Factors leading to the drop out of women from the family planning program in Zanzibar

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University of Dar es Salaam
The study presented here is concerned with the various factors which lead to the termination of contraceptive use and finally to stop taking services from the Family Planning Program among women acceptors in Zanzibar. The research was done both in rural and urban areas of Unguja and Pemba. Samples of enumeration areas were taken from each district. Zanzibar and Chake Chake were taken as urban areas. The study on factors that lead to drop out of women from the Family Planning Program in Zanzibar is the first systematic study on the Program since its inception in 1985. Much effort has been made by the Program management to increase modern contraception prevalence. Discouraging enough, the dropout rate has been increasing year after year. This prompted the researcher to investigate the causal factors for this so that the program management could know where the weakness was and eradicate it. This work has been presented in five chapters. The first chapter has dwelt much on the background information of the problem. The problem of low acceptance and low prevalence of modern contraception is highlighted for Tanzania and Zanzibar in particular. As of December 1991 acceptance level in Zanzibar was 13.3% while the prevalence level was 7.3% and a dropout rate of 46%. The reasons for this high dropout rate were unknown. The researcher had assumed that poor quality of family planning services, experience of side effects and contraceptive failure. Husband’s disapproval of modern contraception, age of the contraceptor and the need to have more children affect continuous use of modern contraceptives. The second chapter has cited literature related to the study. Unfortunately, not many systematic studies have been done on drop out in Africa. In Tanzania, Omari (1990) and Heguye (1990) did researches at the Karimjee clinic and Kilimanjaro, and at the BIT clinic in Dar es Salaam respectively. The results of the Karimjee/ Kilimanjaro study did not come out with concrete reasons for drop out since clinic records did not reveal this while tracing bf dropouts proved to be abortive in most cases. The study of the BIT clinic showed that poorly trained personnel were a contributing factor to the drop out. Chapter three has briefly delineated the background to the study area and the research methodology employed. Both random household interview and tracing of ever users were done. MCH/FP Aides were also interviewed in order to assess the quality of services and their recommendations. Findings presented in chapter four have shown that the permanent dropout rate is 18.4% and the temporary discontinuation rate is 17.9%. The experiences of side effects and contraception failures have been found to contribute much to the dropout rate. Husband's disapproval of modern contraceptives also is a factor leading to the drop out of women from the program. However the quality of services has been found to contribute less to drop out. The lack of positive community attitude towards family planning was revealed by family planning providers and in depth focus groups to be a hindrance for both acceptance and continued use of contraceptives. In order to raise contraception use, the masses and especially men should be thoroughly educated on the advantages and disadvantages of family planning. More campaign on family planning should be directed to rural areas. Also, women status should be raised. Updating current providers and training new ones will allow counseling of clients and conduction of follow up for those who stop use. Small clinics should be expanded so as to allow privacy in the provision of family planning services.
Available in print form, EAF collection, Dr. Wilbert Chagula Library (THS EAF HQ 763.6T3R8)
Birth control, Tanzania, Zanzibar
Rugano, Gwalema S. N (1993) Factors leading to the drop out of women from the family planning program in Zanzibar ,Masters dissertation, University of Dar es Salaam, Dar es Salaam.