PMID- 37608320 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231120 IS - 2055-7426 (Electronic) IS - 2055-7426 (Linking) VI - 8 IP - 1 DP - 2023 Aug 23 TI - Postpartum family planning uptake in Uganda: findings from the lot quality assurance sampling survey. PG - 44 LID - 10.1186/s40834-023-00243-x [doi] LID - 44 AB - BACKGROUND: The initiation and use of family planning (FP) services within the first 12 months following childbirth, postpartum family planning (PPFP), promotes safe motherhood by reducing unintended pregnancies and ensuring appropriate pregnancy spacing. However, there is a paucity of information on PPFP uptake from community surveys. This study aimed to quantify the reported use of PPFP and identify predictors and barriers to PPFP uptake from a large community survey. METHODS: We analysed data collected from the 2021 Lot Quality Assurance Sampling (LQAS) survey, a cross-sectional community and household survey that covered 68 districts in Uganda. The survey uses small sample sizes to designate health or administrative geographical areas which are assessed to determine whether they achieved the pre-determined target for defined indicators of interest. We abstracted and analysed data collected from mothers of children aged 12 months or younger on reproductive health and FP. PPFP use was defined as the reported use of modern FP by the mother or their partner. Associations were measured using Pearson's chi-square test at 5% significance. Multivariate logistic regression was performed for variables that were significantly associated with PPFP use to identify the predictors of PPFP. RESULTS: Overall, 8103 mothers of children aged less than 12 years were included in the analysis; the majority of mothers, 55.8% (4521/8103) were above 24 years while 11.7% (950/8103) were 19 years and under. 98% (7942/8103) of the mothers attended at least one antenatal care (ANC) visit and 86.3% (6997/8103) delivered at a health facility. Only 10% (814/8103) of mothers who participated in the survey reported PPFP use at the time of the survey. Reporting of PPFP use was 5 times higher among mothers of children aged 7-12 months (AOR 4.9; 95%CI 4.1-5.8), 50% higher among mothers with secondary education (AOR 1.5; 95%CI 1.0-2.3), 80% higher among breastfeeding mothers (AOR 1.8; 95%CI 1.3-2.4) and 30% lower among those that didn't receive a health worker visit within 3 months preceding the survey (AOR 0.7; 95% CI 0.5-0.8). Among 4.6% (372/8103) who stated a reason for non-use of PPFP, the most cited reasons for not using were breastfeeding 43% (161/372), fear of side effects 26.9% (100/372), respondent/partner opposition 17.6% (48/372) and infrequent sex 12.1% (48/372). CONCLUSION: The analysis showed a low proportion of PPFP uptake among mothers of children under 12 years. Possible barriers included child age, education, a health worker visit, and side effects and perceived benefits of possibly improperly implementing lactation amenorrhea method. Integration of social, community and health services could provide a more holistic approach to improving PPFP uptake. CI - (c) 2023. BioMed Central Ltd., part of Springer Nature. FAU - Nakaggwa, Florence AU - Nakaggwa F AD - Social & Scientific Systems, Inc., a DLH Holdings Company / USAID SITES, Plot 2730 Church Road, Kironde Zone, P.O.Box 12761, Kampala, Uganda. florence.nakaggwa@dlhcorp.com. FAU - Kimuli, Derrick AU - Kimuli D AD - Social & Scientific Systems, Inc., a DLH Holdings Company / USAID SITES, Plot 2730 Church Road, Kironde Zone, P.O.Box 12761, Kampala, Uganda. FAU - Kasule, Kenneth AU - Kasule K AD - Social & Scientific Systems, Inc., a DLH Holdings Company / USAID SITES, Plot 2730 Church Road, Kironde Zone, P.O.Box 12761, Kampala, Uganda. FAU - Katwesige, Justine Fay AU - Katwesige JF AD - Social & Scientific Systems, Inc., a DLH Holdings Company / USAID SITES, Plot 2730 Church Road, Kironde Zone, P.O.Box 12761, Kampala, Uganda. FAU - Kintu, Denis AU - Kintu D AD - Office of Health and HIV, USAID/Uganda, US Mission Compound - South Wing, Plot 1577 Ggaba Road, P. O. Box 7856, Nsambya, Kampala, Uganda. FAU - Ssempebwa, Rhobbinah AU - Ssempebwa R AD - Office of Health and HIV, USAID/Uganda, US Mission Compound - South Wing, Plot 1577 Ggaba Road, P. O. Box 7856, Nsambya, Kampala, Uganda. FAU - Sevume, Solome AU - Sevume S AD - Office of Health and HIV, USAID/Uganda, US Mission Compound - South Wing, Plot 1577 Ggaba Road, P. O. Box 7856, Nsambya, Kampala, Uganda. FAU - Komakech, Patrick AU - Komakech P AD - Office of Health and HIV, USAID/Uganda, US Mission Compound - South Wing, Plot 1577 Ggaba Road, P. O. Box 7856, Nsambya, Kampala, Uganda. FAU - Mubiru, Norbert AU - Mubiru N AD - Office of Health and HIV, USAID/Uganda, US Mission Compound - South Wing, Plot 1577 Ggaba Road, P. O. Box 7856, Nsambya, Kampala, Uganda. FAU - Maggwa, Baker AU - Maggwa B AD - Office of Family Planning and Reproductive Health, USAID, 05.4.1A, 500 D Street SW, 20547, Washington, DC, USA. FAU - Carrasco, Maria Augusta AU - Carrasco MA AD - Office of Family Planning and Reproductive Health, USAID, 05.4.1A, 500 D Street SW, 20547, Washington, DC, USA. FAU - Namuwenge, Norah AU - Namuwenge N AD - Social & Scientific Systems, Inc., a DLH Holdings Company / USAID SITES, Plot 2730 Church Road, Kironde Zone, P.O.Box 12761, Kampala, Uganda. FAU - Nsubuga, Rebecca N AU - Nsubuga RN AD - Social & Scientific Systems, Inc., a DLH Holdings Company / USAID SITES, Plot 2730 Church Road, Kironde Zone, P.O.Box 12761, Kampala, Uganda. FAU - Amuron, Barbara AU - Amuron B AD - Social & Scientific Systems, Inc., a DLH Holdings Company / USAID SITES, Plot 2730 Church Road, Kironde Zone, P.O.Box 12761, Kampala, Uganda. FAU - Bukenya, Daraus AU - Bukenya D AD - Social & Scientific Systems, Inc., a DLH Holdings Company / USAID SITES, Plot 2730 Church Road, Kironde Zone, P.O.Box 12761, Kampala, Uganda. FAU - Wandera, Bonnie AU - Wandera B AD - Social & Scientific Systems, Inc., a DLH Holdings Company / USAID SITES, Plot 2730 Church Road, Kironde Zone, P.O.Box 12761, Kampala, Uganda. LA - eng PT - Journal Article DEP - 20230823 PL - England TA - Contracept Reprod Med JT - Contraception and reproductive medicine JID - 101703414 PMC - PMC10463570 OTO - NOTNLM OT - Family planning OT - Postpartum OT - Uganda COIS- The authors declare no competing interests. EDAT- 2023/08/23 06:42 MHDA- 2023/08/23 06:43 PMCR- 2023/08/23 CRDT- 2023/08/23 00:22 PHST- 2023/05/03 00:00 [received] PHST- 2023/08/07 00:00 [accepted] PHST- 2023/08/23 06:43 [medline] PHST- 2023/08/23 06:42 [pubmed] PHST- 2023/08/23 00:22 [entrez] PHST- 2023/08/23 00:00 [pmc-release] AID - 10.1186/s40834-023-00243-x [pii] AID - 243 [pii] AID - 10.1186/s40834-023-00243-x [doi] PST - epublish SO - Contracept Reprod Med. 2023 Aug 23;8(1):44. doi: 10.1186/s40834-023-00243-x.