Advertisement

Effect of Family Planning Counseling After Delivery on Contraceptive Use at 24 Weeks Postpartum in Kinshasa, Democratic Republic of Congo

  • Paul N. ZivichEmail author
  • Bienvenu Kawende
  • Bruno Lapika
  • Frieda Behets
  • Marcel Yotebieng
Article
  • 32 Downloads

Abstract

Introduction Unintended pregnancy during the postpartum period is common. The aim of this study was to describe contraceptive use among postpartum women and assess whether family planning counseling offered by health care providers during well-baby clinic visits increased use of modern contraceptive methods at 6 months following delivery. Methods Data comes from a cohort of women enrolled in a breastfeeding promotion trial in Kinshasa, Democratic Republic of Congo who reported being sexually active at 24-weeks post-partum. Modern contraceptive methods included intrauterine devices, injectables, implants, and contraception pills. Logistic regression models were used to estimate odd ratios (OR) and 95% confidence intervals (CI) for the impact of nurse counseling on use of modern birth control methods. Results Of 522 participants who reported being sexually active, 251 (48.0%) reported doing at least one thing to avoid pregnancy and were included in this analysis. Of these 251, 14.3% were using a modern contraceptive method, despite availability at the clinic. Discussion with a nurse about family planning was associated with increased odds of using modern birth control relative to other methods (OR 4.0, 95% CI 1.9, 8.6). Discussion Discussion of family planning with a nurse increased the odds of using a modern contraceptive among postpartum women. Integration of family planning counseling into postpartum services offers a potential avenue to increase modern contraceptive use among women with access.

Keywords

Postpartum Contraceptive use Family planning counselling Well-baby clinics DR Congo 

Notes

Acknowledgements

We are grateful for the participation and time of the study mothers and infants; the time and efforts of the personnel of the participating clinics (Esengo, Kikenda, Kitega, Libikisi, Lukunga, and Luyindu); the technical support of Drs. Aimee Lulebo, Dinah Kayembe, Landry Kiketa, Jean Lambert S. Chalachala, Mrs. Kathryn Salisbury, and Deidre Thompson; the data collection and data entry contributions of Clever Akili, Dyna Anambatu, Valerie B. Chalachala, Marie Dauly, Dydy Kayembe, Mamie Lulebo, Fanny Matadi, Myriam Mbonze, Espérance Mindia, Sarah Mushiya, Gisèle Mvumbi, Dodo Mwela, Jolly Ntirume, Ros Samba; and the administrative support of the UNC, KSPH, and Alive & Thrive administrative teams.

Funding

The original trial was supported by a grant from the Bill & Melinda Gates Foundation to FHI 360, through the Alive & Thrive Small Grants Program managed by UC Davis via a sub-award to the University of North Carolina at Chapel Hill. MY is partially supported by the NIAID U01AI096299-01 and the NICHD R01HD087993. The sponsors of the study had no role in study design, data collection, data analysis, data interpretation, writing of the report, or the decision to submit the paper for publication. PNZ is supported by NICHD T32-HD091058.

References

  1. Ahmed, S., Ahmed, S., McKaig, C., Begum, N., Mungia, J., Norton, M., & Baqui, A. H. (2015). The effect of integrating family planning with a maternal and newborn health program on postpartum contraceptive use and optimal birth spacing in Rural Bangladesh. Studies in Family Planning, 46(3), 297–312.  https://doi.org/10.1111/j.1728-4465.2015.00031.x.CrossRefPubMedGoogle Scholar
  2. Ahmed, S., Li, Q., Liu, L., & Tsui, A. O. Maternal deaths averted by contraceptive use: An analysis of 172 countries. The Lancet, 380(9837), 111–125.  https://doi.org/10.1016/S0140-6736(12)60478-4.
  3. Alkema, L., Kantorova, V., Menozzi, C., & Biddlecom, A. (2013). National, regional, and global rates and trends in contraceptive prevalence and unmet need for family planning between 1990 and 2015: A systematic and comprehensive analysis. Lancet, 381(9878), 1642–1652.  https://doi.org/10.1016/s0140-6736(12)62204-1.CrossRefPubMedGoogle Scholar
  4. Ayiasi, R. M., Muhumuza, C., Bukenya, J., & Orach, C. G. (2015). The effect of prenatal counselling on postpartum family planning use among early postpartum women in Masindi and Kiryandongo districts, Uganda. Pan African Medical Journal, 21, 138.  https://doi.org/10.11604/pamj.2015.21.138.7026.CrossRefPubMedGoogle Scholar
  5. Barber, S. L. (2007). Family planning advice and postpartum contraceptive use among low-income women in Mexico. International Family Planning Perspectives, 33(1), 6–12.  https://doi.org/10.1363/ifpp.33.006.07.CrossRefPubMedGoogle Scholar
  6. Boerma, J. T., & Bicego, G. T. (1992). Preceding birth intervals and child survival: Searching for pathways of influence. Studies in Family Planning, 23(4), 243–256.CrossRefGoogle Scholar
  7. Bossyns, P., Miye, H., & VLerberghe, W. (2002). Supply-level measures to increase uptake of family planning services in Niger: The effectiveness of improving responsiveness. Tropical Medicine & International Health, 7(4), 383–390.CrossRefGoogle Scholar
  8. Canning, D., & Schultz, T. P. (2012). The economic consequences of reproductive health and family planning. Lancet, 380(9837), 165–171.  https://doi.org/10.1016/s0140-6736(12)60827-7.CrossRefPubMedGoogle Scholar
  9. Chirwa, T. F., Mantempa, J. N., Kinziunga, F. L., Kandala, J. D., & Kandala, N. B. (2014). An exploratory spatial analysis of geographical inequalities of birth intervals among young women in the Democratic Republic of Congo (DRC): A cross-sectional study. BMC Pregnancy Childbirth, 14, 271.  https://doi.org/10.1186/1471-2393-14-271.CrossRefPubMedPubMedCentralGoogle Scholar
  10. Conde-Agudelo, A., Rosas-Bermudez, A., & Kafury-Goeta, A. C. (2006). Birth spacing and risk of adverse perinatal outcomes: A meta-analysis. JAMA, 295(15), 1809–1823.  https://doi.org/10.1001/jama.295.15.1809.CrossRefPubMedGoogle Scholar
  11. Jarvis, L., Wickstrom, J., Vance, G., & Gausman, J. (2018). Quality and cost interventions during the extended perinatal period to increase family planning use in Kinshasa, DRC: Results from an initial study. Global Health: Science and Practice, 6(3), 456–472.  https://doi.org/10.9745/ghsp-d-18-00075.CrossRefGoogle Scholar
  12. Kandala, N. B., Mandungu, T. P., Mbela, K., Nzita, K. P., Kalambayi, B. B., Kayembe, K. P., & Emina, J. B. (2014). Child mortality in the Democratic Republic of Congo: Cross-sectional evidence of the effect of geographic location and prolonged conflict from a national household survey. BMC Public Health, 14, 266.  https://doi.org/10.1186/1471-2458-14-266.CrossRefPubMedPubMedCentralGoogle Scholar
  13. Kayembe, P., Babazadeh, S., Dikamba, N., Akilimali, P., Hernandez, J., Binanga, A., & Bertrand, J. T. (2015). Family planning supply environment in Kinshasa, DRC: Survey findings and their value in advancing family planning programming. Global Health: Science and Practice, 3(4), 630–645.  https://doi.org/10.9745/ghsp-d-15-00298.CrossRefGoogle Scholar
  14. Keogh, S. C., Urassa, M., Kumogola, Y., Kalongoji, S., Kimaro, D., & Zaba, B. (2015). Postpartum Contraception in Northern Tanzania: Patterns of use, relationship to antenatal intentions, and impact of antenatal counseling. Studies in Family Planning, 46(4), 405–422.  https://doi.org/10.1111/j.1728-4465.2015.00040.x.CrossRefPubMedGoogle Scholar
  15. Kuate Defo, B. (1997). Effects of infant feeding practices and birth spacing on infant and child survival: A reassessment from retrospective and prospective data. Journal of Biosocial Science, 29(3), 303–326.CrossRefGoogle Scholar
  16. Kuhlmann, A. S., Gavin, L., & Galavotti, C. (2010). The integration of family planning with other health services: A literature review. International Perspectives on Sexual and Reproductive Health, 36(4), 189–196.  https://doi.org/10.1363/3618910.CrossRefPubMedGoogle Scholar
  17. Mathe, J. K., Kasonia, K. K., & Maliro, A. K. (2011). Barriers to adoption of family planning among women in Eastern Democratic Republic of Congo. African Journal of Reproductive Health, 15(1), 69–77.PubMedGoogle Scholar
  18. Morse, J. E., Rowen, T. S., Steinauer, J., Byamugisha, J., & Kakaire, O. (2014). A qualitative assessment of Ugandan women’s perceptions and knowledge of contraception. International Journal of Gynecology & Obstetrics, 124(1), 30–33.  https://doi.org/10.1016/j.ijgo.2013.07.014.CrossRefGoogle Scholar
  19. Muanda, M., Ndongo, G., Taub, L. D., & Bertrand, J. T. (2016). Barriers to modern contraceptive Use in Kinshasa, DRC. PLoS ONE, 11(12), e0167560.  https://doi.org/10.1371/journal.pone.0167560.CrossRefPubMedPubMedCentralGoogle Scholar
  20. Muanda, M. F., Ndongo, G. P., Messina, L. J., & Bertrand, J. T. (2017). Barriers to modern contraceptive use in rural areas in DRC. Culture, Health & Sexuality, 19(9), 1011–1023.  https://doi.org/10.1080/13691058.2017.1286690.CrossRefGoogle Scholar
  21. Orji, E. O., Ojofeitimi, E. O., & Olanrewaju, B. A. (2007). The role of men in family planning decision-making in rural and urban Nigeria. The European Journal of Contraception & Reproductive Health Care, 12(1), 70–75.  https://doi.org/10.1080/13625180600983108.CrossRefGoogle Scholar
  22. Pasha, O., Goudar, S. S., Patel, A., Garces, A., Esamai, F., Chomba, E., et al. (2015). Postpartum contraceptive use and unmet need for family planning in five low-income countries. Reproductive Health, 12(Suppl 2), S11.  https://doi.org/10.1186/1742-4755-12-s2-s11.CrossRefPubMedPubMedCentralGoogle Scholar
  23. Perin, J., & Walker, N. (2015). Potential confounding in the association between short birth intervals and increased neonatal, infant, and child mortality. Global Health Action, 8, 29724.  https://doi.org/10.3402/gha.v8.29724.CrossRefPubMedGoogle Scholar
  24. Ross, J. A., & Winfrey, W. L. (2001). Contraceptive use, intention to use and unmet need during the extended postpartum period. International Family Planning Perspectives, 27(1), 20–27.  https://doi.org/10.2307/2673801.CrossRefGoogle Scholar
  25. Sano, Y., Antabe, R., Atuoye, K. N., Braimah, J. A., Galaa, S. Z., & Luginaah, I. (2018). Married women’s autonomy and post-delivery modern contraceptive use in the Democratic Republic of Congo. BMC Womens Health, 18(1), 49.  https://doi.org/10.1186/s12905-018-0540-1.CrossRefPubMedPubMedCentralGoogle Scholar
  26. Sedgh, G., Singh, S., & Hussain, R. (2014). Intended and unintended pregnancies worldwide in 2012 and recent trends. Studies in Family Planning, 45(3), 301–314.  https://doi.org/10.1111/j.1728-4465.2014.00393.x.CrossRefPubMedPubMedCentralGoogle Scholar
  27. Yotebieng, M., Chalachala, J. L., Labbok, M., & Behets, F. (2013). Infant feeding practices and determinants of poor breastfeeding behavior in Kinshasa, Democratic Republic of Congo: A descriptive study. International Breastfeeding Journal, 8(1), 11.  https://doi.org/10.1186/1746-4358-8-11.CrossRefPubMedPubMedCentralGoogle Scholar
  28. Yotebieng, M., Labbok, M., Soeters, H. M., Chalachala, J. L., Lapika, B., Vitta, B. S., et al. (2015). Ten steps to successful breastfeeding programme to promote early initiation and exclusive breastfeeding in DR Congo: A cluster-randomised controlled trial. Lancet Global Health, 3(9), e546–e555.  https://doi.org/10.1016/s2214-109x(15)00012-1.CrossRefPubMedGoogle Scholar
  29. You, D., Hug, L., Ejdemyr, S., Idele, P., Hogan, D., Mathers, C., et al. (2015). Global, regional, and national levels and trends in under-5 mortality between 1990 and 2015, with scenario-based projections to 2030: A systematic analysis by the UN Inter-agency group for child mortality estimation. Lancet, 386(10010), 2275–2286.  https://doi.org/10.1016/s0140-6736(15)00120-8.CrossRefPubMedGoogle Scholar
  30. Zivich, P., Lapika, B., Behets, F., & Yotebieng, M. (2018). Implementation of steps 1–9 to successful breastfeeding reduces the frequency of mild and severe episodes of diarrhea and respiratory tract infection among 0–6 month infants in Democratic Republic of Congo. Maternal and Child Health Journal, 22(5), 762–771.  https://doi.org/10.1007/s10995-018-2446-9.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Paul N. Zivich
    • 1
    Email author
  • Bienvenu Kawende
    • 3
  • Bruno Lapika
    • 4
  • Frieda Behets
    • 5
  • Marcel Yotebieng
    • 2
  1. 1.Department of Epidemiology, Gillings School of Global Public HealthThe University of North Carolina at Chapel HillChapel HillUSA
  2. 2.Division of Epidemiology, College of Public HealthThe Ohio State UniversityColumbusUSA
  3. 3.School of Public HealthThe University of KinshasaKinshasaDemocratic Republic of the Congo
  4. 4.Department of AnthropologyThe University of KinshasaKinshasaDemocratic Republic of the Congo
  5. 5.School of MedicineThe University of North Carolina at Chapel HillChapel HillUSA

Personalised recommendations