Barriers to acceptance of post-partum family planning among women in Montserrado County, Liberia

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Study Justification:
The study aimed to investigate the barriers to acceptance of post-partum family planning (PPFP) among women in Montserrado County, Liberia. This research was conducted due to the high maternal mortality rate in Liberia, which is one of the highest in Sub-Saharan Africa. PPFP has the potential to reduce maternal mortality by preventing unwanted and closely spaced pregnancies. However, the uptake of PPFP in Liberia is low. Understanding the barriers to PPFP acceptance is crucial for developing effective strategies to improve its utilization and ultimately reduce maternal mortality.
Highlights:
– The study found that fear of side effects and post-partum abstinence were the most commonly reported barriers to PPFP acceptance among women in Montserrado County, Liberia.
– Being within the early post-partum period (within the first 6 months) and lack of access to PPFP were identified as significant barriers.
– Women who were married and those who were aware of PPFP were more likely to use PPFP.
– The study emphasizes the importance of health communication targeting mothers for PPFP at every contact with maternal and childcare services.
Recommendations:
– Health communication strategies should be developed and implemented to address the barriers identified, particularly the fear of side effects and post-partum abstinence.
– Efforts should be made to improve access to PPFP services, as lack of access was a significant barrier.
– Awareness campaigns should be conducted to increase knowledge and understanding of PPFP among women in Montserrado County, Liberia.
– Maternal and childcare services should incorporate PPFP counseling and education at every contact with mothers.
Key Role Players:
– Ministry of Health: Responsible for developing and implementing health communication strategies, awareness campaigns, and incorporating PPFP counseling in maternal and childcare services.
– Healthcare providers: Involved in delivering PPFP services, counseling, and education to women.
– Non-governmental organizations (NGOs): Collaborate with the Ministry of Health to support awareness campaigns and provide resources for PPFP services.
– Community leaders and influencers: Engage in community-level advocacy and education to promote PPFP acceptance.
Cost Items for Planning Recommendations:
– Development and implementation of health communication strategies: Includes costs for research, message development, media production, and dissemination.
– Awareness campaigns: Budget for materials, media placement, community engagement activities, and monitoring and evaluation.
– Training and capacity building for healthcare providers: Costs for workshops, training materials, and ongoing support.
– Integration of PPFP counseling in maternal and childcare services: Budget for training, development of counseling materials, and monitoring and evaluation.
– Collaboration with NGOs: Potential costs for partnership agreements, resource allocation, and joint activities.
– Community-level advocacy and education: Budget for community engagement activities, materials, and outreach programs.

The strength of evidence for this abstract is 7 out of 10.
The evidence in the abstract is moderately strong. The study conducted a cross-sectional facility-based survey with a relatively large sample size. The use of binary logistic regression analysis adds to the strength of the findings. However, the abstract does not provide information on the specific methodology used for data collection and analysis, which could have further strengthened the evidence. To improve the evidence, future studies could consider providing more details on the sampling technique, data collection instruments, and statistical methods used. Additionally, including a comparison group or control group could help establish stronger causal relationships between the identified barriers and the acceptance of PPFP.

Background: Maternal mortality in Liberia is one of the highest in Sub-Saharan Africa. Post-partum family planning (PPFP) can reduce the risk of maternal mortality by preventing unwanted and closely spaced pregnancies. Yet, the uptake of PPFP is low in Liberia. Objective: We investigated the barriers to acceptance of PPFP use among women in Montserrado County, Liberia. Materials and Methods: A cross-sectional facility-based survey was conducted using a multistage sampling technique to select 378 women within 12 months’ post-partum period. Results: About half of our respondents were <25 years (52.9%), 24.1% were married, 66.4% had at least secondary education and 92.1% were Christians. The most commonly reported barriers were the fear of side effects (22.0%) and the post-partum abstinence (22.2%). Binary logistic regression analysis showed that being within the early post-partum period, i.e., within the first 6 months (adjusted odds ratio [AOR] = 0.23, 95% confidence interval [CI] [0.09-0.60] and lack of access to PPFP [AOR = 0.22, 95% CI [0.09-0.52]). Importantly, women who were married [AOR = 1.686, 95% CI (0.65, 4.36)] and those who were aware of PPFP [AOR 3.69, 95% CI (1.224, 11.096)] increased the likelihood of using PPFP. Conclusion: Important barriers to the utilisation of PPFP in Liberia were being within early post-partum period, lack of access and awareness of PPFP including myths and misconception. Therefore, health communication targeting mothers for PPFP at every contact with maternal and childcare services should be encouraged.

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I’m sorry, but I cannot provide the specific innovations for the recommendations mentioned in the publication “Barriers to acceptance of post-partum family planning among women in Montserrado County, Liberia” without further information. The publication does not provide specific innovations, but rather suggests implementing a comprehensive health communication strategy to target mothers for post-partum family planning (PPFP) at every contact with maternal and childcare services. The recommendations include increasing awareness, improving access, empowering women, and ensuring continuity of care. To develop specific innovations, further research and analysis would be needed to identify appropriate strategies and interventions that address the barriers identified in the study.
AI Innovations Description
Based on the research findings presented in the publication “Barriers to acceptance of post-partum family planning among women in Montserrado County, Liberia,” the following recommendation can be developed into an innovation to improve access to maternal health:

Innovation Recommendation: Implement a comprehensive health communication strategy to target mothers for post-partum family planning (PPFP) at every contact with maternal and childcare services.

Explanation: The research identified several barriers to the utilization of PPFP in Liberia, including being within the early post-partum period, lack of access to PPFP, and low awareness of PPFP due to myths and misconceptions. To address these barriers and improve access to maternal health, a comprehensive health communication strategy should be developed and implemented. This strategy should focus on targeting mothers at every contact with maternal and childcare services, such as antenatal care visits, postnatal care visits, and immunization sessions.

The health communication strategy should aim to:

1. Increase awareness: Provide accurate and evidence-based information about the benefits of PPFP, dispel myths and misconceptions, and address concerns about side effects. This can be done through educational materials, counseling sessions, and community outreach programs.

2. Improve access: Ensure that PPFP services are readily available and accessible to women in Montserrado County. This may involve training healthcare providers on PPFP counseling and service provision, ensuring the availability of contraceptive methods, and addressing any logistical or infrastructure challenges that hinder access.

3. Empower women: Promote women’s autonomy and decision-making regarding their reproductive health by providing them with the knowledge and tools to make informed choices about PPFP. This can be achieved through counseling sessions that involve active participation and shared decision-making between healthcare providers and women.

4. Continuity of care: Establish a system that ensures continuity of care for women throughout the post-partum period. This can involve developing protocols and guidelines for PPFP provision, strengthening referral systems between different levels of healthcare facilities, and promoting collaboration between maternal and childcare services.

By implementing this comprehensive health communication strategy, it is expected that the barriers to acceptance of PPFP among women in Montserrado County, Liberia, can be addressed, leading to improved access to maternal health and a reduction in maternal mortality rates.
AI Innovations Methodology
To simulate the impact of the main recommendations on improving access to maternal health, the following methodology can be used:

1. Study Design: Conduct a pre- and post-intervention study design to compare the access to maternal health services before and after implementing the comprehensive health communication strategy targeting mothers for PPFP.

2. Sampling: Use a multistage sampling technique to select a representative sample of women within the post-partum period in Montserrado County, Liberia. Ensure that the sample size is adequate to detect significant changes in access to maternal health services.

3. Data Collection: Collect data through structured interviews with women in the post-partum period. The interviews should include questions related to their awareness of PPFP, barriers they face in accessing PPFP, and their utilization of maternal health services.

4. Intervention: Implement the comprehensive health communication strategy targeting mothers for PPFP at every contact with maternal and childcare services. This may involve training healthcare providers, developing educational materials, conducting counseling sessions, and organizing community outreach programs.

5. Post-Intervention Data Collection: Repeat the data collection process after implementing the intervention to assess any changes in women’s awareness of PPFP, barriers faced, and utilization of maternal health services.

6. Data Analysis: Analyze the data using appropriate statistical methods, such as chi-square tests or logistic regression, to compare the pre- and post-intervention outcomes. Assess the impact of the intervention on women’s awareness of PPFP, barriers faced, and utilization of maternal health services.

7. Evaluation: Evaluate the effectiveness of the comprehensive health communication strategy by comparing the pre- and post-intervention results. Determine if there is a significant improvement in access to maternal health services, including the utilization of PPFP.

8. Recommendations: Based on the findings, provide recommendations for further improvements in the implementation of the comprehensive health communication strategy. Identify any challenges or limitations encountered during the study and suggest ways to overcome them.

By following this methodology, researchers can assess the impact of the recommended intervention on improving access to maternal health services, specifically PPFP, in Montserrado County, Liberia. The findings can inform future interventions and policies aimed at reducing maternal mortality rates in the region.

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