Impact of Family Planning and Religious Belief upon Family Growth in Addis Ababa, Ethiopia, 2022

Access to own circle of relatives making plans offerings and birth control is important with the world’s populace presently at seven billion inhabitants. Unfortunately near 250 million humans do now no longer have the manner to manipulate their fertility.¹ A discrepancy exists among the share of ladies who recognize approximately long-time period own circle of relatives making plans strategies that are powerful for three to twelve years and people who make use of them as a preference of birth control ².

The 2005 World Health Organization ³ technical session organization on delivery spacing endorsed a delivery to concept c program language period of at the very least 24months or a delivery to delivery c program language period of 33 or quite a few months ⁴ long performing reversible contraceptives include the contraceptive implant and IUD. alive though there is a few communicate concerning whether or not or now no longer three month contraceptive injections are LARCs, in the course of this paper we was predisposed to do not recall them on this category, in keeping with the definition used by WHO ⁵ and Duration of use and time on account that first and ultimate use of oral contraceptives have been exceedingly correlated, with present day and current customers being much more likely to have used contraceptives for longer. ⁸ Short delivery c program language period ⁹ is thought to have a bad impact on according to natal, neonatal and infant fitness effects such as: preterm delivery, nevertheless delivery, highbrow incapacity and developmental put On the alternative hand moms can also additionally be afflicted by dietary depletion, anemia, ante partum hemorrhage, cervical insufficiency, untimely rupture of membranes and In many research, the maternal dietary depletion speculation has been taken into consideration as a probable reason of SBI and detrimental maternal and infant out comes ⁴.Oral contraceptives were to be had for forty years and, despite the fact that their brief time period outcomes on fitness were studied in detail, relatively little is thought approximately whether or not those outcomes persist after use stops. ⁸ Several research have tested the connection among oral contraceptive pill (OCP) use, abortionns and breast most cancers, with blended results. Hormonal modifications related to OCP use and abortion can also additionally boom hazard of breast most cancers over time.¹⁰

Evidence on childbearing preference and reproductive behaviors in ladies residing with HIV on Associate in Nursing Antiretroviral clinical aid (ART) is scarce, drastically in West The occurrence and related elements of childbearing need in HIV-inflamed women in care in Abidjan, safe haven d’Ivoire and explored whether or not or now no longer such wishes have been translated into behaviors concerning contraceptive use and conversation with fitness personnel. ³ Satisfying the unmet would really like for making plans on my own would possibly reduce the quantity of maternal deaths via way of means of almost a third. However, an calculable 215 million ladies who would really like to put off or keep away from maternity nevertheless lack get right of entry to secure and powerful ¹¹.

Thus along with supplying whole maternal care, supplying making plans is important to avoiding maternal deaths. Eleven though numerous global corporation member international locations, drastically the ones inside the advanced world, have robust own circle of relatives making plans programs, that is frequently now no longer the case in barren region Africa, anyplace in spite of an boom in contraceptive occurrence, many girls nevertheless have unmet would really like for birth control. The resultant excessive fertility is associated with excessive degrees of maternal mortality, specifically most of the poorest communities.¹²

Ethiopia is one of the Sub-Saharan African international locations with excessive unintentional being pregnant fee. Every lady in Ethiopia studies as a minimum one unintentional delivery. Although there have been a few research approximately contraceptive use amongst all ladies in Ethiopia, proof approximately contraceptive use amongst ladies without a fertility aim changed into limited. ¹³ A look at carried out in sixty one international locations, recognized the age of ladies, area of residence, wealth status, academic attainment, parity, age at the beginning marriage and fertility desire because the maximum critical elements influencing contraceptive use. ¹⁴ The own circle of relatives making plans carrier in Ethiopia changed into delivered via way of means of the Family Guidance Association of Ethiopia in 1966. The FP carrier at the moment changed into in particular consciousness advent because of social and political constraints.

Ethiopia advanced a countrywide populace coverage in 1993 to harmonize the fee of populace increase and united states improvement and rational usage of herbal resources.¹ To boost up contraceptive and different maternal carrier use Ethiopia released the fitness extension application in 2003. Family making plans carrier is one of the sixteen programs on this application. Because of this contraceptive use expanded from 8% in 2000 to 36% in 2016. ¹⁵However, 24% of reproductive age women who want to put off or keep away from maternity were not using a contraceptive. Women’s occupational, consciousness concerning FP, dialogue with husband, aid from husband, age of ladies, parity, and wealth status of the own circle of relatives have been elements located associated with contraceptive use. ¹⁶ The Ethiopian fitness quarter transformation set up focused to increase the contraceptive occurrence fee to 55% and reduce returned unmet has to 10% via way of means of the tip of 2020.

Family coming up with is key within the effort to scale back the rate (human population) and therefore the of import maternal mortality and morbidity also as tributary to improvement in child welfare. All fecund and married reproductive-age girls who shall limit their fertility are expected to use contraceptives. However the situation is also totally different in developing countries. distinctive factors related to contraceptive among fecund, married reproductive-age women who need no more youngsters is crucial because the incidence of unmet need for contraceptives may be high among this cluster of women. ¹⁷

According to the International Conference of Population Development Program of Action (ICPD, 1994), procreative health is concerning permitting folks the chance to decide, conjointly the} ability to breed once and the way typically whereas being accountable by leading safer and Furthermore, per the ICPD, men and girls ought to each be knowledgeable of, and have access to approved strategies of contraception while effort their agency in selecting their methods of family This leniency also depends on settings, with some areas a lot of acceptable to contraceptive use than others, despite following a similar religion. Against this backdrop, it remains to be examined whether or not there are contraceptive differentials between spiritual denominations in Ethiopia, and the way this might have an effect on the dynamics of fertility in Ethiopia.

There can be sizeable courting among socio-economic, demographic, logistical, carrier pleasant traits and usage of LAMs amongst own circle of relatives making plans customers

There can be courting among own circle of relatives making plans carrier provider’s understanding and talents and usage of long-time period own circle of relatives techniques amongst own circle of relatives making.

To assess the impact of family planning and religious belief upon family growth in Addis Ababa, Ethiopia.

To assess impact of family planning among the family planning clients in health facilities of Addis Ababa, Ethiopia.

To determine the religious view of family planning utilization among the study group.

The study findings might be used to recommend the MOH thru the department of reproductive fitness on strategies/tactics to beautify fine elements and get rid of poor elements that have an impact on LAM (IUCDs, implants, and male/female) use in order to growth contraceptive occurrence and decrease the unmet want of beginning manipulate.

The study findings might as properly assist the department of reproductive fitness and different key stakeholders in making choices on the way to initiate/continue with LAM competencies schooling applications for fitness care employees in FP clinics and as properly interact fitness care offerings to make complete use of possibilities to offer own circle of relatives making plans facts and Family making plans has been recognized as a key precedence element within side the National Reproductive Health Policy (MOH, and has a excessive effect intervention to decrease maternal and little one mortality with the aid of using the maternal, little one and adolescent reproductive coverage group.

The study findings have additionally furnished treasured facts on uptake of LAMs contraceptives that might help the country’s initiative to cope with the unmet desires for own circle of relatives making plans offerings as properly scale up of long-appearing reversible contraceptives beginning manipulate method. In addition, this study will offer facts concerning the socio-monetary and demographic elements that have an impact on using contraceptives. This can also be checked out in phrases of non secular association wherein those elements might be managed for to be able to have a look at the real impact of faith on contraceptive use. It is crucial to recognize whether or not non secular association is related to contraceptive use within side the context of Ethiopia, which can similarly have an effect on the ranges of Therefore, with contraceptives being important so as for fertility to decline, it's far critical to appearance concurrently at non secular association in addition to the socio-monetary and demographic elements that have an effect on using.

A major strength of the study was that the study applied the Health Belief Model and examined contraceptive use among all sexually active women not just those in union or married. However, this study must be considered in light of some limitations. First, unmarried women might be reluctant to report recent sexual activity in Ethiopia due to the sensitivity of the questions and social desirability bias. Therefore, a few sexually active unmarried women might have been excluded from the analysis. Second, all the data were self-reported, which is subject to recall bias. However, the data were collected using a standardized questionnaire by experienced female data collectors who had never worked at the selected health facilities to minimize biases. Third, we cannot infer associations described to causality because of the cross-sectional nature of the data. Our study did not exclude POC formulations when considering types of OCs, which makes it unique. Furthermore, our sample population is restricted to Medicaid beneficiaries, which provides us with unique insight to underrepresented groups. However, this data registry did not provide information on potential confounders such as diet, physical activity, serum lipids, blood pressure, family history, and other reproductive factors (e.g. menstrual history), estrogen/progesterone receptor status, and post-operative treatment. Limited information was provided on tobacco use, and stratification of events by type of OC use and race led to small numbers and reduced the strength of the association. It would also be interesting to study the long-term use of OCs (including POCs) and breast cancer mortality.

The required sample size for client exit interview was determined by using the following assumption to estimate the sample size of single population proportion for prevalence studies by Kish Leslie (1965).

Where= = 1.96 (For a normal standard distribution table for a CI 95% P is the prevalence; in Kenya the CPR is 46% (KDHS, 2009) (The absolute precision required is ±5%)

D = 5% = 0.05

Therefore n =1.962× (0.46(1-0.46)÷0.05^2) = 381× 10 % ³⁸ was added to cater for incompleteness of questionnaire. The total participants for the exit survey interview was419.

Stratified proportionate sampling was used where eight strata (contraceptive service delivery points) was identified. Given the total monthly average attendance of 2045 clients for all service delivery points and that the estimated attendance for each SDP will be; Gandhi Memorial Hospital 1177, Zewditu Memorial Hospital 517, Yeka Health Center 32, Kazanchis Health Center Approved 63, Feres Meda Health Center 36, Kirkos Health Center 92, Meshalekiya Health Center 32 and Yekatit 12 Hospital Medical College 96.

Inclusion criteria: FP clients aged 15-49 years and who consented to participate in the study.

Exclusion criteria: FP clients < 15 years of age and those > 50 years. Those FP clients who did not consent to participate in the study

Data was collected using structured interview questionnaire for family planning clients. They are constructed from research questions.

A pilot study intended to pretest the data collection instruments was carried out at urban government health facilities of Addis Ababa, which shared similar characteristics with the study area. ⁴² (10% of the study sample) structured interview questionnaires was pretested. The results of the pilot study was cleaned, coded and analyzed by SPSS to check for data quality control; amendment was done to the data collecting instruments guided by study objectives. Control of bias was done through appropriate selection and training of research assistants and piloting of data collection tools and procedures. The recruitment of research assistant followed the understanding of the subject understudy, dynamics of the study area and avoidance of bias. A second year nursing student with a better understanding of English and Amharic‟ was recruited and trained. Three of them were assisted in data collection.

An exit structured interview questionnaires was given to clients by the researcher and trained research assistants.

The validity and reliability of data was achieved through pre-testing and piloting of the study in a different field before the actual study. The research assistants was thoroughly trained and closely supervised by the investigator and data collection tools was checked in the field to ensure completeness and consistency.

A collected data was coded, entered and cleaned in the Microsoft Excel software 2010. All quantitative statistical analysis was performed using the statistical package for social sciences (SPSS) software version 25. Descriptive statistics was computed to generate frequencies, mean, mode and standard deviation. Chi-square test was used to test the association between dependent and independent variables. A p-value of less than 0.05 was considered for all statistical analysis. Strength and direction of the relationship was established using multiple regressions.

Ethical approval was obtained from Gelila international Seminary Ethical Committee, and permission from Addis Ababa health bureau, and from MOH Ethiopia, before the study was carried out. Informed consent was also sought from the study participant and was informed of their rights to withdraw from the study any time by way of signature or thumbprint. Study numbers other than names was used to promote anonymity and confidentiality. There was no direct benefit to study participants. The final report of the project was disseminated to the participating institutions through the County Director of Medical Services.

In conclusion, the finding revealed that the women’s decision making on contraceptive utilization was low compared to the expected reality of women’s decision on her reproductive issue. But the majority of women decide jointly with their husbands or partners. Women’s decision on contraceptive use was influenced by many factors such as age of women, place of residence and region in which the women dwell, women and husbands education, occupation of both woman and her husband, and number of children were significantly associated with women’s decision for contraceptive use.

The majority of sexually active women in our study were using contraception, which gives insights into the role contraception plays in meeting family planning goals as well as in supporting PMTCT programs. Despite this, our findings also suggest the need for ongoing counseling and access to effective contraception given the rate of unmet needs for contraception and unintended pregnancies. Further interventions are required to address factors that impede the use of contraception when women do not want to conceive, particularly in terms of increasing the uptake of highly effective contraception because of lower efficacy of some of the methods (e.g., condom use only). The concepts within the Health Belief Model could shape contraceptive counseling for the identified ‘at risk’ women to achieve their reproductive goals as well as prevent mother to child transmission of HIV although this might require further investigation using an interventional study.

Use of modern contraceptive methods was low while unmet need was high among postpartum women who participated in the study. In spite of integration of services at the mother baby care points. Among premenopausal women using OCs, COCs were the strongest predictor of breast cancer mortality and POC+COCs were the strongest predictor of overall mortality. The type of OC used should be taken into account when assessing breast cancer mortality risk. POCs may be associated with less short- and long-term adverse events related to the estrogen component of COCs. However, due to the small sample size of POC users in the current study, additional research is necessary to confirm whether the association with breast cancer mortality differs by OC type. The impact of hormonal contraception, specifically progestogen-only injectables, on risk of HIV acquisition or transmission remains inconclusive. If an increased risk is determined with certain contraceptives, this would need to be balanced against consequences of reducing availability of hormonal contraception, especially in regions with high rates of injectable use and maternal morbidity and mortality. However, in certain regions with high HIV prevalence, particularly South Africa, should increased risk of HIV acquisition or transmission via specific contraceptive methods be proven, the overall public health impact of increased HIV incidence might warrant policy changes. Any policies must carefully balance regional HIV risk, contraceptive method safety, regional maternal mortality, and availability and acceptance of alternative effective methods. Both HIV and pregnancy risk reduction strategies, such as the development of female-controlled prevention technology, should be the focus of research efforts. Dual protection with consistent and correct condom use in addition to more effective contraception is a critical.

Strength health education about modern contraceptive utilization for reproductive age.

Creating awareness on using modern contraceptives on different mass media and printing medias as well as using brushers and fliers.

Strengthen community mobilization regarding to modern contraceptives utilizations.

The findings also suggest the Health Belief Model would be a valuable resource for healthcare providers, program planners and policymakers to develop guidelines and policies for contraceptive counseling and choices.

Hence, policymakers and health managers should pay special attention to empower women to decide on their matters including contraceptive use. Moreover, due emphasis should be given about empowering women by all stakeholders including governmental and nongovernmental organizations during their plan and implementation.

The findings suggest the need for further strengthening of contraceptive service delivery at these Health care points.

Improved access to modern contraceptive methods at the care points, provision of counseling and promotion of male partner involvement through couple communication may enhance modern contraceptive use.