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Increasing the uptake of long-acting and permanent methods of family planning: A qualitative study with village midwives in East Java and Nusa Tenggara Barat Provinces, Indonesia.
Just published in the October 2017 issue of Midwifery, this article describes a qualitative study of the Improving Contraceptive Method Mix Project (ICMM) in Indonesia. The article looks at attitudes and perceptions of village level midwives regarding provision of family planning, particularly long-acting methods. Highlights:
- Shortage of knowledge about LAPMs—resulting in misconceptions at the community level—can prevent utilization of LAPMs.
- Confusion about midwives eligibility to deliver family planning services can further hinder LAPM availability and utilization.
- Village midwives have limited opportunities to attend CTU and counseling trainings.
- Only a few midwives have IEC materials to use during family planning counseling sessions.
- There was a shortage of LAPM-related equipment among village midwives.
The article is available online here.
Filling the Void: Addressing AMA and HP Pregnancy Through Research and Social and Behavior Change Communication
Pregnancies among women of advanced maternal age (AMA, 35 years or older) or among women of high parity (HP, having had five or more births) are linked to maternal and infant mortality. To better understand the context in which AMA and HP pregnancies occur, the USAID-funded Health Communication Capacity Collaborative (HC3) project conducted qualitative research on the perception and determinants of such pregnancies in rural and urban locations of two USAID family planning (FP) priority countries – Niger and Togo. HC3 supplemented this research with secondary analyses of DHS data and data from a 2014 Niger study referred to here as the AMA/HP Niger Women’s Insights Research.
The study showed that urban locations had less restrictive cultural norms preventing FP method use compared to rural locations, and urban Togolese participants demonstrated more knowledge about AMA and HP pregnancy risks than Nigerian participants as a whole. We found that AMA and HP pregnancies were generally seen as part of the reproductive norms in situations where fertility rates remain exceptionally high, such as in Niger. However, pregnancy risks, such as loss of the mother or child’s life, were key fears among men and women in both countries. The study provided important insights needed to address AMA/HP pregnancies through culturally appropriate health communication interventions.
HC3 used these findings to create an Implementation Kit (I-Kit) for FP and maternal and child health program managers. While the I-Kit provides guidance on addressing AMA and HP through social and behavior change communication in Niger and Togo specifically, the resource is designed to be adapted for use in the broader Sub-Saharan Africa region. The I-Kit includes ready-to-use health communication tools for engaging women, decision-makers, communities, healthcare providers, journalists and others. In 2016 and 2017, one organization each in Niger and Togo piloted the I-Kit, integrating selected I-Kit tools into their unique programs and documenting their experiences. Both organizations credit the I-Kit with expanding the scope of topics their programs now address to include AMA and HP pregnancy, and provided concrete suggestions for adapting the materials according to activity and intended audience.
Download Health Communication Capacity Collaborative (HC3)'s full text of the study.
Economic Empowerment: A Potential Pathway for Women and Girls to Gain Control Over Their Sexual and Reproductive Health
Economic empowerment is the ability to make and act on decisions that involve the control over and allocation of financial resources. Women’s influence over financial decisions is associated with increased use of preventive health services by children and women, including use of modern contraceptive methods.
Thus, interventions that aim to increase the economic power of women and girls may improve reproductive health behaviors, including sustained use of modern contraception, particularly when linked with investments that directly address reproductive health and family planning and/or gender norms.
This brief summarizes the current evidence on interventions used by family planning programs that sought to improve women’s or girls’ economic empowerment and that measured key family planning outcomes. The interventions cluster in three primary focus areas:
- Vocational Training
- Cash transfers