Accepted for/Published in: JMIR Formative Research
Date Submitted: Oct 13, 2022
Open Peer Review Period: Oct 13, 2022 - Oct 21, 2022
Date Accepted: Jan 19, 2023
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Barriers and enablers for family planning use A Qualitative Exploratory Study on perspectives of community and health care providers from rural Sindh, Pakistan
ABSTRACT
Background:
Pakistan is the fifth most populous country in the world with 68% of its population below 30 years of age. Moreover, with a Total Fertility Rate (TFR) of 3.6, the country’s population is growing much faster than its neighboring countries in South Asia. Furthermore, the unmet need for Family Planning (FP) is high with 17% of all married women wanting to avoid or delay their pregnancies but being unable to do so due to inaccessibility to contraception methods.
Objective:
This study aims to explore the barriers and facilitators of community residents (male and women of reproductive age and adolescents) and healthcare providers in improving access to and utilization of family planning methods through socio-culturally appropriate health service delivery and mechanisms in two districts of Sindh.
Methods:
This qualitative study utilized an exploratory design to explore the barriers, facilitators, and perceived acceptability of FP services amongst the community and healthcare providers. Overall, 11 FGDs were conducted with men, and women as well as adolescent boys and girls (married and unmarried), split into different groups by gender. Similarly, 11 IDIs were conducted with healthcare workers including the Head of department/ Administrator from the Department of Health (DoH), Gynecologists, Staff Nurses, Lady Health Visitors, Lady Health Workers, and Community health workers /health visitors/midwives.
Results:
Seven key themes were identified starting with (i) Family planning: A Matter of Life and Death, (ii) The Social Context of Family Planning and Reproductive Health, (iii) Intersections between Family Planning and Gender, (iv) Financial Implications of Family Planning and Reproductive Health Uptake, (v) Family Planning and Reproductive Health Service Provision at the Facility Level, (vi)Assessing Family Planning and Reproductive Health Service Responsiveness and (vii) The Role of Men in improving Family Planning and Reproductive Health.
Conclusions:
This study uncovered themes exploring barriers, facilitators, and acceptability toward FP and RH uptake in the context of Sindh. The findings call for designing and rolling out context-specific and culturally sensitive interventions to address multiple barriers at the health system and community level. Clinical Trial: ClinicalTrials.gov NCT05045599; https://clinicaltrials.gov/ct2/show/NCT05045599
Citation
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Copyright
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