Use of modern methods of family planning and associated factors among women of reproductive age with at least one living child in Korogwe district, Tanga. Tanzania.

Abstract

High morbidity and mortality associated with high parity, adolescent pregnancy, and poor spacing of children are among the most important public health problems in the world. Use of modern methods of family planning has a positive influence on women, family life, the community and nation at large. A cross sectional study was done between 8th June and 4th July 2000 to determine the extent of use of modern family planning methods and associated factors among women of reproductive age with at least one living child in Korogwe district, Tanga region Tanzania. Both quantitative and qualitative methods were used whereby four hundred randomly selected women from twenty villages participated in the quantitative study and fifteen randomly selected women participated in the qualitative part of the study. The criteria for the selection of respondents were the same for both the quantitative and qualitative data collection i.e. women of reproductive age and having at least one living child. For the quantitative method both structured and semi-structured questions were used in a questionnaire. While for the qualitative data collection in- depth interviews were conducted. Also observation of availability of lEC material at the health facilities and village level was done. Check list was used to assess the availability of modern methods of family planning at ten randomly selected dispensaries 'and one health center. 1'" The results revealed that the extent of use of modern methods of family planning was relatively high as 44.5% of the respondents were using the modern methods of family planning. It was found that the knowledge of family planning was high among the respondents (86.5%) and also majority (82.7%) of the respondents had positive

VI attitude towards modern family planning methods. The high knowledge and positive attitude on modern methods of family planning were also detected during the in- depth interviews. These two factors in association with others factors such as level of education (p = 0.001), discussion of family planning issues with health workers (p = 0.001) were found to have positive association with the use of modern family planning methods. Other factors found to have significant association with the use of modern methods of family planning were, having own source of income (p = 0.0003) and discussion with spouse or other persons (p = 0.001), believing that spouse is an ideal person for deciding on the use of modern family planning methods (p = 0.02) were found to have positive effect on the use of modern family planning methods. The history of having infant or child death was associated with low use of modern family planning methods. It was found that only 37.7% of women who have history of having infant/ death are using the modern methods of family planning compared to 48.49C of those with no the history of infant or child death. Women identified the MCH clinic as an ideal place for obtaining modern methods of family planning. Various reason were given for the choice of this place but among them, 'VI"e have the dual services offered at the MCH clinic, the quality of services offered and confidentiality. - -Feurs of side effects and spousal refusal were mentioned as reason for not using modern methods of family planning among the women who are currently not using the methods. Also lad of wide choice of methods might influence the negativity on the use of modern methods of family planning.

- -- --- - ~-- - ------~-~~ --~~~~ VII Only two types of modern methods of family planning (Depo-Provera and pill) are available at the health cent er and dispensaries and are widely use. Also it was found that, women relate the male condoms with promiscuity, not as method to be used by stable couple for family planning. No enough IEC materials at the health facilities level and almost none at the village level. It is recommended that the health facility capability in handling family planning issues should be increased, so that wide varieties of family planning methods are always available for the couple or women to choose. Health workers should be trained on the dynamic of family planning counseling and communication skills so that they will be able to refute the" side effects" claims. Make available enough IEC materials at all levels. Involvement of men' in family planning should be a reality, not only promoting vasectomy and use of condoms. There is a need of promoting conducive environment by establishing clinics or clubs to offer family planning and reproductive health counseling for male clients, within the health facility or outside. The local and central government should look for ways of ensuring that girl are having at least secondary education. s