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Challenges Addressing Unmet Need for Contraception: Voices of Family Planning Service Providers in Rural Tanzania

Jitihada Baraka(1), Asinath Rusibamayila(2), Admirabilis Kalolella(3), Colin Baynes(4),


(1) Ifakara Health Institute, Plot 463, Kiko Avenue, Mikocheni, Dar es Salaam, Tanzania
(2) Ifakara Health Institute, Plot 463, Kiko Avenue, Mikocheni, Dar es Salaam, Tanzania Columbia University, Mailman School of Public Health, 60 Haven Avenue B-2. New York, NY 10032, USA
(3) Ifakara Health Institute, Plot 463, Kiko Avenue, Mikocheni, Dar es Salaam, Tanzania
(4) Columbia University, Mailman School of Public Health, 60 Haven Avenue B-2. New York, NY 10032, USA
Corresponding Author

Abstract


Provider perspectives have been overlooked in efforts to address the challenges of unmet need for family planning (FP). This qualitative study was undertaken in Tanzania, using 22 key informant interviews and 4 focus group discussions. The research documents perceptions of healthcare managers and providers in a rural district on the barriers to meeting latent demand for contraception. Social-ecological theory is used to interpret the findings, illustrating how service capability is determined by the social, structural and organizational environment. Providers‘ efforts to address unmet need for FP services are constrained by unstable reproductive preferences, low educational attainment, and misconceptions about contraceptive side effects. Societal and organizational factors – such as gender dynamics, economic conditions, religious and cultural norms, and supply chain bottlenecks, respectively – also contribute to an adverse environment for meeting needs for care. Challenges that healthcare providers face interact and produce an effect which hinders efforts to address unmet need. Interventions to address this are not sufficient unless the supply of services is combined with systems strengthening and social engagement strategies in a way that reflects the multi-layered, social institutional problems.

References


Tanzania Demographic and Health Survey. National

Bureau of Statistics Dar es Salaam, Tanzania, ICF Macro Calverton, Maryland, USA. 2010 p. 1–482.

World Population Review. Tanzania Population 2014.

http://worldpopulationreview.com/countries/tanzania-population/ (accessed on 18 Mar 2015).

Tanzania Ministry of Planning Economy and

Empowerment. Tanzania: Population, Reproductive Health and Development, Dar es Salaam, 2006.

Mturi a J, Curtis SL. The determinants of infant and

child mortality in Tanzania. Health Policy and Planning 1995;10(4):384–94.

Asiimwe JB, Ndugga P, Mushomi J, Manyenye Ntozi

JP. Factors associated with modern contraceptive use among young and older women in Uganda; a comparative analysis. BMC Public Health 2014;14(1):926.

Sriprasert I, Chaovisitsaree S, Sribanditmongkhol N,

Sunthornlimsiri N, Kietpeerakool C. Unintended pregnancy and associated risk factors among young pregnant women. Int J Gynaecol Obstet 2014; 128(3):228-231.

Adebowale SA, Fagbamigbe FA, Bamgboye EA.

Contraceptive Use: Implication for Completed Fertility, Parity Progression and Maternal Nutritional Status in Nigeria. African Journal of Reproductive Health 2014 15(4): 60-66;

Okigbo CC, Mccarraher DR, Chen M, Gwarzo U,

Chabikuli O. Unmet Need for Contraception among Clients of FP /HIV Integrated Services in Nigeria: The Role of Partner Opposition. African Journal of Reproductive Health. 2014;18(2):134–44.

Caldwell JC, Caldwell P. The Cultural Context of High

Fertility in Africa sub-Saharan. Popul Dev Rev. 1987;13(3):409–37.

Koenig MA, Hossain MB, Whittaker M. The Influence

of Quality of Care upon Contraceptive Use in Rural Bangladesh. Studies in Family Planning. 1997;28(4):278–89.

Akin JS, Jeffrey J. Effect of Provider Characteristics on

Choice of Contraceptive Provider: a Two-Equation Full-Information Maximum-Likelihood Estimation. Demography. 1997;34(4):513–23.

Bruce J. Fundamental Elements of the Quality of Care:

A Simple Framework. Studies in Family Planning. 1990; 21(2): 61-91.

Beegle K. The Quality and Availability of Family

Planning Services and Contraceptive Use in Tanzania. Washington D.C.; World Bank 1995.

Angeles G, Guilkey DK, Mroz TA. Purposive Program

Placement and the Estimation of Family Planning Program Effects in Tanzania. Journal of the American Statistical Association. 2014;93(443): 884–99.

Arends-Kuenning M, Kessy FL. The impact of demand

factors, quality of care and access to facilities on contraceptive use in Tanzania. J Biosoc Sci. 2007; 39(1):1–26.

Casterline, J. B., & Sinding, S. W. (2000). Unmet

Need for Family Planning in Developing Countries and Implications for Population Policy. Population and Development Review, 26(4), 691–723.

Shelton JD. The Provider Perspective: Human after All.

Int Fam Plan Perspect. 2001;27(3):152.

Hutchinson PL, Do M, Agha S. Measuring client

satisfaction and the quality of family planning services: a comparative analysis of public and private health facilities in Tanzania, Kenya and Ghana. BMC Health Serv Res. 2011;11(1):203.

Speizer IS, Hotchkiss DR, Magnani RJ, Nelson K. Do

Family Planning Service Providers in Tanzania Unnecessarily Restrict Access to Contraceptive Methods? International Family Planning Perspectives and Digest. 2000; 26(1): 13-20.

Ramsey K, Hingora A, Kante M, Jackson EF, Exavery

A, Pemba S, et al. The Tanzania Connect Project: a cluster-randomized trial of the child survival impact of adding paid community health workers to an existing facility-focused health system. BMC Health Serv Res. 2013;13(Supplement 2:S6):S2 – S6.

Corbin JM, Strauss A. Grounded theory research:

Procedures, canons, and evaluative criteria. Qual Sociol. 1990;13(1):3–21.

Stokols D. Establishing and maintaining healthy

environments: Toward a social ecology of health promotion. Am Psychol. 1992; 47(1):6–22.

Mugisha JF, Reynolds H. Provider perspectives on

barriers to family planning quality in Uganda: a qualitative study. J Fam Plann Reprod Health Care.

Jan;34(1):37–41.

Baraka et al. Provider Perspective on Unmet Need

African Journal of Reproductive Health December 2015; 19 (4): 30

Akers et. al. Providers ‘ Perspectives on Challenges to

Contraceptive Counseling in Primary Care Settings. 2010;19(6).


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