Abstract:
Background: Family planning is a strategy of balancing population growth with economic development for
sustainable use of natural resources. A high population growth induces increased demand for resources and the
rate at which these resources are exploited. Population, health and environment are connected inextricably. Population
growth unbalanced with economic development leads to food insecurity which exposes households to the
consumption of food with reduced quality and quantity leading to increased risk of malnutrition and poor
health. Food insecurity again obliges people to encroach into the natural environment leading to a spiraling
progress to destitution. A study in the Philippines provided concrete evidence that integrated development
programming incorporating population, health, and the environment (PHE) can be more effective in lowering
population growth rates and preserving critical coastal ecosystems than single-sector development interventions”.
Although the PHE approach has been implemented for 5 years (2008–2012) Guraghe Zone of South Ethiopia, its
outcomes have not been evaluated. The objective of this study was to evaluate the effectiveness of PHE approach for
achieving family planning (FP) outcomes in Gurage Zone.
Methods: A comparative cross-sectional study was conducted in October, 2012. A total of 962 married women in the
reproductive age group were included in the study. Data were collected using an interviewer administered Amharic
version questionnaire. Descriptive statistics and multivariable logistic regression analyses were performed to compare
the PHE and non-PHE Woredas (district) based on family planning parameters adopted from Measure Evaluation Manual.
Results: Comparison of non-new family panning acceptor women showed that PHE Woreda had a significantly high CPR
compared to non-PHE (78 % vs 52 %, P < 0.0001). Among these sub-groups, women in the PHE Woreda were over four
times more likely to use family planning methods during the study period (P < 0.0001) compared with women in the
non-PHE Woreda. Women whose husbands’ supported their use of family planning methods were 17 times as likely to
use family panning methods (AOR: 17.2, 95 % CI [11.1, 26.8]), P < 0.0001. This was even increased to 20 times more when
we did sub-group analysis only for women who were not new acceptors (AOR: 20.4:95 % CI [9.7, 42.7]), P < 0.0001. The
qualitative results showed that there was a better integration of FP, health and environmental issues into the grassroots
level interventions in the PHE Woreda through using students as a medium for reaching parents on family planning and
environmental issues.
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