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Couples’ decision-making on post-partum family planning and antenatal counselling in Uganda: a qualitative study

Couples’ decision-making on post-partum family planning and antenatal counselling in Uganda: a qualitative study
Couples’ decision-making on post-partum family planning and antenatal counselling in Uganda: a qualitative study
Background: although health workers have been trained to provide post-partum family planning (PPFP), uptake remains low in Uganda. An important reason is that women want the agreement of their partner, who is often absent at the time of delivery. In order to address this, we aimed to understand the views of couples and explore barriers and facilitators to implementation of antenatal couples’ counselling on PPFP in Uganda.

Methods: we conducted individual interviews with a purposive sample of 12 postpartum and 3 antenatal couples; and 34 focus groups with a total of 323 participants (68 adolescent women, 83 women aged 20–49, 79 men, 93 health workers) in four contrasting communities (urban and rural) in South-West and Central Uganda. These were recorded, transcribed, translated, and analysed thematically.

Results: although most participants felt that it is important for partners to discuss family planning, half of the couples were unaware of each other’s views on contraception. Most had similar views on motivation to use family planning but not on preferred contraceptive methods. Most liked the idea of antenatal couples’ counselling on PPFP. The main barrier was the reluctance of men to attend antenatal clinics (ANC) in health facilities. Respondents felt that Village Health Teams (VHTs) could provide initial counselling on PPFP in couples’ homes (with telephone support from health workers, if needed) and encourage men to attend ANC. Suggested facilitators for men to attend ANC included health workers being more welcoming, holding ANC clinics at weekends and “outreach” clinics (in rural villages far from health facilities).

Conclusion: antenatal couples’ counselling has the potential to facilitate agreement PPFP, but some men are reluctant to attend antenatal clinics. Counselling at home by VHTs as well as simple changes to the organisation of antenatal clinics, could make it possible to deliver antenatal couples’ counselling on PPFP.
1932-6203
Willcox, Merlin
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Mubangizi, Vincent
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Natukunda, Sylvia
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Owokuhaisa, Judith
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Nahabwe, Haeven
54170f39-ff9e-496c-918c-ec304a92ef53
Nakaggwa, Florence
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Laughton, Matthew
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Chambers, Isabella
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Coates, Sabine
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King, Emma
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Fall, Emma
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Muller, Ingrid
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Goodhart, Clare
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Graffy, Jonathan
e0dfe927-16f9-43cd-bb80-40cf435ea894
Willcox, Merlin
dad5b622-9ac2-417d-9b2e-aad41b64ffea
Mubangizi, Vincent
28691d9b-344c-4779-9512-29377e09ae8c
Natukunda, Sylvia
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Owokuhaisa, Judith
b0484d76-a718-4a2a-a6c2-81fe6595b2c8
Nahabwe, Haeven
54170f39-ff9e-496c-918c-ec304a92ef53
Nakaggwa, Florence
53165ca0-0636-442e-a902-411853225eff
Laughton, Matthew
30edb77f-449a-4485-ae4b-faffacbc5d24
Chambers, Isabella
3d2a0d8c-7a7a-4784-979b-1ed58d1de0f0
Coates, Sabine
9f881538-0b1d-4aa1-bff4-827e9f6e06dc
King, Emma
24fd1966-8101-4f55-aae3-912db086cfb1
Fall, Emma
9c9cf217-691d-4498-938d-f7f6365c58c3
Muller, Ingrid
2569bf42-51bd-40da-bbfd-dd4dbbd62cad
Goodhart, Clare
6609457f-bc4a-4680-a84c-32fd3f874c57
Graffy, Jonathan
e0dfe927-16f9-43cd-bb80-40cf435ea894

Willcox, Merlin, Mubangizi, Vincent, Natukunda, Sylvia, Owokuhaisa, Judith, Nahabwe, Haeven, Nakaggwa, Florence, Laughton, Matthew, Chambers, Isabella, Coates, Sabine, King, Emma, Fall, Emma, Muller, Ingrid, Goodhart, Clare and Graffy, Jonathan (2021) Couples’ decision-making on post-partum family planning and antenatal counselling in Uganda: a qualitative study. PLoS ONE, 16 (5). (doi:10.1371/journal.pone.0251190).

Record type: Article

Abstract

Background: although health workers have been trained to provide post-partum family planning (PPFP), uptake remains low in Uganda. An important reason is that women want the agreement of their partner, who is often absent at the time of delivery. In order to address this, we aimed to understand the views of couples and explore barriers and facilitators to implementation of antenatal couples’ counselling on PPFP in Uganda.

Methods: we conducted individual interviews with a purposive sample of 12 postpartum and 3 antenatal couples; and 34 focus groups with a total of 323 participants (68 adolescent women, 83 women aged 20–49, 79 men, 93 health workers) in four contrasting communities (urban and rural) in South-West and Central Uganda. These were recorded, transcribed, translated, and analysed thematically.

Results: although most participants felt that it is important for partners to discuss family planning, half of the couples were unaware of each other’s views on contraception. Most had similar views on motivation to use family planning but not on preferred contraceptive methods. Most liked the idea of antenatal couples’ counselling on PPFP. The main barrier was the reluctance of men to attend antenatal clinics (ANC) in health facilities. Respondents felt that Village Health Teams (VHTs) could provide initial counselling on PPFP in couples’ homes (with telephone support from health workers, if needed) and encourage men to attend ANC. Suggested facilitators for men to attend ANC included health workers being more welcoming, holding ANC clinics at weekends and “outreach” clinics (in rural villages far from health facilities).

Conclusion: antenatal couples’ counselling has the potential to facilitate agreement PPFP, but some men are reluctant to attend antenatal clinics. Counselling at home by VHTs as well as simple changes to the organisation of antenatal clinics, could make it possible to deliver antenatal couples’ counselling on PPFP.

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Accepted/In Press date: 22 April 2021
Published date: 5 May 2021

Identifiers

Local EPrints ID: 481454
URI: http://eprints.soton.ac.uk/id/eprint/481454
ISSN: 1932-6203
PURE UUID: 07302adf-13d4-4bcd-8b51-de63cf9e0300
ORCID for Merlin Willcox: ORCID iD orcid.org/0000-0002-5227-3444
ORCID for Ingrid Muller: ORCID iD orcid.org/0000-0001-9341-6133

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Date deposited: 29 Aug 2023 16:51
Last modified: 18 Mar 2024 03:39

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Contributors

Author: Merlin Willcox ORCID iD
Author: Vincent Mubangizi
Author: Sylvia Natukunda
Author: Judith Owokuhaisa
Author: Haeven Nahabwe
Author: Florence Nakaggwa
Author: Matthew Laughton
Author: Isabella Chambers
Author: Sabine Coates
Author: Emma King
Author: Emma Fall
Author: Ingrid Muller ORCID iD
Author: Clare Goodhart
Author: Jonathan Graffy

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