POSTPARTUM MODERN CONTRACEPTIVE UTILIZATION IN ADDIS ABABA: ANTEPARTUM DECIDEDNESS FOR POSTPARTUM UPTAKE

Abstract

Introduction: Family planning (FP) slows population growth and helps achieve national and international development goals. FP counselling is the first intervention in family planning programs and can be done during late pregnancy. Antepartum FP counseling is not practiced adequately during the antenatal care (ANC) service delivery at which time women can decide to use Post-Partum Modern Contraceptive (PPMC). Women’s antenatal decidedness rate to use PPMC is not known.

Objective: To assess the prevalence of antenatal decidedness to use PPMC among pregnant women in Addis Ababa city.

Methods: A cross-sectional study was conducted from Tir 01, 2012 to Tir 30, 2012 EC on a population of women who had their 4^th ANC visits in 98 health centers in Addis Ababa.  The calculated sample size was 422; and the sampling procedure was made in 2 stages: Cluster Sampling and Simple Random Sampling. Study subjects were enrolled in a continuous all-inclusive manner starting from the first woman who came on her scheduled 4^th ANC visit on day one of the study period until the total number of study subjects was obtained. A semi-structured, anonymous, self-prepared & pre-tested questionnaire was used to collect data; and data collection was as an exit interview. Data was entered & analyzed using SPSS version 25 software.

Results: During the routine ANC follow up only 153 (36.9%) have had FP counseling, and the study team delivered the service for 262 (63.1%). Three hundred eighteen (76.6%) have antenatally decided to use PPMC. The rate of antenatal decidedness to use PPMC was higher for those who had FP counseling by the study team compared to those counseled during the routine ANC follow up (77.9% Vs 74.5%). Religion, the round of ANC visit the FP counseling was given, and the number of topics covered during the FP counseling were found to be determining factors for women’s antenatal decidedness to use PPMC.

Conclusion: The FP counseling service delivery rate during the routine ANC service is low. Women will decide to use PPMC antenatally if they get a FP planning counseling conducted during the ANC follow up. The FP counseling should include 4 major topics (available types, efficacy, advantages & disadvantages, and side effects of each method), and an adequate duration should be allocated for it. Further study to find out why ANC care providers at health centers are not providing FP counseling service to all of their clients is recommended.