Chitalu Miriam Chama-Chiliba, Peter Hangoma, Natalia Cantet, Patricia Funjika, Grayson Koyi, Maria Laura Alzúa
Monetary incentives are often used to increase the motivation and output of health service providers. However, the focus has generally been on frontline health service providers. Using a cluster randomized trial, we evaluate the effect of monetary incentives provided to community-based volunteers on early initiation of antenatal care (ANC) visits and deliveries in health facilities in communities in Zambia. Monetary incentives were assigned to community-based volunteers in treatment sites, and payments were made for every woman referred or accompanied in the first trimester of pregnancy during January-June 2020. We find a significant increase of about 32 percent in the number of women completing ANC visits in the first trimester but no effect on service coverage rates. The number of women accompanied by community-based volunteers for ANC in the first trimester increased by 33 percent. The number of deliveries in health facilities also increased by 22 percent. These findings suggest that the use of health facilities during the first trimester of pregnancy can be improved by providing community-based volunteers with monetary incentives and that such incentives can also increase deliveries in health facilities, which are key to improving the survival of women and newborns.
{"title":"Monetary Incentives and Early Initiation of Antenatal Care: A Matched-Pair, Parallel Cluster-Randomized Trial in Zambia.","authors":"Chitalu Miriam Chama-Chiliba, Peter Hangoma, Natalia Cantet, Patricia Funjika, Grayson Koyi, Maria Laura Alzúa","doi":"10.1111/sifp.12215","DOIUrl":"https://doi.org/10.1111/sifp.12215","url":null,"abstract":"<p><p>Monetary incentives are often used to increase the motivation and output of health service providers. However, the focus has generally been on frontline health service providers. Using a cluster randomized trial, we evaluate the effect of monetary incentives provided to community-based volunteers on early initiation of antenatal care (ANC) visits and deliveries in health facilities in communities in Zambia. Monetary incentives were assigned to community-based volunteers in treatment sites, and payments were made for every woman referred or accompanied in the first trimester of pregnancy during January-June 2020. We find a significant increase of about 32 percent in the number of women completing ANC visits in the first trimester but no effect on service coverage rates. The number of women accompanied by community-based volunteers for ANC in the first trimester increased by 33 percent. The number of deliveries in health facilities also increased by 22 percent. These findings suggest that the use of health facilities during the first trimester of pregnancy can be improved by providing community-based volunteers with monetary incentives and that such incentives can also increase deliveries in health facilities, which are key to improving the survival of women and newborns.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"53 4","pages":"595-615"},"PeriodicalIF":2.1,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10538999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-01Epub Date: 2022-06-22DOI: 10.1111/sifp.12203
Constancia V Mavodza, Sarah Bernays, Constance R S Mackworth-Young, Rangarirayi Nyamwanza, Portia Nzombe, Ethel Dauya, Chido Dziva Chikwari, Mandikudza Tembo, Tsitsi Apollo, Owen Mugurungi, Bernard Madzima, Katharina Kranzer, Rashida Abbas Ferrand, Joanna Busza
The COVID-19 pandemic has had serious impacts on economic, social, and health systems, and fragile public health systems have become overburdened in many countries, exacerbating existing service delivery challenges. This study describes the impact of the COVID-19 pandemic on family planning services within a community-based integrated HIV and sexual and reproductive health intervention for youth aged 16-24 years being trialled in Zimbabwe (CHIEDZA). It examines the experiences of health providers and clients in relation to how the first year of the pandemic affected access to and use of contraceptives.
{"title":"Interrupted Access to and Use of Family Planning Among Youth in a Community-Based Service in Zimbabwe During the First Year of the COVID-19 Pandemic.","authors":"Constancia V Mavodza, Sarah Bernays, Constance R S Mackworth-Young, Rangarirayi Nyamwanza, Portia Nzombe, Ethel Dauya, Chido Dziva Chikwari, Mandikudza Tembo, Tsitsi Apollo, Owen Mugurungi, Bernard Madzima, Katharina Kranzer, Rashida Abbas Ferrand, Joanna Busza","doi":"10.1111/sifp.12203","DOIUrl":"10.1111/sifp.12203","url":null,"abstract":"<p><p>The COVID-19 pandemic has had serious impacts on economic, social, and health systems, and fragile public health systems have become overburdened in many countries, exacerbating existing service delivery challenges. This study describes the impact of the COVID-19 pandemic on family planning services within a community-based integrated HIV and sexual and reproductive health intervention for youth aged 16-24 years being trialled in Zimbabwe (CHIEDZA). It examines the experiences of health providers and clients in relation to how the first year of the pandemic affected access to and use of contraceptives.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"53 3","pages":"393-415"},"PeriodicalIF":1.9,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9350188/pdf/SIFP-9999-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9952736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mobolaji Ibitoye, John B Casterline, Chenyao Zhang
The past four decades have witnessed an enormous increase in modern contraception in most low- and middle-income countries. We examine the extent to which this change can be attributed to changes in fertility preferences versus fuller implementation of fertility preferences, a distinction at the heart of intense debates about the returns to investments in family planning services. We analyze national survey data from five major survey programs: World Fertility Surveys, Demographic Health Surveys, Reproductive Health Surveys, Pan-Arab Project for Child Development or Family Health, and Multiple Indicator Cluster Surveys. We perform regression decomposition of change between successive surveys in 59 countries (330 decompositions in total). Change in preferences accounts for little of the change: less than 10 percent in a basic decomposition and about 15 percent under a more elaborate specification. This is a powerful empirical refutation of the view that contraceptive change has been driven principally by reductions in demand for children. We show that this outcome is not surprising given that the distribution of women according to fertility preferences is surprisingly stable over time.
{"title":"Fertility Preferences and Contraceptive Change in Low- and Middle-Income Countries.","authors":"Mobolaji Ibitoye, John B Casterline, Chenyao Zhang","doi":"10.1111/sifp.12202","DOIUrl":"https://doi.org/10.1111/sifp.12202","url":null,"abstract":"<p><p>The past four decades have witnessed an enormous increase in modern contraception in most low- and middle-income countries. We examine the extent to which this change can be attributed to changes in fertility preferences versus fuller implementation of fertility preferences, a distinction at the heart of intense debates about the returns to investments in family planning services. We analyze national survey data from five major survey programs: World Fertility Surveys, Demographic Health Surveys, Reproductive Health Surveys, Pan-Arab Project for Child Development or Family Health, and Multiple Indicator Cluster Surveys. We perform regression decomposition of change between successive surveys in 59 countries (330 decompositions in total). Change in preferences accounts for little of the change: less than 10 percent in a basic decomposition and about 15 percent under a more elaborate specification. This is a powerful empirical refutation of the view that contraceptive change has been driven principally by reductions in demand for children. We show that this outcome is not surprising given that the distribution of women according to fertility preferences is surprisingly stable over time.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"53 2","pages":"361-376"},"PeriodicalIF":2.1,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9219575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10526921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elizabeth A. Sully, S. Shiferaw, A. Seme, S. Bell, Margaret Giorgio
Abstract The Global Gag Rule (GGR) makes non‐U.S. nongovernmental organizations (NGOs) ineligible for U.S. Government global health funding if they provide, refer, or promote access to abortion. This study quantitatively examines the impacts of the GGR on family planning service provision in Ethiopia. Using a panel of health facilities (2017–2020), we conduct a pre–post analysis to investigate the overall changes in family planning service provision before and after the policy came into effect in Ethiopia. Our pre–post analyses revealed post‐GGR reductions in the proportions of facilities reporting family planning provision through community health volunteers (−5.6, 95% CI [−10.2, −1.0]), mobile outreach visits (−13.1, 95% CI [−17.8, −8.4]), and family planning and postabortion care service integration (−4.8, 95% CI: [−9.1, −0.5]), as well as a 6.1 percentage points increase in contraceptive stock‐outs over the past three months (95% CI [−0.6, 12.8]). We further investigate the impacts of the GGR on facilities exposed to noncompliant organizations that did not sign the policy and lost U.S. funding. We do not find any significant additional impacts on facilities in regions more exposed to noncompliant organizations. Overall, while the GGR was slow to fully impact NGOs in Ethiopia, it ultimately resulted in negative impacts on family planning service provision.
{"title":"Impact of the Trump Administration's Expanded Global Gag Rule Policy on Family Planning Service Provision in Ethiopia","authors":"Elizabeth A. Sully, S. Shiferaw, A. Seme, S. Bell, Margaret Giorgio","doi":"10.1111/sifp.12196","DOIUrl":"https://doi.org/10.1111/sifp.12196","url":null,"abstract":"Abstract The Global Gag Rule (GGR) makes non‐U.S. nongovernmental organizations (NGOs) ineligible for U.S. Government global health funding if they provide, refer, or promote access to abortion. This study quantitatively examines the impacts of the GGR on family planning service provision in Ethiopia. Using a panel of health facilities (2017–2020), we conduct a pre–post analysis to investigate the overall changes in family planning service provision before and after the policy came into effect in Ethiopia. Our pre–post analyses revealed post‐GGR reductions in the proportions of facilities reporting family planning provision through community health volunteers (−5.6, 95% CI [−10.2, −1.0]), mobile outreach visits (−13.1, 95% CI [−17.8, −8.4]), and family planning and postabortion care service integration (−4.8, 95% CI: [−9.1, −0.5]), as well as a 6.1 percentage points increase in contraceptive stock‐outs over the past three months (95% CI [−0.6, 12.8]). We further investigate the impacts of the GGR on facilities exposed to noncompliant organizations that did not sign the policy and lost U.S. funding. We do not find any significant additional impacts on facilities in regions more exposed to noncompliant organizations. Overall, while the GGR was slow to fully impact NGOs in Ethiopia, it ultimately resulted in negative impacts on family planning service provision.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"53 1","pages":"339 - 359"},"PeriodicalIF":2.1,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47781288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Fuseini, L. Jarvis, A. Ankomah, Fatou Bintou Mbow, M. Hindin
Abstract This study assessed the impact of the COVID‐19 pandemic on the number of new contraceptive acceptors in Senegal overall and by method. Monthly service data from March 2019 to December 2020 were extracted for the number of new contraceptive users of IUDs, implants, injectables, and oral contraceptive pills (OCPs). Data were analyzed using descriptive statistics and interrupted time series analysis for trend analyses overall and by the contraceptive method. Following the announcement of the first COVID‐19 case in Senegal in March 2020, there was an immediate significant decrease in the number of new acceptors overall, and for new users of implants and injectables. From March–December 2020, the trend in monthly new family planning acceptors increased overall, mainly driven by significant increases in new IUD and implant acceptors. Compared to the period before the onset of COVID‐19, there was a statistically significant shift from shorter‐acting methods (OCPs, injectables) to long‐acting reversible methods (IUDs, implants). Despite the immediate adverse impact of COVID‐19‐related restrictions, the number of new acceptors rebounded, trends in the number of new monthly acceptors significantly increased, and there was a significant shift to longer‐acting methods.
{"title":"Did COVID‐19 Impact Contraceptive Uptake? Evidence from Senegal","authors":"K. Fuseini, L. Jarvis, A. Ankomah, Fatou Bintou Mbow, M. Hindin","doi":"10.1111/sifp.12195","DOIUrl":"https://doi.org/10.1111/sifp.12195","url":null,"abstract":"Abstract This study assessed the impact of the COVID‐19 pandemic on the number of new contraceptive acceptors in Senegal overall and by method. Monthly service data from March 2019 to December 2020 were extracted for the number of new contraceptive users of IUDs, implants, injectables, and oral contraceptive pills (OCPs). Data were analyzed using descriptive statistics and interrupted time series analysis for trend analyses overall and by the contraceptive method. Following the announcement of the first COVID‐19 case in Senegal in March 2020, there was an immediate significant decrease in the number of new acceptors overall, and for new users of implants and injectables. From March–December 2020, the trend in monthly new family planning acceptors increased overall, mainly driven by significant increases in new IUD and implant acceptors. Compared to the period before the onset of COVID‐19, there was a statistically significant shift from shorter‐acting methods (OCPs, injectables) to long‐acting reversible methods (IUDs, implants). Despite the immediate adverse impact of COVID‐19‐related restrictions, the number of new acceptors rebounded, trends in the number of new monthly acceptors significantly increased, and there was a significant shift to longer‐acting methods.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"53 1","pages":"301 - 314"},"PeriodicalIF":2.1,"publicationDate":"2022-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46651283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jill M Peterson, Jaden Bendabenda, Alexander Mboma, Mario Chen, J. Stanback, G. Gunnlaugsson
Abstract Family planning (FP) has been a development priority since the mid‐1990s, yet barriers to access persist globally, including women being turned away from facilities without a method. This study aimed to assess the extent of, and reasons for, FP turnaway in three districts of Malawi. In 2019, data collectors screened women exiting 30 health facilities and surveyed those who had been denied a method. Follow‐up surveys were conducted via telephone with turned away clients at six and 12 weeks postvisit. Of the 2,246 women who were screened, 562 were new or restarting users. Of these, 15% (83/562) reported having been turned away from the health facility without an FP method. Women cited 14 different reasons for turnaway; the top three were unavailability of method (34%), unavailability of a provider (17%), or a requirement to return on the scheduled FP day (15%). The multiple reasons cited for leaving the health facility without an FP method indicate that reducing turnaway will not be achieved easily. The top reasons for turnaway are related to health systems or management issues within health facilities. Facilities need additional support for staffing, training on long‐acting and permanent methods, and a consistent supply of methods.
{"title":"Turned Away and at Risk: Denial of Family Planning Services to Women in Malawi","authors":"Jill M Peterson, Jaden Bendabenda, Alexander Mboma, Mario Chen, J. Stanback, G. Gunnlaugsson","doi":"10.1111/sifp.12192","DOIUrl":"https://doi.org/10.1111/sifp.12192","url":null,"abstract":"Abstract Family planning (FP) has been a development priority since the mid‐1990s, yet barriers to access persist globally, including women being turned away from facilities without a method. This study aimed to assess the extent of, and reasons for, FP turnaway in three districts of Malawi. In 2019, data collectors screened women exiting 30 health facilities and surveyed those who had been denied a method. Follow‐up surveys were conducted via telephone with turned away clients at six and 12 weeks postvisit. Of the 2,246 women who were screened, 562 were new or restarting users. Of these, 15% (83/562) reported having been turned away from the health facility without an FP method. Women cited 14 different reasons for turnaway; the top three were unavailability of method (34%), unavailability of a provider (17%), or a requirement to return on the scheduled FP day (15%). The multiple reasons cited for leaving the health facility without an FP method indicate that reducing turnaway will not be achieved easily. The top reasons for turnaway are related to health systems or management issues within health facilities. Facilities need additional support for staffing, training on long‐acting and permanent methods, and a consistent supply of methods.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"53 1","pages":"281 - 299"},"PeriodicalIF":2.1,"publicationDate":"2022-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44394820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diverse models of self-managed medication abortion exist-ranging from some interaction with medical personnel to completely autonomous abortion. In this commentary, we propose a new classification of self-managed medication abortion and describe the different modalities. We highlight autonomous abortion accompanied by feminist activists, called "acompañantes," as a community- and rights-based strategy that can be a safe alternative to clinical abortion services in clandestine as well as legal settings. To improve access, abortion needs to be decriminalized and governments must acknowledge and facilitate the diversity of safe abortion options so women may choose where, when, how, and with whom to abort.
{"title":"Locating Autonomous Abortion Accompanied by Feminist Activists in the Spectrum of Self-Managed Medication Abortion.","authors":"S. Veldhuis, Georgina Sánchez-Ramírez, B. Darney","doi":"10.1111/sifp.12194","DOIUrl":"https://doi.org/10.1111/sifp.12194","url":null,"abstract":"Diverse models of self-managed medication abortion exist-ranging from some interaction with medical personnel to completely autonomous abortion. In this commentary, we propose a new classification of self-managed medication abortion and describe the different modalities. We highlight autonomous abortion accompanied by feminist activists, called \"acompañantes,\" as a community- and rights-based strategy that can be a safe alternative to clinical abortion services in clandestine as well as legal settings. To improve access, abortion needs to be decriminalized and governments must acknowledge and facilitate the diversity of safe abortion options so women may choose where, when, how, and with whom to abort.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48236464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Despite a general understanding that interviewers might cause measurement errors on sensitive questions in sample surveys, there is relatively little research on interviewer effects on responses to questions on women justifying a woman's refusal to have sex with her husband, women justifying wife beating, women's experience of physical and sexual violence, and whether the woman's father ever beat her mother. This study examines interviewer effects on these indicators that were collected in two large-scale National Family Health Surveys (NFHS) in India (2005-2006 and 2015-2016). We use cross-classified random intercept multivariable multilevel logit models to examine interviewer effects. In both surveys, we find large interviewer effects on questions about the justification of a woman refusing to have sex with her husband (32-33% in NFHS-3 and 45-46% in NFHS-4) and the justification of wife beating (27-28% in NFHS-3 and 33-34% in NFHS-4). The interviewer effects were much larger in the 2015-2016 survey than in the 2005-2006 survey. Such large interviewer effects should be considered when interpreting trends and patterns on these topics, especially since the interviewer effects might have changed between survey rounds. Understanding interviewer effects is important given the wide use of these surveys in policy formulation and monitoring in India.
{"title":"How Interviewers Affect Responses to Sensitive Questions on the Justification for Wife Beating, the Refusal to have Conjugal Sex, and Domestic Violence in India.","authors":"Abhishek Singh, Kaushalendra Kumar, F. Arnold","doi":"10.1111/sifp.12193","DOIUrl":"https://doi.org/10.1111/sifp.12193","url":null,"abstract":"Despite a general understanding that interviewers might cause measurement errors on sensitive questions in sample surveys, there is relatively little research on interviewer effects on responses to questions on women justifying a woman's refusal to have sex with her husband, women justifying wife beating, women's experience of physical and sexual violence, and whether the woman's father ever beat her mother. This study examines interviewer effects on these indicators that were collected in two large-scale National Family Health Surveys (NFHS) in India (2005-2006 and 2015-2016). We use cross-classified random intercept multivariable multilevel logit models to examine interviewer effects. In both surveys, we find large interviewer effects on questions about the justification of a woman refusing to have sex with her husband (32-33% in NFHS-3 and 45-46% in NFHS-4) and the justification of wife beating (27-28% in NFHS-3 and 33-34% in NFHS-4). The interviewer effects were much larger in the 2015-2016 survey than in the 2005-2006 survey. Such large interviewer effects should be considered when interpreting trends and patterns on these topics, especially since the interviewer effects might have changed between survey rounds. Understanding interviewer effects is important given the wide use of these surveys in policy formulation and monitoring in India.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45958523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Globally, millions of unintended pregnancies occur each year resulting in a host of social, economic, and health-related problems. Improving knowledge of and access to family planning services is an effective way to prevent unintended pregnancy, and research suggests that men's involvement promotes greater contraceptive uptake. To explore this issue, we assess contraceptive knowledge, attitudes, and behaviors among Sierra Leonean men who experienced an unplanned pregnancy. Findings indicate that men's participation in family planning was limited due to barriers including inadequate knowledge about contraception, poor access to services, and gender norms that consider family planning a woman's responsibility. As a result, men often resorted to a pattern of control that put the onus of contraceptive use on women and blamed women when they became pregnant, without considering their own role in pregnancy prevention. We suggest that family planning policies and interventions both engage men and address the barriers to their participation in reproductive health.
{"title":"\"If the Woman Doesn't Prevent, You Will Become Pregnant\": Exploring Male Involvement in Contraceptive Use Preceding Unplanned Pregnancy in Sierra Leone.","authors":"Kristen E. McLean, E. Thulin","doi":"10.1111/sifp.12189","DOIUrl":"https://doi.org/10.1111/sifp.12189","url":null,"abstract":"Globally, millions of unintended pregnancies occur each year resulting in a host of social, economic, and health-related problems. Improving knowledge of and access to family planning services is an effective way to prevent unintended pregnancy, and research suggests that men's involvement promotes greater contraceptive uptake. To explore this issue, we assess contraceptive knowledge, attitudes, and behaviors among Sierra Leonean men who experienced an unplanned pregnancy. Findings indicate that men's participation in family planning was limited due to barriers including inadequate knowledge about contraception, poor access to services, and gender norms that consider family planning a woman's responsibility. As a result, men often resorted to a pattern of control that put the onus of contraceptive use on women and blamed women when they became pregnant, without considering their own role in pregnancy prevention. We suggest that family planning policies and interventions both engage men and address the barriers to their participation in reproductive health.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"1 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43256380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Issue Information","authors":"","doi":"10.1111/sifp.12163","DOIUrl":"https://doi.org/10.1111/sifp.12163","url":null,"abstract":"","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45562181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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