Barriers and missed opportunities towards immediate and early post-partum family planning methods in Pakistan.

Abstract

The postpartum family planning (PPFP) services are offered immediately after delivery (immediate PPFP), within 40 days after delivery (early PPFP) and within 12 month after delivery (extended PPFP). To promote PPFP the counselling during antenatal visit, before discharge from maternity ward, during postnatal visit and visit during immunization of their babies are the opportunities where health providers help them to decide about the post-partum contraception. Objectives: To compare the coverage of immediate and early postpartum family planning to extended postpartum family planning. To analyze the socio demographic barriers for adopting immediate and early postpartum family planning methods. To identify the missed opportunities for immediate and early postpartum family planning. Study Design: Community Based Comparative Cross Sectional study. Setting: Tando Jam and Hali Road Hyderabad, Sindh. Period: Three months from 01-07-2017 to 30-09-2017. Material & Methods: Three Hundred females of reproductive age (15 to 49 years) during immediate, early and extended postpartum period residing in study area were selected through Purposive Sampling Technique. A pre-designed questionnaire was used as a data collection tool. The data was analyzed using SPSS version 16. The participants were inquired about the usage and concerns towards immediate and early post-partum family planning methods. Barriers and opportunities were identified. The association between various socio-demographic variables and family planning method was determined by applying Chi-square test at ≤0.05 level of significance. Results: Highest number of the study participants were practicing extended method of post-partum family planning i.e. 223(74.33%), only 65(21.67%) had adopted early PPFP and 12 (4%) were practicing immediate post-partum family planning.  Low socio-economic status, low literacy rate of both partner, young age of women, and permission from husband, fear of health problem due to contraception and previous bad experience with contraceptive methods were identified barriers towards family planning adoption. Deliveries in homes or in maternity home, facilitated by Dais, not going through ante-natal checkups and not bringing the last born for vaccination were reported with non-adoption of immediate post-partum family planning. Conclusion: The coverage of immediate and early postpartum family planning is very low in the community so the barriers and opportunities identified should be addressed to overcome the hindrances.