Knowledge, Attitude, and Practice of Family Planning Among Saudi Primary Health Care Attendees in Al-Ahsa, Kingdom of Saudi Arabia.

BACKGROUND:  Assessing community awareness and practice of the significance and methods of family planning is critical for improving the effectiveness and quality of services, policies, and planning, which has a positive impact on the health and quality of life of women, children, families, and communities. OBJECTIVE:  This study aims to determine Saudi population's knowledge, attitude, and practice of family planning in Al-Ahsa, Kingdom of Saudi Arabia. METHODOLOGY:  A cross-sectional study was conducted in Al-Ahsa, Saudi Arabia. The study included randomly selected participants (male and female Saudi primary health care attendees). All adult Saudi individuals of both genders attending primary health care centers were eligible for inclusion in this study. Data were analyzed using IBM SPSS Statistics for Windows, Version 15 (Released 2006; IBM Corp., Armonk, New York, United States). Descriptive statistics for the prevalence and quantitative variables was used.  Results: The study included 672 participants; 78.6% of them were females and 21.4% were males. 23.8% of participants aged between 20 and 30 years old. 73.8% of participants heard of family planning before. The source of information about family planning was reported as 36.9% from the Internet, 27.4% from relatives, 21.4% from the doctor, and 14.3% from books. 21.4% think that long-term contraceptive use led to permanent infertility. 81.0% of the participants said that they tend to use family planning methods. 78.6% of the participants have used a family planning method before, where 25.8% of the participants used natural contraception methods, 21.2% used surgical contraception, 27.3% used condoms, and 12.1% used hormonal tablets, while 13.6% used nothing. However, 65.2% currently use contraceptives. 31.8% use the natural method of family planning currently, 21.2% use surgical methods, and 6.1% use condoms. CONCLUSION:  In comparison to many studies previously mentioned, the rate of family planning utilization was average, as was the level of knowledge and attitude toward family planning. However, there were some mistaken beliefs among participants regarding contraceptives. Age, gender, the duration of a marriage, education level, working status, and monthly income were all found to be significantly associated with knowledge of family planning.

Lived Experience of Women Who Underwent Early Removal of Long-Acting Family Planning Methods in Bedesa Town, Wolaita Zone, Southern Ethiopia: A Phenomenological Study.

BACKGROUND: Long-acting family planning method (LAFP) is a low-cost yet effective method of reducing maternal mortality, limiting and spacing childbirth. In Ethiopia, the family planning prevalence rate rises from 15% in 2005 to 36% in 2016. However, the discontinuation rate of LAFP is still high in the region. Therefore, the aim of this study was to explore the lived experiences of women who underwent early removal of long-acting family planning methods in Bedesa town, Southern Ethiopia. METHODS: An interpretative phenomenological study design was employed. Women aged 15-49 years who removed LAFP therapy in the past 12 months were our sampled population. Data were collected through in-depth interviews (IDIs) by using open-ended structured interview guide. Purposive sampling technique was used to select 10 participants from the family planning logbook registration of Bedesa health center. The interview continued until information saturation was reached. Open code version 4.03 was used to code and facilitate analysis. Transcripts were read and re-read separately to identify emerging themes. A thematic analysis technique was used. RESULTS: This study revealed that the side effects, seeking more children and the husband's opposition were the main reason for early removal of LAFP. Amongst side effects, heavy and irregular menses were occurred most frequently. Besides, there were various myths and misconceptions about family planning methods. It also noted that the counseling services provided by health professionals were not adequate. CONCLUSION: Side effects, desired to have more children, and the husband's opposition are the most important reason of early removal of LAFP methods. Furthermore, there were misunderstanding, fear and rumors raised by women about each method. Hence, greater public awareness on family planning should be delivered to change community perception on LAFP methods.

Factors associated with the uptake of immediate postpartum intrauterine contraceptive devices (PPIUCD) in Rwanda: a mixed methods study.

BACKGROUND: Rwanda has a high unmet need for family planning which could be reduced by improving access to postpartum intrauterine contraceptives device (PPIUCD) insertion. The objective of the study was to assess the prevalence and factors associated with the uptake of PPIUCD among postpartum women in Muhima Hospital. METHODS: A concurrent mixed-method study was used. Three hundred eight three (383) immediate postpartum mothers, and 10 health services providers were interviewed using a structured questionnaire and in-depth interviews respectively. Logistics regression was done to assess for factors associated with PPIUCD uptake and thematic analysis was used for qualitative data. RESULTS: The prevalence for PPIUCD use was 28.1%, women who had spontaneous vaginal delivery were more likely to take up PPIUCD (Adjusted Odds Ratio (AOR) 2.623, 95% CI = 2.017-6.507 compared to those who had cesarean section; women who received PPIUCD counselling during the antenatal period were more likely to use PPIUCD ((AOR 2.072, 95% CI = 1.018-4.218) as compared to those who didn't receive any form of counselling; mothers who received spouse approval were more likely to use PPIUCD (AOR 2.591,95% CI = 1.485-4.492); as compared to those who didn't receive any spousal approval; women who had more than one child were more likely to use PPIUCD (AOR =2.265, 95% CI = 1.472-3.163) as compared to prime gravida; Mothers with birth to pregnancy interval less than two years were more likely to use PPIUCD (AOR =2.123, CI =1.477-2.706) as compared to those who had birth to pregnancy interval more than 2 years. From the qualitative findings, health education of mothers and partners on PPIUCD, training of health care providers, and availability of supplies to provide PPIUCD influenced the use of PPIUCD. CONCLUSION: The acceptability to use for PPIUCD was high in this population. PPIUCD uptake was associated with normal birth, PPIUCD counselling, spousal approval, parity, birth interval, level of education. Health education of mothers and partners on PPIUCD, training of health providers, and availability of supplies to provide PPIUCD influenced uptake of PPIUCD.

Prevalencia de los factores asociados a la no coincidencia del método de planificación familiar electo en la atención prenatal y el aplicado post-evento obstétrico / Prevalence of the factors associated with the non-coincidence of the method of elected family planning in prenatal care and applied post-event obstetric

RESUMEN Marco teórico: La atención prenatal tiene varios objetivos y entre ellos está el fomentar y sentar bases para una decisión adecuada sobre planificación familiar con base en las condiciones clínicas de la mujer. Es frecuente encontrar en la atención de puerperio que la paciente no haya recibido un método de planificación familiar por distintos factores. Objetivo: Identificar la prevalencia de los factores asociados a la no coincidencia del método de planificación familiar electo en la atención prenatal y el aplicado post-evento obstétrico. Metodología: Diseño transversal descriptivo en pacientes en puerperio inmediato cuyo método de planificación familiar solicitado en consentimiento informado firmado en la atención prenatal no coincidió con el aplicado post-evento obstétrico. Se midieron factores intrínsecos y extrínsecos Resultados: El factor intrínseco más importante fue el cambio de decisión personal 59.0% (IC 95%; 53.10-64.90) y el factor extrínseco la falta de insumos en el 31.20% (IC 95%; 25.60-36.80). Cuando se realizó la evaluación conjunta la prevalencia del cambio de decisión personal se modificó a 35.20% (IC 95%; 29.4-41.0) y la falta de insumos a 12.6% (IC95%; 8.6-16.6) Conclusión: Los factores intrínsecos y extrínsecos asociados a la no coincidencia del método de planificación familiar con mayor prevalencia son el cambio de decisión por la paciente y la falta de insumos respectivamente.

ABSTRACT Background: Prenatal care has several objectives and among them is to promote and lay the groundwork for an adequate decision on family planning based on the clinical conditions of women. It is common to find in puerperium care that the patient has not received a family planning method due to different factors. Objective: To identify the prevalence of the factors associated with the non-coincidence of the method of family planning elected in prenatal care and the post-obstetric event applied. Methods: Descriptive cross-sectional design in patients in the immediate puerperium whose family planning method requested in signed informed consent in prenatal care did not coincide with the applied post-obstetric event. Intrinsic and extrinsic factors were measured Results: The most important intrinsic factor was the change of personal decision 59.0% (95% CI, 53.10-64.90) and the extrinsic factor the lack of inputs in 31.20% (95% CI, 25.60-36.80). When the joint evaluation was carried out, the prevalence of the personal decision change was modified to 35.20% (95% CI, 29.4-41.0) and the lack of inputs to 12.6% (95% CI, 8.6-16.6). Conclusion: The intrinsic and extrinsic factors associated with the non-coincidence of the family planning method with the highest prevalence are the change of decision by the patient and the lack of inputs, respectively.

The level of using family planning methods and factors that influence the preference of methods in the Konya-Meram area.

OBJECTIVE: To determine the level of contraceptive method use and factors that influence the preference of method among women of reproductive age that live in Meram, the central district of Konya. MATERIAL AND METHODS: Parameters such as age, duration of marriage, number of pregnancies and births, socioeconomic status, education level, and preferred contraceptive method of women who presented to the family planning outpatient clinic of our hospital over a five-year period between January 1st, 2010, and December 31st, 2015, were recorded and evaluated. RESULTS: The mean age of the women was identified as 31.57±8.14 years, the mean duration of marriage was 10.3±8.14 years, the mean number of births was 1.92±1.01, and the mean number of children was 1.83±0.90. Among the women in the study group, 65% were high school graduates, 88.92% had social security, and 82.84% were in the middle-income group according to their financial status. Only 31 patients were not married officially. It was observed that the most preferred method was intrauterine device (IUD), and the least preferred method was subcutaneous implant (SI). The use of IUD, oral contraceptives, and SI increased as the socioeconomic status and educational level improved (p<0.05). CONCLUSION: To ensure that women of reproductive age use effective family planning methods, the education levels and socioeconomic status of women must be improved.

Long-acting family planning method switching among revisit clients of public health facilities in Dire Dawa, Ethiopia.

BACKGROUND: "Contraceptive switching" from one method to another is a common phenomenon. Switching from a more effective long-acting method to a less effective method exposes women for unplanned pregnancy. The aim of this study was to assess the level and factors associated with long-acting family planning method switching to other methods. METHOD: A facility-based cross-sectional study was conducted from January to March 2013 on 634 women attending public health facilities in Dire Dawa City Administration, Ethiopia. Participants of the study were revisit clients of family planning service and were interviewed as they appear in the clinics. Data were analyzed using crude and adjusted logistic regression, and results were reported using OR and corresponding 95 % CI. RESULTS: Long-acting family planning method switching among revisit clients was 40.4 %; switching from implant was 29.8 % and from IUCD, it was 10.6 %. The main reasons for methods switching were side effects of the methods such as bleeding, weight loss, and feeling of arm numbness. The tendency of switching was less among married women (AOR = 2.41, 95 % CI: 1.01, 5.74), women who had 2-4 and 5 and more children (AOR 3.00, 95 % CI: 1.59, 5.67) and (AOR 2.07, 95 % CI: 1.17, 3.66), respectively. It was also less among women who want to stop birth (AOR 5.11, 95 % CI: 1.15, 24.8), among those who mentioned health care providers as source of information for family planning (AOR 1.88, 95 % CI: 1.18, 3.01), and among women whose husbands were aware of their use of the methods (AOR 3.05, 95 % CI: 1.88, 4.94). CONCLUSIONS: Method switching from long-acting contraceptives to less effective methods is high. Method switching was significant among unmarried women, who had one child, plan to postpone fertility, and whose husbands were not aware of their wive's use of the method. In the provision of family planning service, the health care providers should give adequate information about each method and risks of method switching. Appropriate family planning Information Education and Communication (IEC) and Behavioral Change Communication (BCC) strategies should be emphasized.