The role of family planning counselling during maternal and child health services in postpartum modern contraceptive uptake in Ethiopia: A national longitudinal study

Kalayu Brhane Mruts; Gizachew A Tessema; Amanuel Tesfay Gebremedhin; Jane A Scott; Gavin Pereira

doi:10.1371/journal.pgph.0000563

The role of family planning counselling during maternal and child health services in postpartum modern contraceptive uptake in Ethiopia: A national longitudinal study

PLOS Glob Public Health. 2022 Aug 3;2(8):e0000563. doi: 10.1371/journal.pgph.0000563. eCollection 2022.

Authors

Kalayu Brhane Mruts¹, Gizachew A Tessema^{1

2}, Amanuel Tesfay Gebremedhin^{1

3}, Jane A Scott¹, Gavin Pereira^{1

4

5}

Affiliations

¹ School of Population Health, Curtin University, Perth, Australia.
² School of Public Health, University of Adelaide, Adelaide, Australia.
³ Wesfarmers Centre for Vaccine and Infectious Disease, Telethon Kids Institute, University of Western Australia, Perth, Australia.
⁴ Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, Oslo, Norway.
⁵ enAble Institute, Curtin University, Perth, Australia.

Abstract

Family planning counselling can help improve the postpartum modern contraceptive uptake. However, studies in Ethiopia indicate inconsistent effects of integrated family planning counselling on postpartum modern contraceptive uptake. This study aimed to determine the extent of family planning counselling and its role in improving postpartum contraceptive uptake among women in Ethiopia. We used the Performance Monitoring for Action (PMA) Ethiopia panel survey data, a community-based prospective cohort study. Randomly selected pregnant women were recruited at the baseline interview and followed by six weeks and six months postpartum. A weighted generalised linear model fitted with a Poisson distribution and a log link function was used to estimate the adjusted relative risk (aRR) and 95% Confidence Interval (CI) of modern contraceptive uptake. The coverages of family planning counselling provision during ANC, prior to discharge and child immunisation were 20%, 27% and 23%, respectively. The modern contraceptive uptakes by six weeks and six months postpartum were 18% and 36%, respectively. Family planning counselling prior to discharge from the facility was associated with increased modern contraceptive uptake by six weeks (aRR 1.25; 95% CI 0.94, 1.65) and six months postpartum periods (aRR 1.07; 95% CI 0.90, 1.27). Moreover, women who received family planning counselling during child immunisation were 35% more likely to use modern contraceptives by six months postpartum (aRR 1.35;95% CI 1.12, 1.62). However, counselling during ANC visits was not associated with modern contraceptive uptake by either six weeks or six months postpartum. A significant proportion of women had missed the opportunity, and the postpartum modern contraceptive uptake was low. Despite these, family planning counselling prior to discharge from the facility and during child immunisation improved the postpartum modern contraceptive uptake. However, our finding revealed insufficient evidence that family planning counselling during ANC is associated with postpartum modern contraceptive uptake.

Copyright: © 2022 Mruts 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.

Grants and funding

This research was supported by funding by the National Health and Medical Research Council Project Grants #1099655 and #1173991 for GP, and #1195716 for GAT and institutional funding for the WA Health and Artificial Intelligence Consortium, and the Research Council of Norway through its Centres of Excellence funding scheme #262700 for GP. In addition, KBM was supported by an Australian Government Research Training Program International Scholarship. However, the funders had no role in study design, data collection, analysis, interpretation of the results and decided to publish or prepare the manuscript.