Factors affecting continuity and success of community-based reproductive health service programme in rural community of Northeast Ethiopia

Abstract

Objective: To assess opportunities and threats towards the continuity and success of Community based reproductive health service programme in Northeast Ethiopia.

Design: Community based comparative cross sectional study.

Setting: Two districts of Amhara region, Ethiopia, classified as strong and weak community based reproductive health programme areas.

Subjects: Seven hundred and ninety two women aged 15-49 years residing in the selected districts of Amhara region. Community based reproductive health workers, programme coordinators and field supervisors were used as informants of qualitative data collection.

Main outcome measure: Current use of modern contraceptive methods.

Results: Strong versus weak programme areas: knowledge about modern contraceptive method (MCM), was (90% and 86.8%), [OR (95% CI) = 2.87(1.68,4.91)], ever use of MCM (61.1% and 29.7%), [OR (95% CI) = 3.71(2.72, 5.07)] and current use of MCM (54.8% versus 19.7%), [OR (95% CI) = 4.95(3.53,6.95)]. Method interruption was significantly higher, 37.6% in weak than 10.9% in strongly performing programme area. Causes of defaulting in strong versus weak programme areas were: wanted more pregnancy (4% and 39.5%), fear of contraceptives' side effects (16% and 31.6%) and lack of method of choice (20% and 2.6%). Type of religion, husband approval, awareness of service existence and client satisfaction remained to be the predictors of current use of MCM in multivariate analysis. Qualitative study findings were found coherent with the quantitative results.

Conclusion: Type of religion, husband approval, client satisfaction and awareness of service existence were the predictors of modern contraceptive methods utilisation in the study population.