barriers and enablers to the implementation of immediate postpartum and post-abortion family planning service integration in primary health care units of Wolaita Zone, Southern Ethiopia: A baseline study for implementation research.

Barriers and enablers to the implementation of immediate postpartum and post-abortion family planning service integration in primary health care units of Wolaita Zone, Southern Ethiopia: A baseline study for implementation research.

机构信息

Department of Reproductive Health and Nutrition, School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.

School of Midwifery, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.

出版信息

PLoS One. 2024 Jul 25;19(7):e0303809. doi: 10.1371/journal.pone.0303809. eCollection 2024.

DOI:10.1371/journal.pone.0303809

PMID:39052648

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11271869/

Abstract

INTRODUCTION

Evidence indicates that postpartum and post-abortion women accept family planning at a higher rate when offered timely at appropriate sites. Therefore, this study explored barriers and enablers of postpartum and post-abortion family planning utilization in primary health care units of Wolaita Zone, Southern Ethiopia, from June 20 to July 25, 2022.

METHODS

We used a case study strategy of qualitative research using both the Consolidated Framework for Implementation Research (CFIR) and Gender, Youth, and Social Inclusion (GYSI) frameworks was conducted from June to July 2022. We conducted 41 in-depth and key informant interviews and six focus group discussions. We also used Open Code software version 4.02 for coding and further analysis and applied a framework analysis.

RESULTS

The analysis of this study identified barriers and enablers of postpartum and post-abortion family planning service uptake in five CFIR domains and four GYSI components. The barriers included misconceptions and sole decision-making by husbands, cultural and religious barriers, and healthcare providers paying less attention to adolescents and husbands, which prevented them from using immediate postpartum and postabortion family planning services. The health facilities were not adequately staffed; there was a shortage and delay of supplies and infrastructure, trained staff turnover, and poor accountability among service providers. The existence of community structure, equal access and legal rights to the service, and having waivered services were enablers for postpartum and post-abortion family planning service uptake.

CONCLUSION AND RECOMMENDATION

The current study identified various barriers and enablers to the uptake of postpartum and post-abortion family planning. Therefore, there is a need for high-impact interventions such as targeting male partners and girls, ensuring infrastructure, supplies, and equipment, building staff capacity, and making decisions jointly.

摘要

引言

有证据表明，在适当的地点及时为产后和流产后妇女提供计划生育服务时，她们更愿意接受计划生育。因此，本研究旨在探讨 2022 年 6 月 20 日至 7 月 25 日，在埃塞俄比亚南部沃莱塔地区的初级保健单位中，产后和流产后计划生育利用的障碍和促进因素。

方法

我们采用案例研究策略，使用实施研究综合框架（CFIR）和性别、青年和社会包容（GYSI）框架，于 2022 年 6 月至 7 月进行了定性研究。我们进行了 41 次深入访谈和关键知情人访谈以及 6 次焦点小组讨论。我们还使用 Open Code 软件版本 4.02 进行编码和进一步分析，并应用框架分析。

结果

本研究分析确定了五个 CFIR 领域和四个 GYSI 组成部分中产后和流产后计划生育服务利用的障碍和促进因素。障碍包括丈夫的误解和独断决策、文化和宗教障碍以及医疗保健提供者对青少年和丈夫关注较少，这阻止了他们立即使用产后和流产后计划生育服务。卫生设施人员配备不足；供应和基础设施短缺和延迟、培训人员流失以及服务提供者问责制差。社区结构的存在、平等获得服务的机会和合法权利以及豁免服务是产后和流产后计划生育服务利用的促进因素。