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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (31 December 2022) | Viewed by 39961

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Special Issue Editors

Dr. Gizachew Tessema

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Guest Editor

School of Public Health, Curtin University, Perth, WA 6102, Australia
Interests: reproductive health; family planning; perinatal epidemiology; global health

Prof. Dr. Gavin Pereira

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Assistant Guest Editor

1. National Health & Medical Research Council, Canberra, ACT 2601, Australia
2. Epidemiology and Biostatistics, Curtin School of Population Health, Curtin University, Bentley, WA 6102, Australia
3. Health Economics and Data Analytics, Curtin School of Population Health, Curtin University, Bentley, WA 6102, Australia
4. Family and Child Health, enAble Institute, Curtin University, Bentley, WA 6102, Australia 5. Royal Society of Public Health, London E1 8AN, UK
6. Centre for Fertility and Health, Norwegian Institute of Public Health, N-0213 Oslo, Norway
Interests: biostatistics; environmental sciences; epidemiology; paediatrics and reproductive medicine

Dr. Yordanos Molla

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Assistant Guest Editor

Pathfinder International, 1015 15th Street N.W., Suite 1100, Washington, DC 20005, USA
Interests: reproductive, maternal, newborn, adolescent and child health (RMNCH); monitoring and evaluation; global health programs and implementation research; GIS and spatial analysis; epidemiology

Special Issue Information

Dear Colleagues,

Family planning and reproductive health services are critical interventions to the overall health of a population. These interventions are proven and cost-effective, and are central elements for female empowerment, reducing poverty, and a country’s development. Family planning can help women and men to exercise their rights in making voluntary and informed decisions on the spacing and numbers of children they would like to have. While impressive global gains have been made in recent decades in improving contraceptive use and decreasing fertility rates, over 214 million women of reproductive age, women mostly in low-and middle-income countries and who want to avoid pregnancy, are not using a modern contraceptive method.

Lack of access to proper family planning and reproductive health services may threaten individuals’ ability to build a better future for themselves, their families, and their communities. Improving family planning and reproductive health services is also one of the main focuses for achieving sustainable development goals.

This Special Issue seeks to expand knowledge on examining best practice in family planning and reproductive health services, understand factors impeding family planning and reproductive health services in general or special populations such as young adolescents and people having disabilities, and evaluate effective interventions to improve access to these services. Empirical studies and high-quality systematic reviews will be considered.

Dr. Gizachew Tessema
Prof. Dr. Gavin Pereira
Dr. Yordanos Molla
Guest Editors

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Keywords

Reproductive health
Family planning
Fertility
Contraceptive services
Adolescent reproductive health
Reproductive health needs of special populations, e.g., people with disabilities
Birth spacing
Infertility treatment

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Published Papers (9 papers)

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Research

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19 pages, 2323 KiB

Open AccessArticle

Policy Changes in China’s Family Planning: Perspectives of Advocacy Coalitions

by Zhichao Li, Xihan Tan and Bojia Liu

Int. J. Environ. Res. Public Health 2023, 20(6), 5204; https://doi.org/10.3390/ijerph20065204 - 15 Mar 2023

Cited by 1 | Viewed by 2421

Abstract

Studies on policy change focus on governmental decision-making from a technical rationality perspective, ignoring the fact that policy change is a complicated social construction process involving multiple actors. This study used the modified advocacy coalition framework to explain changes in China’s family planning policy and discourse network analysis to show the debate on the birth control policy among multiple actors (central government, local governments, experts, media, and the public). It found that the dominant coalition and the minority coalition can learn and adjust deep core beliefs from each other; the sharing and flow of actors’ policy beliefs drive change in the network structure; and actors’ obvious preferential attachment when the promulgation of the central document, are all helpful in policy change. This study can explain macro-policy changes from a micro-perspective to reveal the process and mechanism of policy changes in China’s authoritarian regime. Full article

(This article belongs to the Special Issue Family Planning and Reproductive Health)

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16 pages, 362 KiB

Open AccessArticle

Adapting Family Planning Service Delivery in Title X and School-Based Settings during COVID-19: Provider and Staff Experiences

by Andrea Vazzano, Sydney Briggs, Lisa Kim, Jenita Parekh and Jennifer Manlove

Int. J. Environ. Res. Public Health 2023, 20(4), 3592; https://doi.org/10.3390/ijerph20043592 - 17 Feb 2023

Viewed by 2027

Abstract

The COVID-19 pandemic introduced urgent and unique challenges to family planning providers and staff in ensuring continued access to high-quality services, particularly for groups who experience greater barriers to accessing services, such as women with systemically marginalized identities and adolescents and young adults (AYA). While research has documented key adaptations made to service delivery during the early phase of the pandemic, limited studies have used qualitative methods. This paper draws on qualitative interview data from family planning providers and staff in Title-X-funded clinics and school-based clinics—two settings that serve populations that experience greater barriers to accessing care—to (a) describe the adaptations made to service delivery during the first year of the pandemic and (b) explore provider and staff experiences and impressions implementing these adaptations. In-depth interviews were conducted with 75 providers and staff between February 2020 and February 2021. Verbatim transcripts were analyzed via inductive content analysis followed by thematic analysis. Four key themes were identified: (1) Title-X- and school-based staff made multiple, concurrent adaptations to continue family planning services; (2) providers embraced flexibility for patient-centered care; (3) school-based staff faced unique challenges to reaching and serving youth; and (4) COVID-19 created key opportunities for innovation. The findings suggest several lasting changes to family planning service delivery and provider mindsets at clinics serving populations hardest hit by the pandemic. Future studies should evaluate promising practices in family planning service delivery—including telehealth and streamlined administrative procedures—and explore how these are experienced by diverse patient populations, particularly AYA and those in areas where privacy or internet access are limited. Full article

(This article belongs to the Special Issue Family Planning and Reproductive Health)

14 pages, 955 KiB

Open AccessArticle

Experiences with Family Planning amongst Persons with Mental Health Problems: A Nationwide Patient Survey

by Noralie N. Schonewille, Monique J. M. van den Eijnden, Nini H. Jonkman, Anne A. M. W. van Kempen, Maria G. van Pampus, Francisca G. Goedhart, Odile A. van den Heuvel and Birit F. P. Broekman

Int. J. Environ. Res. Public Health 2023, 20(4), 3070; https://doi.org/10.3390/ijerph20043070 - 9 Feb 2023

Cited by 3 | Viewed by 2026

Abstract

High rates of unintended pregnancies in patients with mental health problems reflect the unmet need for tailored family planning. This study aims to explore aspects of family planning that are especially challenging for patients experiencing health problems by obtaining the perspective of (former) patients and those with close relationships with the (former) patients. In August 2021, members of a Dutch national mental health panel, consisting of (former) patients and close ones, were invited to respond to a 34-question online survey that included questions on four domains: reproductive history, decision making, parenting, and sexuality. This study has revealed the severe and adverse impact of mental health problems across all of the four domains of reproductive health and family planning, which the questions specifically targeted. Based on these results, we recommend discussing family planning with all patients experiencing or at risk for mental health problems and their partners. These discussions should address a desire to have children, (involuntary) childlessness, uncertainties about parenting and sexuality, while remaining considerate of experienced taboos. Full article

(This article belongs to the Special Issue Family Planning and Reproductive Health)

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22 pages, 1150 KiB

Open AccessArticle

Trends and Drivers of Unmet Need for Family Planning in Currently Married Tanzanian Women between 1999 and 2016

by Abdon Gregory Rwabilimbo, Kedir Y. Ahmed, Jackline Boniphace Mshokela, Amit Arora, Felix Akpojene Ogbo and on behalf of the Global Maternal and Child Health Research Collaboration (GloMACH)

Int. J. Environ. Res. Public Health 2023, 20(3), 2262; https://doi.org/10.3390/ijerph20032262 - 27 Jan 2023

Viewed by 1869

Abstract

The current study investigated the trends and factors associated with the unmet need for family planning (FP) for limiting and spacing births among married Tanzanian women between 1999 and 2016. The study used Tanzania Demographic and Health Survey (TDHS) data for the years 1999 (N = 2653), 2004–2005 (N = 2950), 2010 (N = 6412), and 2015–2016 (N = 8210). Trends in the unmet need for FP were estimated over the study period. Multivariable multinomial logistic regression models were used to investigate the association between community-level, predisposing, enabling, and need factors with the unmet need for FP in Tanzania. The results showed no significant change in percentage of married women with an unmet need for birth spacing between 1999 and 2016. The proportion of married women with an unmet need for limiting births decreased from 9.5% (95% confidence interval (CI): 7.9%, 10.6%) in 1999 to 6.6% (95% CI: 5.9%, 7.3%) in 2016. Residing in a rural area, parity between 1–4 and 5+, visiting a health facility for any health services within twelve months, and planning to have more children (after two years and/or undecided) were factors positively associated with the unmet need for FP-spacing. Women with parity of 5+ were more likely to experience an unmet need for FP-limiting. Women’s age between 25–34 and 35–49 years, women’s employment status, watching television, women’s autonomy of not being involved in household decisions, and planning to have more children were factors associated with lower odds of having an unmet need for FP-spacing. Women’s age between 25–34 years, watching television, autonomy, and planning to have more children were factors with lower odds of having an unmet need for FP-limiting. Improving FP uptake among married Tanzanian women can reduce the unmet need for FP. Therefore, reducing unmet needs for FP is attainable if government policies and interventions can target women residing in rural areas and other modifiable risk factors, such as parity, health facility visits, planning to having more children, employment, watching television, and women’s autonomy. Full article

(This article belongs to the Special Issue Family Planning and Reproductive Health)

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10 pages, 1080 KiB

Open AccessArticle

Contraceptive Use and the Associated Factors among Women of Reproductive Age in Jazan City, Saudi Arabia: A Cross-Sectional Survey

by Mohamed Salih Mahfouz, Mona Elmahdy, Majed Ahmed Ryani, Amani Osman Abdelmola, Samah Ahmed Ali Kariri, Hayat Yahya Ahmad Alhazmi, Salwa Hussain Mater Almalki, Ons Mohammed Adhabi, Sahar Mohammed Ali Hindi, Nouf Mousa Muqri and Bashayer Abdullah Towhary

Int. J. Environ. Res. Public Health 2023, 20(1), 843; https://doi.org/10.3390/ijerph20010843 - 2 Jan 2023

Cited by 5 | Viewed by 3366

Abstract

The contraceptive use profile is poorly understood in some Gulf Arabian countries, including Saudi Arabia. The present study aimed to assess the knowledge, attitude, and practices related to contraceptive use among women of childbearing age in Jazan city, Saudi Arabia. An observational, analytical cross-sectional study was conducted among a random sample of 450 women in Jazan city. The data were obtained through personal interviews using a questionnaire that included questions on women’s level of knowledge about contraception methods, their attitudes towards contraception methods, and their practices. Data were analyzed using descriptive and inferential statistics techniques using the SPSS program. The prevalence of ever having used contraceptives was significantly different according to age group, job status, children ever born, and the number of pregnancies (p < 0.05 for all). On the other hand, the prevalence of desire to use the contraceptives in the future was high, at 70.9%, with a 95% CI [66.5–74.9]. It differed significantly according to age group and job status (p < 0.05 for both). The most familiar and usable types of contraceptives were pills (36.3%) and intrauterine devices (24.4%). When asked their reasons for using contraceptives, 53.8% of participants cited child spacing and 21.8% improving child health. Logistic regression revealed that the use of contraception among women was more associated with the 20–34 age group [COR = 7.7, 95% CI = 4.4–13.5, p < 0.001] than the 15–24 age group. Having more than one pregnancy and having more than one child were also associated with increased use of contraceptive methods (p < 0.001 for both). These results indicate there is a high level of awareness about contraceptives, a positive attitude toward them, and good practices for the use of them among Saudi women in Jazan. More efforts are needed to improve women’s awareness for better utilization of the available services. Full article

(This article belongs to the Special Issue Family Planning and Reproductive Health)

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10 pages, 333 KiB

Open AccessArticle

Perceptions of the COVID-19 Pandemic among Women with Infertility: Correlations with Dispositional Optimism

by Amanda J. Dillard, Ava E. Weber, Amanda Chassee and Mili Thakur

Int. J. Environ. Res. Public Health 2022, 19(5), 2577; https://doi.org/10.3390/ijerph19052577 - 23 Feb 2022

Cited by 7 | Viewed by 3838

Abstract

People who are more optimistic may experience better psychological health during stressful times. The present study examined the perceptions and emotions surrounding the COVID-19 pandemic among American women who were experiencing fertility problems. We tested if dispositional optimism in these women was associated with less negative perceptions and emotions. We conducted a cross-sectional survey of patients from a single private infertility and reproductive clinic in an urban area in the Midwest, United States. Women, age 18 or older, primarily White and educated, who presented for an appointment to the clinic were invited to participate in an email-based survey. Respondents (N = 304) reported their perceived impact of the COVID-19 pandemic on fertility treatment, emotions associated with this impact, and perceived stress and depressive symptoms. They also completed measures of dispositional optimism and expectations for a future pregnancy. Findings indicated that women perceived an overall negative impact of the pandemic on their treatment plans, which was associated with more negative emotions, lower expectations of future pregnancy, and greater stress and depressive symptoms during the pandemic. However, further correlational analyses revealed that being higher in trait optimism was associated with perceiving a less negative impact of the pandemic, experiencing fewer negative emotions, and less overall stress and depressive symptoms. Although women with fertility problems have perceived the pandemic as negative and disruptive, those who are higher in optimism may be less affected. Full article

(This article belongs to the Special Issue Family Planning and Reproductive Health)

16 pages, 748 KiB

Open AccessArticle

Family Planning Uptake in Kagera and Mara Regions in Tanzania: A Cross-Sectional Community Survey

by Joseph Massenga, Rita Noronha, Bayoum Awadhi, Dunstan R. Bishanga, Oliva Safari, Lusekelo Njonge, Young-Mi Kim, Jos van Roosmalen and Thomas van den Akker

Int. J. Environ. Res. Public Health 2021, 18(4), 1651; https://doi.org/10.3390/ijerph18041651 - 9 Feb 2021

Cited by 4 | Viewed by 6895

Abstract

In Tanzania, 27.1% of all women of reproductive age are currently using modern contraception and 16.8% have an unmet need for family planning. We therefore examined factors associated with family planning uptake after giving birth in two regions of Tanzania. The survey, which collected information beyond that collected in the Tanzania Demographic Health Survey, used a two-stage, stratified-cluster sampling design, conducted in April 2016 in Mara and Kagera regions in Tanzania. A total of 1184 women aged 15–49 years, who had given birth less than two years prior to the survey were included. Logistic regression mixed effect modelling was used to examine factors associated with family planning uptake. A total of 393 (33.2%) women used family planning methods and 929 (79%) required prior approval from their partners. Participation of men in utilization of maternal health care was low, where 680 (57.8%) women responded that their partners accompanied them to at least one antenatal care (ANC) counselling visit and 120 (10%) responded that their partners participated in family planning counselling. Women who did not want to disclose whether they had discussed family planning with their partners, strikingly had the highest percentage of using family planning methods after birth. Factors independently associated with family planning uptake included: having discussed family planning with the partner (aOR 3.22; 95% CI 1.99–5.21), having been counselled on family planning during antenatal care (aOR 2.68; 95% CI 1.78–4.05), having discussed family planning with a community health worker (CHW) (aOR 4.59; 95% CI 2.53–8.33) and with a facility health care worker (aOR 1.93; 95% CI 1.29–2.90), having primary or higher educational level (aOR 1.66; 95% CI 1.01–2.273), and being in union (aOR 1.86; 95% CI 1.02–3.42). Educational interaction with community and facility health workers, as well as having a supportive partner as facilitator increased uptake of family planning. This needs to be prioritized in regions with similar socio-cultural norms in Tanzania and beyond. Full article

(This article belongs to the Special Issue Family Planning and Reproductive Health)

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11 pages, 1413 KiB

Open AccessArticle

Prevalence, Correlates, and Barriers of Contraceptive Use among Women Attending Primary Health Centers in Aljouf Region, Saudi Arabia

by Doaa M. Abdel-Salam, Ibrahim A. Albahlol, Reem B. Almusayyab, Nouf F. Alruwaili, Manar Y. Aljared, Maram S. Alruwaili and Renad M. Alnasser

Int. J. Environ. Res. Public Health 2020, 17(10), 3552; https://doi.org/10.3390/ijerph17103552 - 19 May 2020

Cited by 16 | Viewed by 4916

Abstract

(1) Backgrounds and Objectives: with the rapid alteration in the socio-demographic pattern of the Saudi community, particularly the changes concerned with women’s education and work force, contraceptive use must be a fundamental aspect in the life of women in reproductive age. The present study aimed to identify the prevalence and correlates of contraceptive use among women attending primary health centers in Aljouf region, Saudi Arabia, and to determine the perceived barriers of stopping or not using contraceptive methods in this population. (2) Methods: a primary health center-based cross-sectional study was conducted among 369 women of reproductive age. Data collection was done by using structured questionnaires distributed during face to face interviews with the participants. Data were analyzed using the SPSS program, version 24. (3) Results: most of the participants (n = 166; 45%) were current contraceptive users and 32.2% (n = 119) reported previous use of contraceptive methods. Pills were the most frequently used method (n = 203; 71.2%) and intrauterine devices (IUDs) came next (n = 67; 23.5%) while surgery was the least common method among the respondents (n = 3; 1.1%). Logistic regression analysis showed that the significant predictors of contraceptive use were: age > 35 years (odds ratio (OR): 4.52; confidence interval (CI): 1.56–15.42), Children number ≥ 4 (odds ratio (OR): 1.41; confidence interval (CI): 1.06–1.92) and monthly income ≥ 5000 Saudi Riyal (RS) (odds ratio (OR): 2.29; confidence interval (CI): 1.24–8.27). The most perceived barriers towards contraceptive utilization were cultural, demographic, medical, administrative, and barriers related to the method itself. The least reported barriers were psychosocial and physical. (4) Conclusions: the present study showed a high prevalence of contraceptive use among Saudi women in Aljouf region, Saudi Arabia. The study recommended sustained efforts to increase population awareness of the importance of family planning. Policymakers should discover the barriers that prevent contraceptive utilization by women. Full article

(This article belongs to the Special Issue Family Planning and Reproductive Health)

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Review

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15 pages, 788 KiB

Open AccessReview

Incidence of Post-Vasectomy Pain: Systematic Review and Meta-Analysis

by Austin B. Auyeung, Anas Almejally, Fahad Alsaggar and Frank Doyle

Int. J. Environ. Res. Public Health 2020, 17(5), 1788; https://doi.org/10.3390/ijerph17051788 - 10 Mar 2020

Cited by 13 | Viewed by 9733

Abstract

This is the first systematic review and meta-analysis to ascertain incidences of post-vasectomy pain following traditional scalpel, or non-scalpel vasectomy. Electronic databases PubMed, Embase and PsycINFO were searched up to 1 July 2019 for peer-reviewed articles recording post-vasectomy pain. We identified 733 publications, screened 559 after removal of duplicates and excluded 533. Of the remaining 26 full-text articles, 8 were excluded with reasons, leaving 18 for detailed analyses. Meta-analysis was performed on 25 separate datasets (11 scalpel, 11 non-scalpel, 3 other/combined). Study follow-up ranged from 2 weeks to 37 years and sample sizes from 12 to 723 patients. The overall incidence of post-vasectomy pain was 15% (95% CI 9% to 25%). The incidences of post-vasectomy pain following scalpel and non-scalpel techniques were 24% (95% CI 15% to 36%) and 7% (95% CI 4% to 13%), respectively. Post-vasectomy pain syndrome occurred in 5% (95% CI 3% to 8%) of subjects, with similar estimates for both techniques. We conclude that the overall incidence of post-vasectomy pain is greater than previously reported, with three-fold higher rates of pain following traditional scalpel, compared to non-scalpel vasectomy, whereas the incidence of post-vasectomy pain syndrome is similar. Full article

(This article belongs to the Special Issue Family Planning and Reproductive Health)

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