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Reproductive health seeking behavior of young married women. Dr. Aftab Uddin Gano Unnayan Sangstha (GUS). Outlines of presentation. Objectives Methodology Key Findings Lessons Learned Recommendations.
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Reproductive health seeking behavior of young married women Dr. Aftab Uddin Gano Unnayan Sangstha (GUS)
Outlines of presentation • Objectives • Methodology • Key Findings • Lessons Learned • Recommendations
general objective: to ascertain the health seeking behavior of young married women in Bangladesh Specific objective (s): To assess the socio – economic characteristics of the married adolescents; 1 To investigate the barriers or constraints in health seeking behavior of the adolescents; 2 To assess the attitudes of the parents and the community about health seeking behavior of the married adolescents; 3 4 To investigate the factors affecting the married adolescents health seeking behavior.
Methodology • A cross sectional study designed to obtain information from the primary and secondary sources; • No. and Categories of sample Respondents: • Married Adolescents & Newlywed Couple from upazila, union and village levels: 1680 • Program managers and service providers: 14 UFPO, 14 MO (MCH-FP), 14 Sr. FWVs, 28 Family Planning Inspectors (FPIs), 28 Family Welfare Visitors (FWV), 28 SACMOs, and 84 Family Welfare Assistant (FWAs) • Focus Group Discussion: 10
Methodology • Data collection: data were collected during May 2012 employing 8 sets of pretested instruments; • Data Analysis and results preparation: • Collected data were analysed by using EPI INFO and SPSS in IBM/IBM compatible PC. • Uni-variate and bi-variate analysis were done to prepare tables in line of the objectives of the study and for preparing the report.
Key findings • Adolescent married women: 50% were under 17 and 37% were exactly 18 years, 36% had primary education while 53% had secondary level; • Nearly 90% were aware of the services such as: FP methods (68%), ANC service, delivery care, postnatal care, conduct delivery, general health service, vaccination and childcare. • More than 16% respondents were currently pregnant and…9 in 10 adolescents received ANC; • Main sources were: • Public sector (79%), private practitioners (26.3%), and NGO clinics (24.8%) • 20% of women received ANC at community clinic
Key findings • 45% adolescents wanted to have baby after the age of 20 and only 14% wanted baby earlier. • Current use of contraception: • CPR (any method)- 52% with variations in high performing (62%) and low performing (43%) areas; • The pill was the most popular method in all regions; • Injectables were the second most popular method in low performing area, and • Condoms were the second most popular method in medium performing area; • Public sector provides more than 83% of all users; • FWAs were the most important source supplying 43%, 70% and 60.5% to users in high, medium and low areas respectively.
Key findings • Complication for using FP method-25% users in the low performing area as against 10.3% in high performing area had complications while using FP method; • Obstacles and assistance for receiving services- • Very few young women had faced obstacles from both families and community; • 77.8% of the respondents in high performing area as against 90% in medium performing areas got assistance from health clinics.
Key findings • Factors associate with attitude of health care service: • Two-third respondents suggested that mass campaign and courtyard meeting could raise awareness and increase the utilization of health care service; • Suggested following steps: • improve quality of services • increase the adequate number of doctors • provide aids and medicines • provide adequate contraceptive materials and • give quality training to the service providers
Key findings • Program managers and service providers: • 62.5% managers described the status of health seeking behavior of women as average; • Women sought: • delivery and childcare (50%) and RH care (38%) • mostly (94%) from FWA/FWV/SACMO • 87% providers perceived that clients received appropriate services according to their needs • FP methods and RH services, care for pregnant women, mother and child care. • All program managers opined that the attitude of the parents, community and relatives appear to be good towards women’s health seeking behavior
Key findings • Main obstacles for receiving services by a women • Superstition • lack of awareness of health in the family • lack of skilled worker and their frequent absence • Service providers opined that further steps needed: • courtyard meeting • group meeting with young and new couple • campaign including religious leaders to enhance existing service reception by the clients.
Key findings • One in five managers stated: providers faced difficulties/obstacles while providing services to their clients • The most mentioned reasons: • Religiosity and non-cooperation of husband of the newlywed couples for receiving FP method; • To overcome providers recommended, to: • build awareness in the society and among adolescents (99%) • promote general education (60%), and • develop awareness from religious perspective (68%)
Lessons Learned • Maternal, child and family planning services were available in the health center and 90% adolescent married women during their pregnancy received antenatal care mainly from the public sector. • Overall, 50% of the adolescent women used contraception, and pill was the most popular method in all regions-high, middle and low performing areas. • Negligible amount of respondents were using permanent method.
Lessons Learned • Public sectors have been the important source of supplies for family planning users in Bangladesh • Private sector as the second largest provider • In general, very few young women had faced obstacles from families and community. • However, the main obstacles for the adolescent married women while receiving health service: • Religiosity and the lack of cooperation of husband of the newlywed couples • lack of health awareness in family • lack of skilled workers, and • lack of transport
Recommendations • Launch effective BCC campaigns to increase coverage of RH-FP (ANC, Delivery, PNC and FP) services among adolescents; • Arrange adequate and efficient training programs including refreshers training to increase service providers’ knowledge and skills; • Increase community awareness by medically trained personnel about importance of RH-FP services so that young women can seek institutional and skilled services;
Recommendations • Provide effective counseling with appropriate information, and treat complications of contraceptive use to prevent dropout; • Ensure timely supply of appropriate FP methods based clients’ demand; • Equip service centers with adequate field workers to deliver adolescent care services; • Increase quality of services for FP method: • adequate time for counseling and motivation • clinical examination, and • explaining to the clients about the problems and appropriateness of the FP methods.