Determination of Family Planning utilization among women of reproductive age, Bududa District, Uganda

ABSTRACT The study investigated into determinations of family planning utilization among women of reproductive age between 15 – 49year in Bududa district in Eastern Uganda. Five objectives and six research questions were used to guide the study. The researcher carried out a retrospective descriptive study. Review or study of the available records was used in the collection of the data for the period between April 2011–May 2013.The study was aimed at documenting information on family planning utilization in Bududa district.It involved the use of district health and population records. Data was analyzed, discussed, conclusions drawn and recommendation reachedby using descriptive statistics that included frequencies and percentages.The results were presented in statistical tables, short texts, pie charts and bar graphs. A total of 34,880 women on contraceptives were noted out of 64,620 women in child-bearing age, which gave Bududa a considerable family planning uptake of 53.9% against national utilization of 24% and21% for rural domain. The research however, paradoxically revealed that despite the commanding lead of 53.9%,family planning uptake in Bududa district,it had an annual population growth rate of 3.8% which is higher than the national growth rate at3.4% (Daily Monitor 12th July 2013),the rate of abortions is still high 373 (5%) coming 3rd among the top 5 causes of morbidity among inpatient women of child bearing age.The rate of obstetric surgical procedures were top most among major surgical procedures with caesarian section leading with 191(52.5%) and evacuations coming 4th with 09 (2.5%) among the top 5 surgical procedures conducted in the 2 years of the study, there were as well still undefined forms of contraception represented by 06 (0.025%). The study revealed that the barrier(condoms)method was the most preferred form of contraception at 16,659 (70.7%) new users and 6,234 (53%) revisits, it was also evident that injectable form of contraception was the 2nd highly utilized at 5,101 (21%) new users and 32% revisits. Oral contraceptives were 3 rd in the utilized, Oral Lo-Femenal1,178 (5%) new users and 92 (8%) revisits, Oral Microgynon with 586 (2.5%) new users and 537 (4.8%) revisits, Oral Ovrette 35 (0.14%) new users and 20 (0.2%) revisits, other undefined methods were represented by 06 (0.025%). The study also revealed that family planning services in Bududa are directed at modern forms of family planning with no natural family planning services in the entire district. The research revealed the enormous performance of the CORPs who dispensed 43,392 (97.4%) of condoms against 42,300 (73.2%) dispensed at health units. However, methods which needed more technical skills like injectables 7,207 (12.5%) dispensed at health units compared to low 331 (0.74%) dispensed by the CORPs.Other methods like IUCDs, Oral and others were not dispensed. It was evident that in Bududa most family planning surgical procedures were conducted on females with a prevalence of 52 (81.25%) of female sterilization (Tubaligation) against (0%) of male sterilization(vasectomy) in the 2 years of the study. There were more implant removals 05 (7.8%) as opposed toimplant revisits 03 (4.7%). In conclusion the data analyzed reveal a high level of utilization compared to the national statistics of contraceptive prevalence rate. However the findings still revealed:  High annual population growth rates.  High rates of abortions.  High rates of obstetric surgical procedures.  High population per sq. Km.  Existence of undefined forms of family planning.  Female biased forms of contraception.  Total lack of natural family planning in Bududa district implies that there is still unmet demand for family planning services in Bududa and therefore a need to strengthen the existing efforts.  Poor effectiveness of the use of family planning due to high levels of illiteracy In that regard, the following recommendations were made;  Community based strategies should be promoted rather than vertical approach in order to increase awareness, acceptability, availability, self-reliance and sustenance.  Family planning service providers should adapt an integrated and comprehensive approach that accommodates Natural Family Planning rather than the sole promotion of Artificial forms of Family Planning that may medically be contraindicated, or cause high level side effects to some users or avoided on cultural, religious and moral beliefs.  There is need to improve on family planning records so that information at hand can stand a test of proof in case data is contested by other national studies conducted in the same field that may have varying findings.  There should be increased training of CORPs, VHC and CHWs from the current 250 to improve on service delivery.  There is need to develop family planning approaches that target men since in African societies they are the determinants of family size.  There is need to form women forums which can advocate for rights of women against influence of negative cultures and other social factors like inferiority and subordination to spouses.  There is need for family planning service providers to orient their efforts to the needs and preferences of the users rather than focusing only on contraceptive methods of programme provider’s choice.

 TABLE OF CONTENTS

Content Pages

Declaration i

Dedication ii

Acknowledgement iii

Abstract iv-v

Table of contents vi-vii

List of tables viii

List of figures ix

Acronym/Abbreviations x

Chapter One

1.0 Introduction 1

1.1 Background 1-4

1.2 Problem Statement 4

1.3 Objectives of the study 4

1.4 Research questions 5

1.5 Significance of the study 5

1.6 Scope and delimitation of the study 6

1.7 Definition of key terms 6-7

1.8 Organization of the study 7

Chapter Two:

2.0 Literature review 8

2.1 Introduction 8

2.3 General studies on family planning services 9-12

2.4 Conclusion 12-13

Chapter Three:

3.0 Research design and Methodology 13

3.1 Introduction 13

3.2 Research design 13

3.3 Description of Sample and Sampling procedure 13

3.4 Description of instruments 13

3.5 Data collection and procedure 13

3.6 Data analysis procedure 13-14

Chapter Four

4.0 DATA ANALYSIS, PRESENTATION AND INTERPRETATION 15

4.1Introduction 15

Chapter Five

5.0 Summary, conclusion, recommendations and areas for further research 23

5.1 Introduction 23

5.2 Summary 23

5.3 Conclusion 24

5.4 Recommendations 25

5.5 Areas for further study 25

Reference books/Bibliography 26

Appendices

Appendix 1 Introductory letter

Appendix 2 Research guide

Appendix 3 Map of Uganda

Appendix 4 Map of Bududa District