Process evaluation of immediate postpartum implementation (IPPFP) status at Assosa general hospital, Assosa town, Benishangul Gumuz Regional State, West Ethiopia, 2022.

Abstract

Background: A significant program to prevent unbalanced human population growth, maternal mortality, unplanned pregnancy, and unsafe abortion, is the immediate postpartum family planning program. Family planning averts 32% of all maternal deaths and 10% of childhood deaths that occur each year. Yet there is a shortage of resources & issue of compliance to the national guideline in the program problem in the hospital. Evaluation assessment on the program is important to increase service implementation & utilization. Evaluation Objective: To evaluate the implementation status of the Immediate Postpartum family planning program at Assosa general hospital in, 2022. Methods: Single Case study design using both quantitative and qualitative method of data collection were conducted in Assosa general hospital from June 01, 2022, to July 24, 2022. A total sample of 375 mothers was interviewed by using a semi-structured and interviewer-administered questionnaire. Samples of 55 direct observations of service provision processes were conducted. Document reviews were carried out three months back during the study period. Quantitative data were entered into Epi-data 4.6 and exported to SPSS version 23 for analysis. Bivariate and multivariate logistic regressions were done to determine the predictor of client satisfaction. Qualitative data were collected from 20 Key informants. The qualitative data were analyzed manually using thematic analysis. Results: Availability of program resources were scored 64.75%. For antenatal care, postnatal care units, and maternity wards, there were regulations, registries, and reporting formats. The major concerns were the dearth of private rooms, stock out of long-acting family planning supplies, and shortage of trained healthcare workers in the hospital. Compliance of health care workers with national FP guidelines was scored 62.7%. The overall client satisfaction was 59%. Cleanliness (AOR=2.46, CI= 1.13, 5.36 ), availability of FP methods (AOR=3.33, CI= 1.23, 9.01), waiting time (AOR=4.91, CI= 1.55, 11.91 ), privacy (AOR=7.61, CI= 2.86, 20.2), respectful care (AOR=4.3, CI= 1.69, 11.01 ), counseling (AOR) 4.796, CI=1.67, 13.8 ), age greater than 34 years (AOR=4.36, 95% CI= 1.95, 9.74 ), and education level secondary school (AOR=3.33, CI= 1.13, 9.82), and college/higher education level (AOR=3.39, CI= 1.03, 11.82 ) were the predictor of client satisfaction. Conclusion: the overall implementation of immediate postpartum family planning service was good with an overall achievement score of 61.94% in the three dimensions. Recommendations Rapid action should be taken to address the shortages of private rooms, long-acting family planning supplies, and trained staff to improve client satisfaction and utilization.