Society is a complex manner to analysis the data. but use to rational data to comprehensive and inclusive integrated methodology for family planning.

Dear Olaide,

There are a number of ways to evaluate medical service, including FP utilization and care.

In evaluating MCH services, I like to look at 4 components:

Acceptability of the Service: What are the patient, families, and community’s view of the service? What is culturally acceptability of the service? Is the medical and nursing staff supportive of the service and do they think the service is important for them to provide?

Availability of the Service: Are there available points of care where the service, or some service, is available. If the service is so far away it is unreachable or if there is no transport to the service, it will not be utilized by the population

Accessibility of the service: The service may be close to the population, but there are barriers to accessing the service, such as cost of service, hours of service are limited, and long waiting periods.

Quality of service: If the care provided is of poor quality, or perceived to be of poor quality by the population, it will not be used. For instance, if the staff is judgmental, the service will not be used, i.e. if the staff does not think that unmarried women should be provided a FP method. If the staff promotes IUD’s or OCP’s, but the method is not available or too expensive, the care provided will not be considered appropriate. I have seen this with VIA cancer screening. The patient is told that there are “pre-cancerous” changes of the cervix. But, this is not well explained and the follow-up is not identified. These women then think that they are going to get cervical cancer and just have to live with it.

I remembered a publication from Nigeria some time ago and was able to locate it:

https://www.guttmacher.org/pubs/journals/2316297.html

I liked this tool because it asked women about their view and use of FP methods (acceptability) and was one page and simple to administer and analyze. It also provided a base for comparison of changes in attitudes and usage.

The cornerstone of FP is that it is a patient directed and voluntary service. When I first started working in MCH/FP 40 years ago, I found that families needed a lot of children, because children were their 401K. Many children died or left the family, so one had to have a lot of children to leave a few to care for the elder family members. With time, the mortality of children has decreased leaving more children to grow into adults and care for the family. In our communities, 20-40 y/o women now mostly plan pregnancies and limit children to 2-4, while their mothers had 4-6 children and grandmothers’ 6-10 children.

I suggest that your student find the tool previously used by Nigeria’s Federal Office of Statistics and use it as the bases of a survey first asking the women about their views of family planning. I would then ask a few local and state and/or other “experts” to add a limited number of questions which would reflect the practice now, as compared to that of 1990-1997. This time since the first survey would then identify women’s current views and usage of family planning, as well as allowing for some comparison of previous knowledge, attitudes and utilization and the changes.

Your student may also want to read the following document about Voluntary FP services. It is very long, but does have some good overview and interesting information:

http://futuresgroup.com/files/publications/VRBFP_Evidence_paper_FINAL_9_18_13a.pdf

I hope this is helpful. dot

Dorothy, thanks for your suggestions. We have taken note & would keep them in mind in designing the study.

I was not sure of your email address, but knew you would get the announcement this way.  This is an Award offered by the ACNM.  I think that you would would be competative and would enjoy meeting US midwifes.  But, I am uncertain if he scholorship would cover the entire cost..

Please look at it and see what you think.  I would be will to assist you in the application. 

Pedersen Award will support an international midwife leader to attend 2016 ACNM Annual Meeting Share on FacebookTwitterShare on LinkedinE-mail article

ACNM

Applications will be accepted until Jan. 4 for The A.C.N.M. Foundation's 2016 Bonnie Westenberg Pedersen International Midwife Award, which is given to an international midwife to encourage her/him to follow Bonnie's path of leadership, vision, and significant contributions to the profession of midwifery and international reproductive health, particularly in developing countries. The Pedersen Award consists of a recognition plaque and a $3,000 scholarship to attend the ACNM Annual Meeting & Exhibition in Albuquerque, New Mexico, May 22-26. The 2016 Pedersen Award application is available at www.midwife.org/Foundation-Scholarships-and-Awards. Completed applications must be submitted by Jan. 4. READ MORE

If you are interested, but email is [email protected]  - dot

In my opinion, Demographic Data is the backbone. You should first know the

Dear William, your answer was not complete - I have noticed that at times the responses I send are not complete and with typo's I did not have in the answer I copied into my response.

In any case, your observation is very appropriate.  This type of projects should always begin with an appropriate demographic foundation.  For instance, a FP project will receive much different data from a group of women 20-30 years old vs a group of women 35-40 years old or a group of men.  As you have indicated, data cannot be adequately analyzed without the demographics of the participating population. 

Sorry my internet connection is slow, expensive & unreliable. Yes, latest Demographic Data is Vital. You should know the Percentage of the Reproductive Age Group in your population. Then take a sample & work out those on Family Planning & What Type & Then Those Not on it, then extrapolate to know the picture in the overall population. Then you should work on ways to increase coverage. Generally if people understand the benefits and the side effects, they have a better choice. Another way may be to provide incentives e.g. provide cost of transportation, reward those with good family size etc. After some years you should again check the same sample & extrapolate to population & check the overall increase or  decrease in coverage. Also consider those underage group, after some years, they will be reproductively active, so educate them early. Remember, Good Family Planning Coverage will improve a lot of Health Indicators & cut down cost of basic Healthcare:

1. Abortion Rates

2. Maternal Mortality Rates

3. STI, PID & Ectopic Pregnancy Rates

4. Infant & Childhood Morbidity & Mortality Rates

5. Labor Ward Work Pressure

Overrally, it will cut down cost of Basic Health Care dramatically & increase quality of life for families. 

Cheers! & all the best in your work!

William Mol

(Papua New Guinea Highlands)

Mol, thanks for your contribution, its a community study primarily dirrected at adults of both gender. A section of  the questionnaire would focus on the demographic profile of the study participants & later examined for association with use of family planning.

Dorothy, the information is very timely. I shall explore the opportunity, hope to reach you for further discussions on it through your personal email add. Thank you very much.

Nigeria Demographic  and Health Survey 2013 (www.dhsprogram.com) report contains the most recent instrument on contraceptive use behavior. Nigeria is a heterogenous country with very low CPR in North, comparatively higher CPR in South. Cultural and religious contexts must be taken into account. Check also conceptual framework on contrapti

Saifuddin, thanks for contribution. It thus appears, though, that your response was not completely captured. Could something be done to improve on this?