Utilization of postpartum family planning and associated factors among postpartum women attending five healthcare facilities in a rural district in Northern Uganda.

Abstract

Background: Postpartum women worldwide, despite wishing to delay or avoid pregnancies, often resume sexual activity without family planning, contributing to 121 million unintended pregnancies annually, particularly in sub-Saharan Africa. Postpartum family planning (PPFP) can prevent 71% of unintended pregnancies and reduce maternal and neonatal morbidity and mortality. However, uptake in Uganda is low, at 35%, and data on its use are scarce. Sociocultural barriers, limited access to quality healthcare, and systemic inequities further hinder uptake.

Objective: To assess the level of utilization of PPFP and the contributing factors among postpartum women attending health facilities in a rural district of Northern Uganda.

Methods: A descriptive cross-sectional study was conducted among 483 women within 12-month postpartum, recruited from 5 randomly selected health facilities between October and November 2022. Quantitative data were collected using interviewer-administered questionnaires. Data were analyzed using STATA version 17.0, with descriptive statistics and multivariate logistic regression performed at a 95% confidence interval (CI) to identify predictors of PPFP utilization.

Results: The utilization of PPFP was 41.61% (95% CI: 37.17-46.15). Independent predictors or contributing factors to PPFP utilization included education level (primary-adjusted prevalence ratio (APR): 0.753; 95% CI: 0.641-0.883; p = <0.001), partner's age (APR: 1.203; 95% CI: 1.004-1.443; p = 0.05), parity (APR: 0.755; 95% CI: 0.635-0.897; p = 0.001), uncertainty about timing for next pregnancy (APR: 1.994; 95% CI: 1.09-3.646; p = 0.03), and advice from friends about PPFP methods (APR: 1.358; 95% CI: 1.171-1.575; p = <0.001).