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Published in: BMC Public Health 1/2024

Open Access 01-12-2024 | Contraception | Research

Access to family planning services and associated factors among young people in Lira city northern Uganda

Authors: Eustes Kigongo, Raymond Tumwesigye, Maxson Kenneth Anyolitho, Marvin Musinguzi, Gad Kwizera, Everlyne Achan, Caroline Kambugu Nabasirye, Samson Udho, Amir Kabunga, Bernard Omech

Published in: BMC Public Health | Issue 1/2024

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Abstract

Background

Access to family planning services among young people is crucial for reproductive health. This study explores the access and associated factors among young people in Lira City, Northern Uganda.

Methods and materials

A mixed-methods study was conducted in March to April 2022. Quantitative data were collected using a structured questionnaire from 553 participants aged 15–24 years. Qualitative data were obtained through in-depth interviews and focus group discussions. Data analysis included univariate, bivariate, and multivariate analyses for quantitative data, while interpretative phenomenological analysis was used for qualitative data.

Results

Overall, 31.7% of the respondents had a good perceived access to family planning services, with 64.6% reporting perceived availability of FP methods. Challenges included lack of privacy (57.7%), fear of mistreatment (77.2%), and decision-making difficulties (66.2%). Among females, good perceived access to FP services was less likely among urban residents (AOR: 0.22, 95% CI: 0.09–0.53), Christian respondents (AOR: 0.51, 95% CI: 0.01–0.36), Muslim respondents (AOR: 0.07, 95% CI: 0.01–0.55) and respondents with poor attitude to FP services (AOR: 0.39, 95% CI: 0.24–0.64), but more likely among respondents with a sexual a partner (AOR: 4.48, 95% CI: 2.60–7.75). Among males, good perceived access to FP services was less likely among respondents living with parents (AOR: 0.19, 95% CI: 0.05–0.67) but more likely among respondents with good knowledge of FP services (AOR: 2.28, 95% CI: 1.02–5.32). Qualitative findings showed that three themes emerged; knowledge of family planning methods, beliefs about youth contraception and, friendliness of family planning services.

Conclusion

The study revealed a substantial gap in perceived access to family planning services among young people in Lira City. Barriers include privacy concerns, fear of mistreatment, and decision-making difficulties. Tailored interventions addressing urban access, religious beliefs for females, and knowledge enhancement for males are essential. Positive aspects like diverse FP methods and physical accessibility provide a foundation for targeted interventions. Youth-friendly services, comprehensive sexual education, and further research are emphasized for a nuanced understanding and effective interventions in Northern Uganda.
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Literature
3.
go back to reference Bongaarts J, Hardee K. The role of public-sector family planning programs in meeting the demand for contraception in Sub-saharan Africa. Int Perspect Sex Reprod Health. 2017;43(2):41–50.CrossRefPubMed Bongaarts J, Hardee K. The role of public-sector family planning programs in meeting the demand for contraception in Sub-saharan Africa. Int Perspect Sex Reprod Health. 2017;43(2):41–50.CrossRefPubMed
4.
go back to reference Organization WH. A vision for primary health care in the 21st century: towards universal health coverage and the Sustainable Development Goals. World Health Organization; 2018. Organization WH. A vision for primary health care in the 21st century: towards universal health coverage and the Sustainable Development Goals. World Health Organization; 2018.
6.
go back to reference Nabwowe Kasule A, Mncwabe N. Reclaiming public health services in Uganda. 2021. Nabwowe Kasule A, Mncwabe N. Reclaiming public health services in Uganda. 2021.
7.
go back to reference Boydell V, Neema S, Wright K, Hardee K. Closing the gap between people and programs: lessons from implementation of social accountability for family planning and reproductive health in Uganda. Afr J Reprod Health. 2018;22(1):73–84.PubMed Boydell V, Neema S, Wright K, Hardee K. Closing the gap between people and programs: lessons from implementation of social accountability for family planning and reproductive health in Uganda. Afr J Reprod Health. 2018;22(1):73–84.PubMed
12.
go back to reference Leerlooijer JN, Bos AE, Ruiter RA, van Reeuwijk MA, Rijsdijk LE, Nshakira N et al. Qualitative evaluation of the Teenage Mothers Project in Uganda: a community-based empowerment intervention for unmarried teenage mothers. BMC Public Health [Internet]. 2013 Sep 8 [cited 2023 Mar 27];13(1):816. https://doi.org/10.1186/1471-2458-13-816 Leerlooijer JN, Bos AE, Ruiter RA, van Reeuwijk MA, Rijsdijk LE, Nshakira N et al. Qualitative evaluation of the Teenage Mothers Project in Uganda: a community-based empowerment intervention for unmarried teenage mothers. BMC Public Health [Internet]. 2013 Sep 8 [cited 2023 Mar 27];13(1):816. https://​doi.​org/​10.​1186/​1471-2458-13-816
16.
18.
20.
go back to reference Napyo A, Nankabirwa V, Mukunya D, Tumuhamye J, Ndeezi G, Arach AAO, et al. Prevalence and predictors for unintended pregnancy among HIV-infected pregnant women in Lira, Northern Uganda: a cross-sectional study. Sci Rep. 2020;10(1):1–8.CrossRef Napyo A, Nankabirwa V, Mukunya D, Tumuhamye J, Ndeezi G, Arach AAO, et al. Prevalence and predictors for unintended pregnancy among HIV-infected pregnant women in Lira, Northern Uganda: a cross-sectional study. Sci Rep. 2020;10(1):1–8.CrossRef
21.
go back to reference Abdel-Tawab NG, Attia S, Bader N, Roushdy R, El-Nakib S, Oraby D. Fertility preferences and behaviors among younger cohorts in Egypt: Recent trends, correlates, and prospects for change. 2020. Abdel-Tawab NG, Attia S, Bader N, Roushdy R, El-Nakib S, Oraby D. Fertility preferences and behaviors among younger cohorts in Egypt: Recent trends, correlates, and prospects for change. 2020.
22.
go back to reference Draucker CB, Rawl SM, Vode E, Carter-Harris L. Integration through connecting in explanatory sequential mixed method studies. West J Nurs Res. 2020;42(12):1137–47.CrossRefPubMedPubMedCentral Draucker CB, Rawl SM, Vode E, Carter-Harris L. Integration through connecting in explanatory sequential mixed method studies. West J Nurs Res. 2020;42(12):1137–47.CrossRefPubMedPubMedCentral
23.
go back to reference Regnault A, Willgoss T, Barbic S, On behalf of the International Society for Quality of Life Research (ISOQOL) Mixed Methods Special Interest Group (SIG). Towards the use of mixed methods inquiry as best practice in health outcomes research. J Patient-Rep Outcomes [Internet]. 2018 Apr 11 [cited 2023 Mar 28];2(1):19. https://doi.org/10.1186/s41687-018-0043-8 Regnault A, Willgoss T, Barbic S, On behalf of the International Society for Quality of Life Research (ISOQOL) Mixed Methods Special Interest Group (SIG). Towards the use of mixed methods inquiry as best practice in health outcomes research. J Patient-Rep Outcomes [Internet]. 2018 Apr 11 [cited 2023 Mar 28];2(1):19. https://​doi.​org/​10.​1186/​s41687-018-0043-8
24.
go back to reference Simegn A, Azale T, Addis A, Dile M, Ayalew Y, Minuye B. Youth friendly sexual and reproductive health service utilization among high and preparatory school students in Debre Tabor town, Northwest Ethiopia: a cross sectional study. PLoS ONE. 2020;15(9):e0240033.CrossRefPubMedPubMedCentral Simegn A, Azale T, Addis A, Dile M, Ayalew Y, Minuye B. Youth friendly sexual and reproductive health service utilization among high and preparatory school students in Debre Tabor town, Northwest Ethiopia: a cross sectional study. PLoS ONE. 2020;15(9):e0240033.CrossRefPubMedPubMedCentral
25.
go back to reference Rade BK, Tamiru AT, Aynalem GL, Taye EB, Melkie M, Abera A, et al. Prevalence and factors associated with sexual and reproductive health services use among reproductive age women with disabilities: a community based cross-sectional study. BMC Womens Health. 2023;23(1):215.CrossRefPubMedPubMedCentral Rade BK, Tamiru AT, Aynalem GL, Taye EB, Melkie M, Abera A, et al. Prevalence and factors associated with sexual and reproductive health services use among reproductive age women with disabilities: a community based cross-sectional study. BMC Womens Health. 2023;23(1):215.CrossRefPubMedPubMedCentral
26.
go back to reference Smith JA, Fieldsend M. Interpretative phenomenological analysis. American Psychological Association; 2021. Smith JA, Fieldsend M. Interpretative phenomenological analysis. American Psychological Association; 2021.
27.
go back to reference Eatough V, Smith JA. Interpretative phenomenological analysis. Sage Handb Qual Res Psychol. 2017;193–209. Eatough V, Smith JA. Interpretative phenomenological analysis. Sage Handb Qual Res Psychol. 2017;193–209.
28.
go back to reference Campbell S, Greenwood M, Prior S, Shearer T, Walkem K, Young S, et al. Purposive sampling: complex or simple? Research case examples. J Res Nurs JRN. 2020;25(8):652–61.CrossRefPubMed Campbell S, Greenwood M, Prior S, Shearer T, Walkem K, Young S, et al. Purposive sampling: complex or simple? Research case examples. J Res Nurs JRN. 2020;25(8):652–61.CrossRefPubMed
30.
go back to reference Choi Y, Fabic MS, Adetunji J. Measuring Access to Family Planning: conceptual frameworks and DHS Data. Stud Fam Plann. 2016;47(2):145–61.CrossRefPubMed Choi Y, Fabic MS, Adetunji J. Measuring Access to Family Planning: conceptual frameworks and DHS Data. Stud Fam Plann. 2016;47(2):145–61.CrossRefPubMed
31.
go back to reference Penchansky R, Thomas JW. The concept of access: definition and relationship to consumer satisfaction. Med Care. 1981;19(2):127–40.CrossRefPubMed Penchansky R, Thomas JW. The concept of access: definition and relationship to consumer satisfaction. Med Care. 1981;19(2):127–40.CrossRefPubMed
32.
go back to reference Levesque JF, Harris MF, Russell G. Patient-centred access to health care: conceptualising access at the interface of health systems and populations. Int J Equity Health. 2013;12(1):18.CrossRefPubMedPubMedCentral Levesque JF, Harris MF, Russell G. Patient-centred access to health care: conceptualising access at the interface of health systems and populations. Int J Equity Health. 2013;12(1):18.CrossRefPubMedPubMedCentral
33.
go back to reference Bekele D, Surur F, Nigatu B, Teklu A, Getinet T, Kassa M, et al. Knowledge and attitude towards Family Planning among women of Reproductive Age in emerging regions of Ethiopia. J Multidiscip Healthc. 2020;13:1463–74.CrossRefPubMedPubMedCentral Bekele D, Surur F, Nigatu B, Teklu A, Getinet T, Kassa M, et al. Knowledge and attitude towards Family Planning among women of Reproductive Age in emerging regions of Ethiopia. J Multidiscip Healthc. 2020;13:1463–74.CrossRefPubMedPubMedCentral
34.
go back to reference Taber KS. The Use of Cronbach’s alpha when developing and Reporting Research Instruments in Science Education. Res Sci Educ. 2018;48(6):1273–96.CrossRef Taber KS. The Use of Cronbach’s alpha when developing and Reporting Research Instruments in Science Education. Res Sci Educ. 2018;48(6):1273–96.CrossRef
35.
go back to reference Collett D. Modelling Binary Data. 2nd ed. New York: Chapman and Hall/CRC; 2014. p. 408. Collett D. Modelling Binary Data. 2nd ed. New York: Chapman and Hall/CRC; 2014. p. 408.
36.
go back to reference Brown HM, Stahmer AC, Dwyer P, Rivera S. Changing the story: How diagnosticians can support a neurodiversity perspective from the start. Vol. 25, Autism. SAGE Publications Sage UK: London, England; 2021. pp. 1171–4. Brown HM, Stahmer AC, Dwyer P, Rivera S. Changing the story: How diagnosticians can support a neurodiversity perspective from the start. Vol. 25, Autism. SAGE Publications Sage UK: London, England; 2021. pp. 1171–4.
37.
go back to reference Flick U. Triangulation in data collection. SAGE Handb Qual Data Collect. 2018;527–44. Flick U. Triangulation in data collection. SAGE Handb Qual Data Collect. 2018;527–44.
38.
go back to reference Kriel Y, Milford C, Cordero JP, Suleman F, Steyn PS, Smit JA. Access to public sector family planning services and modern contraceptive methods in South Africa: a qualitative evaluation from community and health care provider perspectives. PLoS ONE. 2023;18(3):e0282996.CrossRefPubMedPubMedCentral Kriel Y, Milford C, Cordero JP, Suleman F, Steyn PS, Smit JA. Access to public sector family planning services and modern contraceptive methods in South Africa: a qualitative evaluation from community and health care provider perspectives. PLoS ONE. 2023;18(3):e0282996.CrossRefPubMedPubMedCentral
39.
go back to reference Murungi T, Benyumiza D, Apio J, Nekesa C, Nalubuuka A, Misuk I, et al. Factors Associated with Utilization of Sexual and Reproductive Health Services among the Youth in Lira City West, Northern Uganda: a cross-sectional study. BioMed Res Int. 2023;2023:e9649792.CrossRef Murungi T, Benyumiza D, Apio J, Nekesa C, Nalubuuka A, Misuk I, et al. Factors Associated with Utilization of Sexual and Reproductive Health Services among the Youth in Lira City West, Northern Uganda: a cross-sectional study. BioMed Res Int. 2023;2023:e9649792.CrossRef
40.
go back to reference Brittain AW, Williams JR, Zapata LB, Pazol K, Romero LM, Weik TS. Youth-Friendly Family Planning services for Young people. Am J Prev Med. 2015;49(2 Suppl 1):S73–84.CrossRefPubMedPubMedCentral Brittain AW, Williams JR, Zapata LB, Pazol K, Romero LM, Weik TS. Youth-Friendly Family Planning services for Young people. Am J Prev Med. 2015;49(2 Suppl 1):S73–84.CrossRefPubMedPubMedCentral
41.
go back to reference Abera L, Ejigu E, Hailu M, Tadesse D, Omer A. Quality of family planning services and associated factors among reproductive age women attending family planning unit at public health facilities in dire Dawa, Eastern Ethiopia, 2021. Contracept Reprod Med. 2023;8(1):33.CrossRefPubMedPubMedCentral Abera L, Ejigu E, Hailu M, Tadesse D, Omer A. Quality of family planning services and associated factors among reproductive age women attending family planning unit at public health facilities in dire Dawa, Eastern Ethiopia, 2021. Contracept Reprod Med. 2023;8(1):33.CrossRefPubMedPubMedCentral
42.
go back to reference Osamor PE, Grady C. Women’s autonomy in health care decision-making in developing countries: a synthesis of the literature. Int J Womens Health. 2016;8:191–202.CrossRefPubMedPubMedCentral Osamor PE, Grady C. Women’s autonomy in health care decision-making in developing countries: a synthesis of the literature. Int J Womens Health. 2016;8:191–202.CrossRefPubMedPubMedCentral
43.
go back to reference Namasivayam A, Schluter PJ, Namutamba S, Lovell S. Understanding the contextual and cultural influences on women’s modern contraceptive use in East Uganda: a qualitative study. PLOS Glob Public Health. 2022;2(8):e0000545.CrossRefPubMedPubMedCentral Namasivayam A, Schluter PJ, Namutamba S, Lovell S. Understanding the contextual and cultural influences on women’s modern contraceptive use in East Uganda: a qualitative study. PLOS Glob Public Health. 2022;2(8):e0000545.CrossRefPubMedPubMedCentral
44.
go back to reference Asingwire N, Muhangi D, Kyomuhendo S, Leight J. Impact evaluation of youth-friendly family planning services in Uganda. 2019. Asingwire N, Muhangi D, Kyomuhendo S, Leight J. Impact evaluation of youth-friendly family planning services in Uganda. 2019.
45.
go back to reference Schenker JG, Rabenou V. Family planning: cultural and religious perspectives. Hum Reprod. 1993;8(6):969–76.CrossRefPubMed Schenker JG, Rabenou V. Family planning: cultural and religious perspectives. Hum Reprod. 1993;8(6):969–76.CrossRefPubMed
Metadata
Title
Access to family planning services and associated factors among young people in Lira city northern Uganda
Authors
Eustes Kigongo
Raymond Tumwesigye
Maxson Kenneth Anyolitho
Marvin Musinguzi
Gad Kwizera
Everlyne Achan
Caroline Kambugu Nabasirye
Samson Udho
Amir Kabunga
Bernard Omech
Publication date
01-12-2024
Publisher
BioMed Central
Keyword
Contraception
Published in
BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-024-18605-8

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