opeyemi Oladunni
- 1 Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Ayo S Adebowale
- 2 Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| |
Collapse
|
31
|
Dougherty A, Kayongo A, Deans S, Mundaka J, Nassali F, Sewanyana J, Migadde E, Kiyemba R, Katali E, Holcombe SJ, Heil SH, Kalyesubula R. Knowledge and use of family planning among men in rural Uganda. BMC Public Health 2018; 18:1294. [PMID: 30477477 PMCID: PMC6258500 DOI: 10.1186/s12889-018-6173-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 10/31/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Unmet need for family planning exceeds 33% in Uganda. One approach to decreasing unmet need is promoting male involvement in family planning. Male disapproval of use of family planning by their female partners and misconceptions about side effects are barriers to family planning globally and in Uganda in particular. Researchers have conducted a number of qualitative studies in recent years to examine different aspects of family planning among Ugandan men. The present study aimed to quantify men's knowledge of family planning in rural Uganda to understand how better to involve men in couples' contraceptive decision-making, particularly in low-resource settings. METHODS Data were derived from in-person, researcher-administered surveys of men in a rural agrarian district in Uganda (N = 178). Participant demographics and knowledge of family planning methods, side effects, and use were queried. Descriptive statistics were used for analysis. RESULTS Men were 34 years of age on average (range 18-71) and about half (56%) had a primary school education or less. Ninety-eight percent reported any knowledge of family planning, with 73% of men reporting obtaining information via radio and only 43% from health workers. The most common method known by men was the male condom (72%), but more than half also knew of injections (54%) and pills (52%). Relatively few men reported knowing about the most effective reversible contraceptive methods, intrauterine devices and implants (both 16%). Men identified many common contraceptive side-effects, such as vaginal bleeding (31%), and misconceptions about side effects, such as increased risk of infertility and birth defects, were relatively uncommon (both < 10%). About half of all men reported ever using a family planning method (53%), and 40% reported current use. CONCLUSIONS This study's quantitative results build on those of recent qualitative studies and provide information about the types of family planning information men are lacking and avenues for getting this information to them.
Collapse
Affiliation(s)
- Anne Dougherty
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Vermont, Burlington, VT, USA
| | - Alex Kayongo
- Department of Medicine, Makerere College of Health Sciences, Kampala, Uganda.,African Community Center for Social Sustainability (ACCESS), Nakaseke, Uganda
| | - Samantha Deans
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Vermont, Burlington, VT, USA
| | - John Mundaka
- African Community Center for Social Sustainability (ACCESS), Nakaseke, Uganda.,Department of Obstetrics and Gynecology, Makerere College of Health Sciences, Kampala, Uganda
| | - Faith Nassali
- African Community Center for Social Sustainability (ACCESS), Nakaseke, Uganda
| | - James Sewanyana
- African Community Center for Social Sustainability (ACCESS), Nakaseke, Uganda
| | - Eric Migadde
- African Community Center for Social Sustainability (ACCESS), Nakaseke, Uganda
| | - Ronald Kiyemba
- African Community Center for Social Sustainability (ACCESS), Nakaseke, Uganda
| | - Estherloy Katali
- African Community Center for Social Sustainability (ACCESS), Nakaseke, Uganda.,Makerere University Business School, Kampala, Uganda
| | - Sarah Jane Holcombe
- Bixby Center for Population, Health, and Sustainability, University of California, Berkeley, USA
| | - Sarah H Heil
- Departments of Psychiatry and Psychological Science, University of Vermont, Burlington, VT, USA
| | - Robert Kalyesubula
- African Community Center for Social Sustainability (ACCESS), Nakaseke, Uganda. .,Departments of Medicine and Physiology, Makerere College of Health Sciences, P.O Box 7072, Kampala, Uganda.
| |
Collapse
|
32
|
Association of men's exposure to family planning programming and reported discussion with partner and family planning use: The case of urban Senegal. PLoS One 2018; 13:e0204049. [PMID: 30252875 PMCID: PMC6155530 DOI: 10.1371/journal.pone.0204049] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 08/31/2018] [Indexed: 11/20/2022] Open
Abstract
Background Family planning programs increasingly aim to encourage men to be involved in women’s reproductive health decision-making as well as support men to be active agents of change for their own and the couple’s reproductive health needs. This study contributes to this area of work by examining men’s exposure to family planning (FP) program activities in urban Senegal and determining whether exposure is associated with reported FP use and discussion of family planning with female partners. Methods This study uses data from two cross-sectional surveys of men in four urban sites of Senegal (Dakar, Pikine, Guédiawaye, Mbao). In 2011 and 2015, men ages 15–59 in a random sample of households from study clusters were approached and asked to participate in a survey about their fertility and family planning experiences. These data were used to determine the association between exposure to the Initiative Sénégalaise de Santé Urbaine (in English: Senegal Urban Reproductive Health Initiative) family planning program interventions with men’s reported modern family planning use and their reported discussion of FP with their partners. Since data come from the same study clusters at each time period, fixed effects methods at the cluster level allowed us to control for possible program targeting by geographic area. Results Multivariate models demonstrate that religious leaders speaking favorably about family planning, seeing FP messages on the television, hearing FP messages on the radio, and exposure to community outreach activities with a FP focus (e.g., house to house and community religious dialogues) are associated with reported modern family planning use and discussion of family planning with partners among men in the four urban sites of Senegal. Conclusions This study demonstrates that it is possible to reach men with FP program activities in urban Senegal and that these activities are positively associated with reported FP behaviors.
Collapse
|
33
|
Adefalu AA, Ladipo OA, Akinyemi OO, Popoola OA, Latunji OO, Iyanda OF. Awareness and opinions regarding contraception by women of reproductive age in North-West Nigeria. Pan Afr Med J 2018; 30:65. [PMID: 30344849 PMCID: PMC6192713 DOI: 10.11604/pamj.2018.30.65.12975] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 04/12/2018] [Indexed: 12/04/2022] Open
Abstract
Introduction North-west Nigeria is a traditionally high fertility setting. Increasing attention is being channeled into scaling up the various interventions that can reduce high fertility, including enhancing contraceptive uptake among women of reproductive age. However, in order to improve demand for contraception, understanding the level of awareness, knowledge and perception of WRA to contraceptive use is essential. This study examines the level of knowledge and perception of WRA to contraceptive use. Methods A descriptive cross-sectional study was carried out in December 2016 in Kebbi and Sokoto states, North-west Nigeria. Semi-structured questionnaires were administered to 500 women between the ages of 15-49 years in 4 randomly selected local government areas across the states. Data analysis included descriptive and bi-variate statistics. Results Only 43.8% claimed to be currently using a modern form of contraception; 82.4% were aware of at least one form of contraception, while health personnel formed the major source of information. The most popular and least common modern contraceptive methods were the male condom (86.8%) and vasectomy (26.6%) respectively. A higher proportion of married respondents (88.8%) than those presently single (68.8%) had good knowledge of contraceptives. Perception of contraceptives was mixed, with majority believing that contraceptives should be made available to every woman, despite stating that it contradicted their religious beliefs. Conclusion These results underline the need for policy makers to focus on improving the knowledge of younger age groups on contraceptives and include other information channels such as peer-to-peer discussions to increase awareness.
Collapse
|
34
|
Asa SS, Titilayo A, Kupoluyi JA. Assessment of Contraceptive Use by Marriage Type Among Sexually Active Men in Nigeria. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2018; 38:181-194. [PMID: 29307287 DOI: 10.1177/0272684x17749800] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Marital status, from the perspective of men (and especially sexually active men), as a potential factor that influences contraceptive use for the purposes of fertility control, has received little consideration in the scientific literature. This study thus assesses contraceptive use among sexually active men occupying different marital statuses. The study employed the 2013 Nigeria Demographic and Health Survey dataset. Using a total sample of 11,476 weighted sexually active men, the study revealed that 30% of the sampled population were currently using contraceptives, with condom as the dominant method (65.9%). The unadjusted odds of contraceptive use was significantly higher (9.4; confidence interval [8.1, 10.9]) among single men than married. Other factors include wealth, educational attainment, ethnicity, region, religion, and age. The study concludes that there are significant differences in contraceptive use between the single and married men and, therefore, recommends that policy and programs be put in place to promote consistent use of contraceptives among married men in Nigeria.
Collapse
Affiliation(s)
- S S Asa
- 1 Department of Demography and Social Statistics, 313034 Obafemi Awolowo University , Ile-Ife, Nigeria
| | - A Titilayo
- 1 Department of Demography and Social Statistics, 313034 Obafemi Awolowo University , Ile-Ife, Nigeria.,2 Population Training and Research Unit, North-West University, Mafikeng, South Africa
| | - J A Kupoluyi
- 1 Department of Demography and Social Statistics, 313034 Obafemi Awolowo University , Ile-Ife, Nigeria
| |
Collapse
|
35
|
Babalola S, Figueroa ME, Krenn S. Association of Mass Media Communication with Contraceptive Use in Sub-Saharan Africa: A Meta-Analysis of Demographic and Health Surveys. JOURNAL OF HEALTH COMMUNICATION 2017; 22:885-895. [PMID: 29125805 DOI: 10.1080/10810730.2017.1373874] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Literature abounds with evidence on the effectiveness of individual mass media interventions on contraceptive use and other health behaviors. There have been, however, very few studies summarizing effect sizes of mass media health communication campaigns in sub-Saharan Africa. In this study, we used meta-analytic techniques to pool data from 47 demographic and health surveys conducted between 2005 and 2015 in 31 sub-Saharan African countries and estimate the prevalence of exposure to family planning-related mass media communication. We also estimated the average effect size of exposure to mass media communication after adjusting for endogeneity. We performed meta-regression to assess the moderating role of selected variables on effect size. On average, 44% of women in sub-Saharan Africa were exposed to family planning-related mass media interventions in the year preceding the survey. Overall, exposure was associated with an effect size equivalent to an odds ratio of 1.93. More recent surveys demonstrated smaller effect sizes than earlier ones, while the effects were larger in lower contraceptive prevalence settings than in higher prevalence ones. The findings have implications for designing communication programs, setting expectations about communication impact, and guiding decisions about sample size estimation for mass media evaluation studies.
Collapse
Affiliation(s)
- Stella Babalola
- a Johns Hopkins Center for Communication Programs , Johns Hopkins University , Baltimore , Maryland , USA
| | - Maria-Elena Figueroa
- a Johns Hopkins Center for Communication Programs , Johns Hopkins University , Baltimore , Maryland , USA
| | - Susan Krenn
- a Johns Hopkins Center for Communication Programs , Johns Hopkins University , Baltimore , Maryland , USA
| |
Collapse
|
36
|
Hasselback L, Dicko M, Viadro C, Ndour S, Ndao O, Wesson J. Understanding and addressing contraceptive stockouts to increase family planning access and uptake in Senegal. BMC Health Serv Res 2017; 17:373. [PMID: 28549472 PMCID: PMC5446687 DOI: 10.1186/s12913-017-2316-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 05/17/2017] [Indexed: 11/23/2022] Open
Abstract
Background Senegal’s government has pledged to reduce contraceptive stockouts, which have been frequent in public sector health facilities. An innovative distribution system called the Informed Push Model (IPM) addresses supply chain obstacles through direct regional-to-facility delivery of contraceptives and use of private sector logistics operators. Following promising pilot results, Senegal’s Ministry of Health and Social Action committed to a three-year (2013–2016) expansion of IPM to all public health facilities nationwide. Methods From August 2014–July 2016, IPM’s six logisticians made 29,319 visits to restock public sector health facilities. During these regular facility visits, the logisticians conducted a physical inventory to flag contraceptive stockouts (no usable stock of any single method available) and asked facility staff to identify the primary reason for documented stockouts. Our descriptive study examines stockout trends over the course of IPM scale-up. We also describe trends in contraceptive consumption over the three-year period using facility-level data collected by the logisticians. Results Contraceptive consumption rose by 91% over 35 months in the first three IPM regions, and by 118% in the next five regions (over 26 months). After scale-up to 1,394 health facilities, nationwide consumption rose by 48% over one year. On average, logisticians documented stockouts at fewer than 2% of facility visits. In comparison, two pre-IPM studies in 2011 identified stockouts of selected modern contraceptives at 60–70% of facilities visited, with 84% of clients reporting stockouts in the past year. Six factors (including consumption spikes, IPM-preventable causes, and community outreach) explained most remaining stockouts. Conclusions IPM has been highly successful in ensuring full availability of contraceptives across regions and health facilities. The model also has facilitated the flow of essential data on consumption and stockouts from facilities up to district, regional, and central-level managers. These achievements highlight the relevance of professionalizing supply chain management while continuing to mitigate stockouts through enhanced stakeholder communication and improved training, coaching, and supervision of third-party logistics operators. Supply reliability is critical in shaping demand for and regular use of contraception. The government is transitioning the IPM to full management by the National Supply Pharmacy.
Collapse
Affiliation(s)
- Leah Hasselback
- Formerly IntraHealth International, Sacré Cœur Cité Keur Gorgui, derrière siège, SONATEL Lot R73, Dakar, Senegal
| | - Modibo Dicko
- IntraHealth International, Sacré Cœur Cité Keur Gorgui, derrière siège, SONATEL Lot R73, Dakar, Senegal
| | - Claire Viadro
- IntraHealth International, 6340 Quadrangle Drive, Suite 200, Chapel Hill, NC, 27517, USA
| | - Soussaba Ndour
- IntraHealth International, Sacré Cœur Cité Keur Gorgui, derrière siège, SONATEL Lot R73, Dakar, Senegal
| | - Oumy Ndao
- IntraHealth International, Sacré Cœur Cité Keur Gorgui, derrière siège, SONATEL Lot R73, Dakar, Senegal
| | - Jennifer Wesson
- IntraHealth International, 6340 Quadrangle Drive, Suite 200, Chapel Hill, NC, 27517, USA.
| |
Collapse
|
37
|
Ochako R, Temmerman M, Mbondo M, Askew I. Determinants of modern contraceptive use among sexually active men in Kenya. Reprod Health 2017; 14:56. [PMID: 28449723 PMCID: PMC5408470 DOI: 10.1186/s12978-017-0316-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Accepted: 04/08/2017] [Indexed: 12/04/2022] Open
Abstract
Background Research in Kenya has focussed on family planning from women’s perspectives, with the aim of helping reduce the burden of unintended pregnancies. As such, the determinants of modern contraceptive use among sexually active women are well documented. However, the perspectives of men should be considered not only as women’s partners, but also as individuals with distinct reproductive histories and desires of their own. This study seeks to understand the determinants of modern contraceptive use among sexually active men, by exploring factors that are correlated with modern contraceptive use. Methods The data source is the nationally representative 2014 Kenya Demographic and Health Survey (DHS) of men aged 15–54 years. The analysis is restricted to 9,514 men who reported being sexually active in the past 12 months prior to the survey, as they were likely to report either doing something or not to avoid or delay pregnancy. We use bivariate and multinomial logistic regression to assess factors that influence modern contraceptive use among sexually active men. Results Findings from the bivariate and multinomial logistic regression indicate that region of residence, marital status, religion, wealth, interaction with a health care provider, fertility preference, number of sexual partners and access to media were all significantly associated with modern contraceptive use among sexually active men. Conclusion Provider-client interaction as well as dissemination of information through mass media has the potential to increase knowledge and uptake of modern contraceptives. Similar efforts targeting segments of the population where contraceptive uptake is low are recommended.
Collapse
Affiliation(s)
- Rhoune Ochako
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. .,Population Council, P.O. Box 17643, 00100, Nairobi, Kenya.
| | - Marleen Temmerman
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium.,Aga Khan University, Nairobi, Kenya
| | - Mwende Mbondo
- CIVITRA Research and Consulting Company Ltd., Nairobi, Kenya
| | - Ian Askew
- World Health Organization, Geneva, Switzerland
| |
Collapse
|
38
|
Babalola S. Changes in Ideational Profiles of Women of Reproductive Age in Urban Nigeria: The Role of Health Communication. HEALTH EDUCATION & BEHAVIOR 2017; 44:907-917. [DOI: 10.1177/1090198117699510] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
39
|
Msovela J, Tengia-Kessy A. Implementation and acceptability of strategies instituted for engaging men in family planning services in Kibaha district, Tanzania. Reprod Health 2016; 13:138. [PMID: 27871299 PMCID: PMC5117686 DOI: 10.1186/s12978-016-0253-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 11/04/2016] [Indexed: 11/25/2022] Open
Abstract
Background Men as the main decision makers in most of African families have an important role to play towards acceptance of family planning methods. This study sought to identify strategies used to engage men in family planning services and determine the extent to which men in Kibaha district in Tanzania accept these interventions. Methods We conducted a cross sectional study using both quantitative and qualitative techniques. We used a questionnaire to interview a random sample of 365 of currently married or cohabiting men who had at least one child under the age of five years. We further conducted in-depth interviews with health workers involved in delivering reproductive health services as well as community dispensers of family planning commodities. Descriptive analysis was used to determine the extent to which men were engaged in family planning services. The data from the indepth interviews were analysed manually according to the predetermined themes, guided by the grounded theory to identify the existing strategies used to encourage male involvement in family planning services. Results According to the key informants, strategies that are used to encourage men to engage in family planning services include invitations through their spouses, either verbally or by using partner notification cards, incorporating family planning messages during monthly meetings and community outreach reproductive health programs. Of 365 men responding to the questionnaire, only 31 (8.4%) said they were invited to accompany their spouses to family planning clinics. Among them, 71% (22/31) visited family planning clinics. A third (32%) of the respondents had heard of community health meetings and only 20.7% of them attended these meetings. More than a third (12/34) of men who attended these meeting asserted that family planning messages targeting men featured in the agenda and subsequently half of them visited health facilities for family planning services. Conclusions Existing strategies such as invitations to clinics and community sensitization have shown to encourage men to engage in family planning services. However, these interventions reach few men and hence there is a need to rolling them up to improve uptake of family planning services. Electronic supplementary material The online version of this article (doi:10.1186/s12978-016-0253-6) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Judith Msovela
- National Institute for Medical Research (NIMR), P.O. Box 9653, Dar es Salaam, Tanzania.
| | - Anna Tengia-Kessy
- Muhimbili University of Health and Allied Sciences (MUHAS), P.O. Box 65015, Dar es Salaam, Tanzania
| |
Collapse
|