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      Why modern family planning needs of women is not met in South Gondar Zone, Ethiopia?

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          Abstract

          Background

          Family planning is critical for the health of women and their families and it can accelerate a country’s progress toward reducing poverty and achieving Sustainable Development Goals. Effective use of family planning methods helps couples achieve the desired number of children, contribute to improving maternal and child health which may help women avoid unwanted pregnancy, and reduce the risk factors for maternal and child deaths. Moreover, contraceptive prevalence and unmet need for family planning are key indicators for determining the level of improvements in access to reproductive health. So, this study aimed to identify the prevalence and associated factors of unmet need of modern family planning among reproductive-age women in the south Gondar zone.

          Methods

          A community-based cross-sectional study design was conducted in the southern Gondar zone among 528 reproductive-age women. Data were collected with pre-tested, structured, interviewer-administered questionnaires. Data were coded and entered into Epi info version 7 and exported to SPSS version 20. Bivariable and multivariable logistic regression models were applied. A P-value0.05 was considered to declare a result as significant at 95% CI.

          Result

          The overall unmet need in this study area was 22.6%, from whom 15.1% of respondents were wanted children later and 7.5% were wanted no more children. For women who had been visited by health care providers within 12 months before the study, women currently on menstrual status, the desired number of children, and induced abortion were found statistically significant.

          Conclusion

          The unmet need for FP was found high in the study area as compared to the national and regional prevalence. Women visited by health care providers, currently menstruating, the desired number of children, and history of induced abortion were significantly associated with the unmet need of modern FP. Health care providers and health extension workers need to visit regularly and promote appropriate and active IEC programs that address the provision of accurate information about the availability of the services and various contraceptive options including techniques to reduce and change perceived barriers to service utilization (such as rumors and misconceptions of FP).

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          Most cited references25

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          Determinants of low family planning use and high unmet need in Butajira District, South Central Ethiopia

          Background The rapid population growth does not match with available resource in Ethiopia. Though household level family planning delivery has been put in place, the impact of such programs in densely populated rural areas was not studied. The study aims at measuring contraception and unmet need and identifying its determinants among married women. Methods A total of 5746 married women are interviewed from October to December 2009 in the Butajira Demographic Surveillance Area. Contraceptive prevalence rate and unmet need with their 95% confidence interval is measured among married women in the Butajira district. The association of background characteristics and family planning use is ascertained using crude and adjusted Odds ratio in logistic regression model. Results Current contraceptive prevalence rate among married women is 25.4% (95% CI: 24.2, 26.5). Unmet need of contraception is 52.4% of which 74.8% was attributed to spacing and the rest for limiting. Reasons for the high unmet need include commodities' insecurity, religion, and complaints related to providers, methods, diet and work load. Contraception is 2.3 (95% CI: 1.7, 3.2) times higher in urbanites compared to rural highlanders. Married women who attained primary and secondary plus level of education have about 1.3 (95% CI: 1.1, 1.6) and 2 (95% CI: 1.4, 2.9) times more risk to contraception; those with no child death are 1.3 (95% CI: 1.1, 1.5) times more likely to use contraceptives compared to counterparts. Besides, the odds of contraception is 1.3 (95% CI: 1.1, 1.6) and 1.5 (1.1, 2.0) times more likely among women whose partners completed primary and secondary plus level of education. Women discussing about contraception with partners were 2.2 (95% CI: 1.8, 2.7) times more likely to use family planning. Nevertheless, contraception was about 2.6 (95% CI: 2.1, 3.2) more likely among married women whose partners supported the use of family planning. Conclusions The local government should focus on increasing educational level. It must also ensure family planning methods security, increase competence of providers, and create awareness on various methods and their side effects to empower women to make an appropriate choice. Emphasis should be given to rural communities.
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            Postpartum contraceptive use and unmet need for family planning in five low-income countries

            Background During the post-partum period, most women wish to delay or prevent future pregnancies. Despite this, the unmet need for family planning up to a year after delivery is higher than at any other time. This study aims to assess fertility intention, contraceptive usage and unmet need for family planning amongst women who are six weeks postpartum, as well as to identify those at greatest risk of having an unmet need for family planning during this period. Methods Using the NICHD Global Network for Women’s and Children’s Health Research’s multi-site, prospective, ongoing, active surveillance system to track pregnancies and births in 100 rural geographic clusters in 5 countries (India, Pakistan, Zambia, Kenya and Guatemala), we assessed fertility intention and contraceptive usage at day 42 post-partum. Results We gathered data on 36,687 women in the post-partum period. Less than 5% of these women wished to have another pregnancy within the year. Despite this, rates of modern contraceptive usage varied widely and unmet need ranged from 25% to 96%. Even amongst users of modern contraceptives, the uptake of the most effective long-acting reversible contraceptives (intrauterine devices) was low. Women of age less than 20 years, parity of two or less, limited education and those who deliver at home were at highest risk for having unmet need. Conclusions Six weeks postpartum, almost all women wish to delay or prevent a future pregnancy. Even in sites where early contraceptive adoption is common, there is substantial unmet need for family planning. This is consistently highest amongst women below the age of 20 years. Interventions aimed at increasing the adoption of effective contraceptive methods are urgently needed in the majority of sites in order to reduce unmet need and to improve both maternal and infant outcomes, especially amongst young women. Study registration Clinicaltrials.gov (ID# NCT01073475)
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              Levels and trends in contraceptive prevalence, unmet need, and demand for family planning for 29 states and union territories in India: a modelling study using the Family Planning Estimation Tool.

              Improving access to reproductive health services and commodities is central to development. Efforts to assess progress on this front have been largely focused on national estimates, but such analyses can mask local disparities. We assessed progress in reproductive health services subnationally in India.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: ResourcesRole: SoftwareRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SupervisionRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SoftwareRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLOS Glob Public Health
                PLOS Glob Public Health
                plos
                PLOS Global Public Health
                Public Library of Science (San Francisco, CA USA )
                2767-3375
                7 June 2022
                2022
                : 2
                : 6
                : e0000335
                Affiliations
                [1 ] Department of Medical Laboratory Sciences, Dembya Primary Hospital, North Gondar, Gondar, Ethiopia
                [2 ] Health Systems Strengthening Directorate, Federal Ministry of Health, Addis Ababa, Ethiopia
                [3 ] Department of Health Systems and Policy, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
                Pai Chai University, REPUBLIC OF KOREA
                Author notes

                The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0002-6581-0923
                https://orcid.org/0000-0001-7059-1449
                Article
                PGPH-D-21-00733
                10.1371/journal.pgph.0000335
                10021848
                36962335
                7667569d-8a95-4d41-bf58-b3c4223d6ab4
                © 2022 Ewunetie et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 6 November 2021
                : 9 May 2022
                Page count
                Figures: 0, Tables: 7, Pages: 11
                Funding
                The authors received no specific funding for this work.
                Categories
                Research Article
                Social Sciences
                Anthropology
                Cultural Anthropology
                Religion
                Social Sciences
                Sociology
                Religion
                Medicine and Health Sciences
                Women's Health
                Maternal Health
                Pregnancy
                Medicine and Health Sciences
                Women's Health
                Obstetrics and Gynecology
                Pregnancy
                Medicine and Health Sciences
                Health Care
                Health Care Providers
                People and Places
                Geographical Locations
                Africa
                Ethiopia
                Social Sciences
                Sociology
                Human Families
                Medicine and Health Sciences
                Women's Health
                Obstetrics and Gynecology
                Contraception
                Female Contraception
                Medicine and Health Sciences
                Health Care
                Health Care Facilities
                People and Places
                Population Groupings
                Age Groups
                Custom metadata
                The ethical review committee of University of Gondar restricted the sharing of this data set because of the sensitive data nature of this study. For further information, please contact the leader of the Ethical review committee at: Name Nigusu Worku E-mail: nigusuworku29@ 123456gmail.com Phone: 0918021437.

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