Does family planning counselling during health service contact improve postpartum modern contraceptive uptake in Ethiopia? A nationwide cross-sectional study

doi:10.1136/bmjopen-2021-060308

. 2022 May 10;12(5):e060308.

doi: 10.1136/bmjopen-2021-060308.

Does family planning counselling during health service contact improve postpartum modern contraceptive uptake in Ethiopia? A nationwide cross-sectional study

Kalayu Brhane Mruts^{1

2}, Gizachew Assefa Tessema^{3

4}, Jennifer Dunne³, Amanuel Tesfay Gebremedhin^{3

5}, Jane Scott³, Gavin F Pereira^{3

6}

Affiliations

¹ School of Population Health, Curtin University, Perth, Western Australia, Australia kalayu.brhanemruts@postgrad.curtin.edu.au.
² School of Public Health, Debre Berhan University, Debre Berhan, Amhara, Ethiopia.
³ School of Population Health, Curtin University, Perth, Western Australia, Australia.
⁴ School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia.
⁵ Wesfarmers Centre for Vaccine and Infectious Disease, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia.
⁶ School of Population, Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, Oslo, Norway.

PMID: 35537784
PMCID: PMC9092163
DOI: 10.1136/bmjopen-2021-060308

Does family planning counselling during health service contact improve postpartum modern contraceptive uptake in Ethiopia? A nationwide cross-sectional study

Kalayu Brhane Mruts et al. BMJ Open. 2022.

. 2022 May 10;12(5):e060308.

doi: 10.1136/bmjopen-2021-060308.

Authors

Kalayu Brhane Mruts^{1

2}, Gizachew Assefa Tessema^{3

4}, Jennifer Dunne³, Amanuel Tesfay Gebremedhin^{3

5}, Jane Scott³, Gavin F Pereira^{3

6}

Affiliations

¹ School of Population Health, Curtin University, Perth, Western Australia, Australia kalayu.brhanemruts@postgrad.curtin.edu.au.
² School of Public Health, Debre Berhan University, Debre Berhan, Amhara, Ethiopia.
³ School of Population Health, Curtin University, Perth, Western Australia, Australia.
⁴ School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia.
⁵ Wesfarmers Centre for Vaccine and Infectious Disease, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia.
⁶ School of Population, Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, Oslo, Norway.

PMID: 35537784
PMCID: PMC9092163
DOI: 10.1136/bmjopen-2021-060308

Abstract

Objective: This study examined the association between family planning counselling receipt during the 12 months preceding the survey and postpartum modern contraceptive uptake in Ethiopia. We hypothesised that receiving family planning counselling either within the community setting by a field health worker or at a health facility by a healthcare attendant during the 12 months preceding the survey improves postpartum modern contraceptive uptake.

Design: We used a cross-sectional study of the Ethiopian Demographic and Health Survey conducted in 2016.

Setting: Ethiopia.

Participants: A total of 1650 women who gave birth during the 12 months and had contact with service delivery points during the 12 months preceding the survey.

Primary outcome: A weighted modified Poisson regression model was used to estimate an adjusted relative risk (RR) of postpartum modern contraceptives.

Results: Approximately half (48%) of the women have missed the opportunity to receive family planning counselling at the health service contact points during the 12 months preceding the survey. The postpartum modern contraceptive uptake was 27%. Two hundred forty-two (30%) and 204 (24%) of the counselled and not counselled women used postpartum modern contraceptive methods, respectively. Compared with women who did not receive counselling for family planning, women who received counselling had higher contraceptive uptake (RR 1.32, 95% CI 1.04 to 1.67).

Conclusion: Significant numbers of women have missed the opportunity of receiving family planning counselling during contact with health service delivery points. Modern contraceptive uptake among postpartum women was low in Ethiopia. Despite this, our findings revealed that family planning counselling was associated with improved postpartum modern contraceptive uptake.

Keywords: epidemiology; public health; reproductive medicine.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

**Figure 1**
Participants’ selection. The sample weights account for the probability of selection and interview in the EDHS 2016. EDHS, Ethiopian Demographic and Health Survey.

See this image and copyright information in PMC

Cited by

Do women with a previous unintended birth subsequently experience missed opportunities for postpartum family planning counseling? A multilevel mixed effects analysis.
Ujah OI, Salemi JL, Rapkin RB, Sappenfield WM, Daley EM, Kirby RS. Ujah OI, et al. PLOS Glob Public Health. 2024 Jun 5;4(6):e0002570. doi: 10.1371/journal.pgph.0002570. eCollection 2024. PLOS Glob Public Health. 2024. PMID: 38838062 Free PMC article.
Effects of family planning education given to married illiterate women of reproductive age via visual material support on family planning related attitudes and contraceptive preferences: the example of Viranşehir, Türkiye.
Güney E, Karakaş S, Doğan Y. Güney E, et al. BMC Womens Health. 2025 May 9;25(1):219. doi: 10.1186/s12905-025-03756-6. BMC Womens Health. 2025. PMID: 40346653 Free PMC article. Clinical Trial.
Missed opportunities of method information index plus (MII+) counseling among current modern contraceptive users. multi-level analysis from the Ethiopian PMA 2021 data set.
Demissie KA, Belachew TB, Dellie E, Tiruneh MG, Jejaw M, Worku N, Teshale G, Geberu DM, Addis B, Tafere TZ, Yazachew L, Getnet M. Demissie KA, et al. BMC Public Health. 2024 Oct 28;24(1):2980. doi: 10.1186/s12889-024-20471-3. BMC Public Health. 2024. PMID: 39468552 Free PMC article.
The Effect of a Decade Implemented Project in Improving the Uptake of Comprehensive Contraception: Difference-In-Difference Analysis.
Titiyos A, Kassaw J, O'Connell KA. Titiyos A, et al. Ethiop J Health Sci. 2023 Nov;33(6):927-934. doi: 10.4314/ejhs.v33i6.2. Ethiop J Health Sci. 2023. PMID: 38784488 Free PMC article.
Health care providers' knowledge and associated factors towards the components of post abortion care service in hospitals of Tigray, Northern Ethiopia.
Goitom G, Dimtsu B, Haftu A, Gebrehiwot SW, Redae GH. Goitom G, et al. PLOS Glob Public Health. 2025 Apr 24;5(4):e0004412. doi: 10.1371/journal.pgph.0004412. eCollection 2025. PLOS Glob Public Health. 2025. PMID: 40273132 Free PMC article.

See all "Cited by" articles

References

1. Cleland J, Conde-Agudelo A, Peterson H, et al. . Contraception and health. Lancet 2012;380:149–56. 10.1016/S0140-6736(12)60609-6 - DOI - PubMed
1. Dev R, Kohler P, Feder M, et al. . A systematic review and meta-analysis of postpartum contraceptive use among women in low- and middle-income countries. Reprod Health 2019;16:154. 10.1186/s12978-019-0824-4 - DOI - PMC - PubMed
1. Moore Z, Pfitzer A, Gubin R, et al. . Missed opportunities for family planning: an analysis of pregnancy risk and contraceptive method use among postpartum women in 21 low- and middle-income countries. Contraception 2015;92:31–9. 10.1016/j.contraception.2015.03.007 - DOI - PubMed
1. Ameyaw EK, Budu E, Sambah F, et al. . Prevalence and determinants of unintended pregnancy in sub-Saharan Africa: a multi-country analysis of demographic and health surveys. PLoS One 2019;14:e0220970–e70. 10.1371/journal.pone.0220970 - DOI - PMC - PubMed
1. Bearak J, Popinchalk A, Ganatra B, et al. . Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990-2019. Lancet Glob Health 2020;8:e1152–61. 10.1016/S2214-109X(20)30315-6 - DOI - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Substances

Actions

LinkOut - more resources

Full Text Sources
Medical
- MedlinePlus Health Information

[1] Cleland J, Conde-Agudelo A, Peterson H, et al. . Contraception and health. Lancet 2012;380:149–56. 10.1016/S0140-6736(12)60609-6 - DOI - PubMed

[2] Cleland J, Conde-Agudelo A, Peterson H, et al. . Contraception and health. Lancet 2012;380:149–56. 10.1016/S0140-6736(12)60609-6 - DOI - PubMed

[3] Dev R, Kohler P, Feder M, et al. . A systematic review and meta-analysis of postpartum contraceptive use among women in low- and middle-income countries. Reprod Health 2019;16:154. 10.1186/s12978-019-0824-4 - DOI - PMC - PubMed

[4] Dev R, Kohler P, Feder M, et al. . A systematic review and meta-analysis of postpartum contraceptive use among women in low- and middle-income countries. Reprod Health 2019;16:154. 10.1186/s12978-019-0824-4 - DOI - PMC - PubMed

[5] Moore Z, Pfitzer A, Gubin R, et al. . Missed opportunities for family planning: an analysis of pregnancy risk and contraceptive method use among postpartum women in 21 low- and middle-income countries. Contraception 2015;92:31–9. 10.1016/j.contraception.2015.03.007 - DOI - PubMed

[6] Moore Z, Pfitzer A, Gubin R, et al. . Missed opportunities for family planning: an analysis of pregnancy risk and contraceptive method use among postpartum women in 21 low- and middle-income countries. Contraception 2015;92:31–9. 10.1016/j.contraception.2015.03.007 - DOI - PubMed

[7] Ameyaw EK, Budu E, Sambah F, et al. . Prevalence and determinants of unintended pregnancy in sub-Saharan Africa: a multi-country analysis of demographic and health surveys. PLoS One 2019;14:e0220970–e70. 10.1371/journal.pone.0220970 - DOI - PMC - PubMed

[8] Ameyaw EK, Budu E, Sambah F, et al. . Prevalence and determinants of unintended pregnancy in sub-Saharan Africa: a multi-country analysis of demographic and health surveys. PLoS One 2019;14:e0220970–e70. 10.1371/journal.pone.0220970 - DOI - PMC - PubMed

[9] Bearak J, Popinchalk A, Ganatra B, et al. . Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990-2019. Lancet Glob Health 2020;8:e1152–61. 10.1016/S2214-109X(20)30315-6 - DOI - PubMed

[10] Bearak J, Popinchalk A, Ganatra B, et al. . Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990-2019. Lancet Glob Health 2020;8:e1152–61. 10.1016/S2214-109X(20)30315-6 - DOI - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Does family planning counselling during health service contact improve postpartum modern contraceptive uptake in Ethiopia? A nationwide cross-sectional study

Affiliations

Does family planning counselling during health service contact improve postpartum modern contraceptive uptake in Ethiopia? A nationwide cross-sectional study

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

Similar articles

Cited by

References

Publication types

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Medical