Use of family planning methods by women of childbearing age in Kibondo district, Kigoma, Tanzania.

Morbidity and mortality associated with high parity, adolescent pregnancies, and poor spacing of children are among the most important public health problems in the developing or underdeveloped world. Sub-Saharan Africa is among such affected countries which Tanzania is part of. Use of family planning methods has a positive influence on women, family life, the community and nation at large. A cross sectional study was done between 9th and 24th June 2006 to determine the use of family planning methods by women of childbearing age in Kibondo district, Kigoma region Tanzania. Two hundred and seventy-one randomly selected women from eight villages participated. Criteria for selection of participants were women of childbearing age irrespective of their parity. Both structured and semi-structured questions were used in a questionnaire. Observation of availability of IEC materials at the health facility and village level was done. A checklist was used to assess the availability of family planning methods at the health facilities serving the study population. The results revealed that the extent of use of methods of family planning was slightly high whereby 42.1% of the respondents were using methods of family planning. It was found that 88.2% of the respondents knew about methods of family planning. The majority of women were married 132 (48.7%) and about three quarters 201 (74.2%), had completed primary school. Although 186 (08.6%) women have ever used some form of family planning, less than half, 114 (42.1%) reported current use of family planning. Current use of family planning methods was, however, found to be independent of the woman’s age, marital status, and gravidity, level of education, religious denomination or primary source of income. While more women, 32 (53.3%), reporting current use of family planning were aged 30- 34 years, the least age group to report current use of family planning was 15 to 10 years, 5 (29.4%). With regard to current use of family planning methods by religious affiliation of the respondents, Catholic women reported highest proportion 55 (46.6%) followed by those who belong to “other” religions 11 (45.8%) and protestants 48 (37.2%). Respondents who had above primary education had the highest proportion of users 7 (50%) followed by those who had completed primary school 87(43.3%). Those with no formal education had 9 (36%) while those with primary incomplete had 11 (35.5%). Respondents with salaried occupation had the highest proportion of users 12 (54.5%) while the non-salaried who account for 91.9% of all the respondents had 102 (94.1%). Prime-gravida respondents were least likely, 3 (21.4%), to use family planning methods and among women with pregnancies ranging between one and three, 56 (47.5%) reported using family planning methods. Family planning method used by most respondents is the injection depot-medroxy progesterone acetate (DMPA) popularly known as Depo-Provera that was reported by 67 (23.6%) of the current users. Pills ranked second with 24 (8.9%). Other methods in use are female sterilization (BTL) 4 (1.5%), IUCD 2 (0.7%) and the natural methods including abstinence 12 (4.4%). There was little or no male participation as indicated that less than 2% reported using condom and no vasectomy as measures used for fertility regulation. Reasons cited for using family planning methods by current users included spacing children 99 (86.6%), protecting woman’s health and inter-pregnancy# recovery 18 (15.8%), to have more time to breastfeed 2 (1.8%), and being the best those intending to stop child delivering, 10 (8.8%). I Reasons for non users for not using family planning included being scared of side effects, 72 (45.9%), desire for more children, 24 (15.3%). Other reasons against using family planning methods include refusal by the spouse, 18 (14.5%). Side effects were reported by 52 (45.6%) of the respondents. Side effects with large proportion included frequent and excessive bleeding 33 (63.5%). Respondents who reported knowing family planning methods were 239 (88.2%). Method most frequently mentioned by respondents was injection, 220 (81.4%), followed by the pills 218 (80.4%), IUCD 111 (41.0%), implant 80 (29.5%), condom 62 (22.9%), female sterilization 40 (14.8%), male sterilization 23 (8.5%) and natural methods 44 (16.2%). Although on average, older women know more about family planning methods than young ones, knowledge about family planning was found to be independent of age of the women. Health workers were reported by most respondents as being the source of information about family planning methods 196 (72.3%). Accessibility and satisfaction, 170 (62.7%) of all women reported getting free services from council’s health clinics. Only 2 women said they either get family planning supplies from council’s health clinics and sometimes they buy these supplies. More than half, 161 (59.4%), of all women interviewed reported satisfaction with family planning services provided by health facility workers and 19 (7%) reported no satisfaction with services. As expected women who reported to know any family planning methods were more likely to use family planning. There is need for the Council through the CHMT to ensure that IEC materials are made available in order to disseminate knowledge on family planning methods. Health personnel need to be regularly updated on current family planning methods in order to raise the acceptance and uptake by eligible clients. Male involvement in family planning is particularly advocated.