Postpartum family-planning barriers and catalysts in Burkina Faso and the Democratic Republic of Congo: a multiperspective study
Nguyen Toan Tran,1–3,* Wambi Maurice E Yameogo,4,5,* Mary Eluned Gaffield,1 Félicité Langwana,6 James Kiarie,1 Désiré Mashinda Kulimba,6 Seni Kouanda4,5 1Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerla...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2018-11-01
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| Series: | Open Access Journal of Contraception |
| Subjects: | |
| Online Access: | https://www.dovepress.com/postpartum-family-planning-barriers-and-catalysts-in-burkina-faso-and--peer-reviewed-article-OAJC |
| _version_ | 1818229941333917696 |
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| author | Tran NT Yameogo WME Gaffield ME Langwana F Kiarie J Mashinda Kulimba D Kouanda S |
| author_facet | Tran NT Yameogo WME Gaffield ME Langwana F Kiarie J Mashinda Kulimba D Kouanda S |
| author_sort | Tran NT |
| collection | DOAJ |
| description | Nguyen Toan Tran,1–3,* Wambi Maurice E Yameogo,4,5,* Mary Eluned Gaffield,1 Félicité Langwana,6 James Kiarie,1 Désiré Mashinda Kulimba,6 Seni Kouanda4,5 1Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland; 2Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology, Sydney, NSW, Australia; 3Institute of Demography and Socioeconomics, University of Geneva, Geneva, Switzerland; 4Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso; 5Institut Africain de la Santé Publique, Ouagadougou, Burkina Faso; 6School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo *These authors contributed equally to this work Purpose: To address the high unmet need for postpartum family planning (PPFP) in resource-limited settings, particularly in sub-Saharan Africa, this study aimed to identify PPFP-related barriers and catalysts to inform policies and programs to increase access to postpartum contraception.Methods: Using qualitative methodology, we explored the perspectives of women, adolescent girls, men, religious and community leaders, service providers, and decision makers from three rural communities in Burkina Faso and three rural–urban communities in the Democratic Republic of Congo. Both countries have high unmet need for PPFP and are priority countries of the French Muskoka Fund for Maternal and Child Health.Results: Perceived catalysts included negative traditional views on the consequences borne by closely spaced children and their mothers; a 6-week postpartum visit dedicated to PPFP (albeit poorly attended); political will and enabling policies for FP; and support from certain religious leaders and men. Main reported barriers were the lack of male engagement; out-of-pocket copayment for contraceptives; reliance on amenorrhea for pregnancy prevention without knowing its limits; misconceptions about modern contraceptives, including prerequisites for the lactational amenorrhea method; sexual abstinence supported by religious and traditional norms for up to 3–6 months, although women reported earlier resumption of sexual activity; low prioritization of scheduled postpartum visits by women; and limited availability of readily accessible methods, PPFP counseling materials, and clinic days and scheduled visits dedicated to contraceptive services.Conclusion: Based on results found to be most actionable, the following interventions have the potential to optimize access to PPFP services: counseling women on postpartum-pregnancy risks and options at different points in time before and after childbirth through the use of appropriate information, education, and counseling materials; integrating PPFP services into existing maternal and child health visits; making contraceptives readily available and affordable; and meaningfully engaging male partners. Keywords: postpartum contraception, barriers, enablers, sub-Saharan Africa, Burkina Faso, Democratic Republic of Congo |
| first_indexed | 2024-12-12T10:26:36Z |
| format | Article |
| id | doaj.art-42176233928e4c7fb0359b45f890c999 |
| institution | Directory Open Access Journal |
| issn | 1179-1527 |
| language | English |
| last_indexed | 2024-12-12T10:26:36Z |
| publishDate | 2018-11-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Open Access Journal of Contraception |
| spelling | doaj.art-42176233928e4c7fb0359b45f890c9992022-12-22T00:27:26ZengDove Medical PressOpen Access Journal of Contraception1179-15272018-11-01Volume 9637442211Postpartum family-planning barriers and catalysts in Burkina Faso and the Democratic Republic of Congo: a multiperspective studyTran NTYameogo WMEGaffield MELangwana FKiarie JMashinda Kulimba DKouanda SNguyen Toan Tran,1–3,* Wambi Maurice E Yameogo,4,5,* Mary Eluned Gaffield,1 Félicité Langwana,6 James Kiarie,1 Désiré Mashinda Kulimba,6 Seni Kouanda4,5 1Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland; 2Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology, Sydney, NSW, Australia; 3Institute of Demography and Socioeconomics, University of Geneva, Geneva, Switzerland; 4Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso; 5Institut Africain de la Santé Publique, Ouagadougou, Burkina Faso; 6School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo *These authors contributed equally to this work Purpose: To address the high unmet need for postpartum family planning (PPFP) in resource-limited settings, particularly in sub-Saharan Africa, this study aimed to identify PPFP-related barriers and catalysts to inform policies and programs to increase access to postpartum contraception.Methods: Using qualitative methodology, we explored the perspectives of women, adolescent girls, men, religious and community leaders, service providers, and decision makers from three rural communities in Burkina Faso and three rural–urban communities in the Democratic Republic of Congo. Both countries have high unmet need for PPFP and are priority countries of the French Muskoka Fund for Maternal and Child Health.Results: Perceived catalysts included negative traditional views on the consequences borne by closely spaced children and their mothers; a 6-week postpartum visit dedicated to PPFP (albeit poorly attended); political will and enabling policies for FP; and support from certain religious leaders and men. Main reported barriers were the lack of male engagement; out-of-pocket copayment for contraceptives; reliance on amenorrhea for pregnancy prevention without knowing its limits; misconceptions about modern contraceptives, including prerequisites for the lactational amenorrhea method; sexual abstinence supported by religious and traditional norms for up to 3–6 months, although women reported earlier resumption of sexual activity; low prioritization of scheduled postpartum visits by women; and limited availability of readily accessible methods, PPFP counseling materials, and clinic days and scheduled visits dedicated to contraceptive services.Conclusion: Based on results found to be most actionable, the following interventions have the potential to optimize access to PPFP services: counseling women on postpartum-pregnancy risks and options at different points in time before and after childbirth through the use of appropriate information, education, and counseling materials; integrating PPFP services into existing maternal and child health visits; making contraceptives readily available and affordable; and meaningfully engaging male partners. Keywords: postpartum contraception, barriers, enablers, sub-Saharan Africa, Burkina Faso, Democratic Republic of Congohttps://www.dovepress.com/postpartum-family-planning-barriers-and-catalysts-in-burkina-faso-and--peer-reviewed-article-OAJCPostpartum contraceptionbarriersenablersSub-Saharan AfricaBurkina FasoDemocratic Republic of Congo. |
| spellingShingle | Tran NT Yameogo WME Gaffield ME Langwana F Kiarie J Mashinda Kulimba D Kouanda S Postpartum family-planning barriers and catalysts in Burkina Faso and the Democratic Republic of Congo: a multiperspective study Open Access Journal of Contraception Postpartum contraception barriers enablers Sub-Saharan Africa Burkina Faso Democratic Republic of Congo. |
| title | Postpartum family-planning barriers and catalysts in Burkina Faso and the Democratic Republic of Congo: a multiperspective study |
| title_full | Postpartum family-planning barriers and catalysts in Burkina Faso and the Democratic Republic of Congo: a multiperspective study |
| title_fullStr | Postpartum family-planning barriers and catalysts in Burkina Faso and the Democratic Republic of Congo: a multiperspective study |
| title_full_unstemmed | Postpartum family-planning barriers and catalysts in Burkina Faso and the Democratic Republic of Congo: a multiperspective study |
| title_short | Postpartum family-planning barriers and catalysts in Burkina Faso and the Democratic Republic of Congo: a multiperspective study |
| title_sort | postpartum family planning barriers and catalysts in burkina faso and the democratic republic of congo a multiperspective study |
| topic | Postpartum contraception barriers enablers Sub-Saharan Africa Burkina Faso Democratic Republic of Congo. |
| url | https://www.dovepress.com/postpartum-family-planning-barriers-and-catalysts-in-burkina-faso-and--peer-reviewed-article-OAJC |
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