IDENTIFYING FACTORS ASSOCIATED WITH THE USE OF A SCALED-UP POSTPARTUM FAMILY PLANNING PROJECT IMPLEMENTED IN PUNJAB, PAKISTAN

Authors

  • Aniza Ismail Associate Professor3Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Jalan Yaakob Latiff Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
  • Mariam Ashraf Researcher
  • Idayu Badilla Idris
  • Inayat Thaver
  • Ahsan Maqbool Ahmad
  • Sarmad Jamal Siddique

DOI:

https://doi.org/10.37268/mjphm/vol.21/no.2/art.1091

Keywords:

Postpartum Family planning uptake, contraceptive use, project-based interventions

Abstract

Pakistan has one of the highest unmet needs for family planning among low and middle-income countries. Postpartum family planning (PPFP) is considered to have the potential of significantly improving the contraceptive prevalence rate and reducing the unmet need for family planning. Jhpiego (John Hopkins Affiliate) implemented a PPFP pilot project in the district headquarter hospital of Mandi Bahauddin.  The key interventions of the Jhpiego pilot were to improve services pertinent to PPFP. Based on the successes of the pilot, the interventions were scaled up to other health facilities. The present study aims to identify the factors associated with the utilization of the postpartum family planning health project implemented in the health facilities once the scale-up activities ended and comparing it with the pilot facility. A cross-sectional survey with a sample of 410 women using postpartum care services in the facilities was conducted using a structured questionnaire. The findings indicated that the complete set of interventions were not present in the facilities.  Postpartum family planning method uptake was low (26%) along with the shortage of contraceptives supplies. Multivariate logistic regression was conducted to identify the predictors for the current use of postpartum family planning. The predictors identified that women with the age of 25 years and above with 3 or more children, who attended antenatal care visits and were counselled on PPFP were more likely to adopt/use PPFP in the postpartum period. The findings indicated scale-up was limited and the interventions were not sustained once the donor support ended. 

References

Tappis H, Kazi A, Hameed W, et al. The role of quality health services and discussion about birth spacing in postpartum contraceptive use in Sindh, Pakistan: A multilevel analysis. PLoS One. 2015;10(10):1–18.

Palamuleni ME. Socio-economic and demographic factors affecting contraceptive use in Malawi. Afr J Reprod Health. 2013;17(3):91–104.

Thapa K, Dhital R, Rajbhandari S, et al. Improving post-partum family planning services provided by female community health volunteers in Nepal: A mixed-methods study. BMC Health Serv Res. 2020;20(1):1–13.

Wulifan JK, Brenner S, Jahn A, et al. A scoping review on determinants of unmet need for family planning among women of reproductive age in low and middle-income countries. BMC Women's Health [Internet]. 2016;16(1). Available from: http://dx.doi.org/10.1186/s12905-015-0281-3

Moore Z, Pfitzer A, Gubin R, et al. Missed opportunities for family planning: An analysis of pregnancy risk and contraceptive method use among postpartum women in 21 low- and middle-income countries. Contraception [Internet]. 2015;92(1):31–9. Available from: http://dx.doi.org/10.1016/j.contraception.2015.03.007

NIPS. Pakistan Demographic Health Survey [Internet]. 2017. Available from: http://nips.org.pk/abstract_files/PDHS 2017-18 - key findings.pdf

Milat AJ, Newson R, King L. Increasing the scale of population health interventions : A Guide. Evid Eval Guide Ser Popul Public Heal Div. 2014;

Darney BG, Sosa-Rubi SG, Servan-Mori E, Rodriguez MI, Walker D, Lozano R. The relationship of age and place of delivery with postpartum contraception prior to discharge in Mexico: A retrospective cohort study. Contraception [Internet]. 2016;93(6):478–84. Available from: http://dx.doi.org/10.1016/j.contraception.2016.01.015

Do M, Hotchkiss D. Relationships between antenatal and postnatal care and post-partum modern contraceptive use: Evidence from population surveys in Kenya and Zambia. BMC Health Serv Res. 2013;13(1).

Villar J, Ba’aqeel H, Piaggio G, et al. WHO antenatal care randomised trial for the evaluation of a new model of routine antenatal care. Lancet (London, England) [Internet]. 2001 May 19 [cited 2019 Oct 18];357(9268):1551–64. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11377642

Janowitz B, Bratt J, Homan R, et al. How much will it cost to scale up a reproductive health pilot project? Reprod Health. 2007;(8).

Simmons R, Fajans P, Ghiron L. Scaling up Health Service Delivery – From pilot innovations to policies and programmes. Public Health [Internet]. 2007;123(9):638–9. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0033350609001541

Downloads

Published

2021-08-28

How to Cite

Ismail, A., Ashraf, M., Badilla Idris, I., Thaver , I., Maqbool Ahmad , A., & Jamal Siddique , S. . (2021). IDENTIFYING FACTORS ASSOCIATED WITH THE USE OF A SCALED-UP POSTPARTUM FAMILY PLANNING PROJECT IMPLEMENTED IN PUNJAB, PAKISTAN. Malaysian Journal of Public Health Medicine, 21(2), 466–474. https://doi.org/10.37268/mjphm/vol.21/no.2/art.1091