Family Planning Counseling Services for Pregnant Women Attending Prenatal Care and Its Challenges in Jimma Town Health Centers

Abstract

The purpose of this research was to investigate quality of family planning counseling and related factors during prenatal care in Jimma town health centers. This study was a mixed Research design which composed of quantitative and qualitative approaches. The sample of the study consists of 240 women for quantitative survey. On the other hand, 12 women and 8 midwiferies were included in the qualitative part. To collect the quantitative data, survey questionnaire on socio-demographic, reproductive, self-efficacy and quality of counseling was administered for study participants via face to face interview. In-depth interview questions were used collect quantitative data from selected women and providers. The data were edited, and entered into and analyzed by SPSS version 25.0 for analysis. Descriptive statistics such as proportion, mean and standard deviation were computed based on the nature of variables. Bivariate analysis i.e. correlation was conducted. Multivariable logistic regression was done to identify factors associated with quality of counseling provided. P-value of less than 0.05 was used to declare statistical significance. In this study, more than half of women were not receiving enough information during family planning counseling during prenatal period. The counseling was tilted to only one or two options, the long term reversible contraceptives (IUCD and implant). Workload, shortage of providers, women’s misconception and competing priorities issues like complication during pregnancy were the challenges reported by providers. Compared to uneducated mother, the odds of receiving quality among educated mothers (at least grade9th) was 2.07 times higher [Adjusted OR = 2.07, 95% CI: 1.05 – 4.06]. Similarly, among mother with primary education status, the odds of reporting quality counseling were 1.80 times higher as compared to the uneducated mother, though it is not statistically significant at p-value less than 0.05. Women who used modern contraceptives before the pregnancy were 3 times higher [Adjusted OR =3.05, 95% CI 1.71 - 5.45] to receive quality counseling as compared to those who did not use modern contraceptive. Furthermore, the odds of reporting quality counseling received were 1.56 higher for antenatal care visit increase by one unity. In conclusion, the quality of family planning counseling is not satisfactory and tilted to few options which are against the standard. I recommend providers to take into account women’s perception and the factors into consideration while providing prenatal care. Finally I recommend further study to be conducted by including all type of facility and obtaining data via direct observation of the counseling sessions.