Exploring barriers to family planning service utilization and uptake among women in Iraq.

BACKGROUND

Family planning helps to avoid unwanted pregnancy and reduce maternal mortality and morbidity. Contraceptive prevalence is still relatively low (58%) in Iraq compared with other countries in the Eastern Mediterranean Region, and the unmet need (12%) and total fertility (4.2 children per woman) rates are still high. Services are available free of charge or heavily subsidized in many public and private health facilities, yet many women may still not use them due to social, cultural, financial or health care services constraints.

AIMS

This scoping review explores barriers to family planning services utilization and uptake among women in Iraq.

METHODS

The review uses an adapted conceptual framework from quality of care and human rights-based frameworks to analyse published scientific studies.

RESULTS

At policy level, the government has supported family planning but not enough resources were allocated. At the service level, low family planning promotion from health care providers (especially during antenatal care visits) along with provider bias for certain types of contraception, have contributed to inaccurate information and misconceptions. At the community and individual level, women's choice is still largely influenced by the husband's position on contraception as men are still considered the key decision-makers in regard to fertility. Valuing a large family is still a barrier to family planning services utilization and uptake whereas religion was found to support the use of family planning.

CONCLUSION

There is a need to provide promotional messages and encouraging mutual fertility decisions.