The effect of prenatal counselling on postpartum family planning use among early postpartum women in Masindi and Kiryandongo districts, Uganda
The effect of prenatal counselling on postpartum family planning use among early postpartum women in Masindi and Kiryandongo districts, Uganda
Blog Article
INTRODUCTION: globally, most postpartum pregnancies are unplanned, mainly as a result of low level of knowledge and fear of contraceptive use especially in low-income settings.The aim of this study was to evaluate the effect of prenatal contraceptive counselling on postpartum contraceptive use and pregnancy outcomes after one year.METHODS: sixteen health centres were equally and randomly allocated to control and intervention arms.Mothers were consecutively recruited during their first antenatal clinic consultations.In the intervention arm Village Health Team members made home visits and provided prenatal contraceptive advice and made telephone consultations with health The Relationship between Humans and Other Animals in European Animal Welfare Legislation workers for advice while in the control arm mothers received routine antenatal care offered in the health centres.
Data were collected in 2014 in the two districts of Kiryandongo and Masindi.This data was collected 12-14 months postpartum.Mothers were asked about their family planning intentions, contraceptive use and screened pregnancy using human Chorionic Gordadotrophin (hCG) levels.hcg pregnancy tests.Socio-demographic and obstetric indices were recorded.
Our primary outcomes of interests were current use of modern contraceptive, decision to use a modern contraceptive method and pregnancy.Multilevel analysis using the xtmelogit stata command was used to determine differences between intervention and control groups.Subgroup analysis of the intervention arm was conducted to determine the effect of home visits on postpartum contraceptive use.RESULTS: a total of 1,385 women, 748 (control) and 627 (intervention) were recruited.About 80% initiated breastfeeding within six hours of delivery 78.
4% (control) and 80.4% (intervention).About half of the mothers in each arm had considered to delay the next pregnancy 47.1% (control) and 49% (intervention).Of these 71.
4% in the control and 87% in the intervention had considered to use a modern contraceptive method, only 28.2% of the control and 31.6% in the intervention were current modern contraceptive users signifying unmet contraceptive needs among immediate postpartum mothers.Regarding pregnancy, 3.3% and 5.
7% of the women were found to be pregnant in the control and intervention arms respectively.There were no statistical differences between the control and intervention arms for all primary outcomes of interests.In the subgroup analysis age (0.68; 95%CI: (0.49-0.
93); p=0.0180), ethnicity 2.05(1.49-2.83); p=0.
001 and education (1.56(1.09-2.22); p=0.015) Occurrence of geohelminths in the soil of public squares in Rio Branco, Acre State, Brazilian Western Amazon were found to be significantly associated with postpartum contraceptive use.
CONCLUSION: prenatal contraceptive counselling did not affect postpartum contraceptive use among postpartum mothers in Masindi and Kiryandongo districts.Being a younger mother; mother having attained eight of higher years of education; and belonging to the indigenous ethnic tribe were predictors of modern contraceptive use among postpartum mothers.Interventions aiming at improving postpartum contraceptive use should target addressing the unmet contraceptive needs and focus on older mothers, mothers of lower education level and internal migrants.