Theoretical Foundation of Family Health Promotion——the Orientation of Family Planning Development in Urban Area

Objective To make a theoretical exploration of the function of family-based health promotion in family planning development. Methods Given the notion of reproductive health and the Junction of family in society, the author bring Jorward a new mode of family planning service, that was ＂healthy, happy household promotion ＂ based on the principle of health education and health promotion. Results The mode of ＂healthy,, happy household promotion ＂ reflected the new KP. service mode, and was the direction of family planning service. It might benefit both service provider and clients to make the family as the entrance point of quality care of reproductive health in communities, to develop health education and health promotion, and promote fiunily health and fanily happiness. Conclusion Family health and family happiness should be the final goal of family planning.

Healthcare Providers' Perceptions of the Sexual and Reproductive Health Needs (Including Family Planning) of Elderly Women from Selected Sites in Botswana

Much of the sexual and reproductive health services and service delivery including family planning target women of child bearing ages (15 - 49 years) and sometimes men. Hardly are there programmes/interventions that specifically target the needs of the elderly women (50 years and above), yet this group has serious sexual and reproductive health needs as many of them are still sexually active. This cross-sectional study obtained the views of a stratified random sample of 169 healthcare providers (doctors, nurses and pharmacists) from four selected sites, Gaborone, Selibe Phikwe, Barolong and Kweneng East health districts in Botswana on how the healthcare system in the selected sites is meeting the SRH/FP needs of the elderly women. The study found out that while overwhelming majority of the healthcare providers feltthat the healthcare system has no programme that specifically target the SRH/FP needs of this significant others and their SRH/FP needs are not being met ,less than 15% indicated that Pap smear screening as well as screening of cervical cancer were on-going. Although there are SRH/FP services available in the healthcare system, the elderly women are minimally accessing these services. Only condom, combined oral contraceptives, progestogen-only pills, treatment of STIs, screening for HIV/AIDS and screening for cervical cancer are accessed and information is also limited to these services. Reasons given by the healthcare providers for the non-accessibility of these services were cultural diversity (80%), people's sexual behavior and perceptions about sex (79%), lack of knowledge about the desired SRH/FP services (76%), religion (73%) and gender issues (62%). The study, advocates as part of policy options to mitigate the obstacles to accessing SRH/FP services, the expansion of counseling programmes, screening and treatment for breast cancer, public awareness campaigns, production and circulation of appropriate educational materials, effective training of healthcare providers and the establishment of separate clinic days for the elderly women' SRH/FP services.

Reproductive Health and Family Planning

I am honoured to have the opportunity to speak about an issue, which lies at the heart of the Cairo agenda, and that is reproductive health.

Induced abortion in China and the advances of post abortion family planning service

This is a review of current situation of induced abortion and post abortion family planning service in China. Induced abortion is an important issue in reproductive health. This article reviewed the distribution of induced abortion in various time, areas, and population in China, and explored the character, reason, and harm to reproductive health of induced abortion.Furthermore, this article introduces the concept of Quality of Care Program in Family Planning,and discusses how important and necessary it is to introduce Quality of Care Program in Family Planning to China.

Family Planning Awareness, Perceptions and Practice among Community Members in the Kintampo Districts of Ghana

Family planning is known to prevent maternal deaths, but some social norms, limited supplies and inconsistent use makes this difficult to achieve in most low- and middle-income countries. In spite of the high fertility levels in most sub-Saharan African countries and the potential economic benefits of family planning, its patronage remains very low in the sub-region. This study was with the objective of identifying the levels of awareness, utilization, access to and perceptions about family planning and contraception. A cross-sectional study design was used for the study, with data collected from multiple sources using both quantitative and qualitative approaches. Relevant findings included a marked disconnect between family planning/contraceptive knowledge and use. The pills and injectables were the most frequently used, but females in the study population poorly patronised emergency contraception. Supplies of most family planning methods were found to be health facility based, requiring clients to have to necessarily go there for services. Some respondents harboured perceptions that family planning was the responsibility of females alone and that it fuelled promiscuity among female users. Recommendations made include ensuring that health facilities had adequate staff and expertise to provide facility-based family planning services and also to disabuse the minds of community members of the negative perceptions towards family planning.

Community-based educational intervention on necklace method as a natural family planning amongst reproductive age group women in India

Objective:To assess the effectiveness of a community-based educational intervention on necklace method as a natural family planning amongst reproductive age group women.This approach helps women decide on their reproductive health choices and avoid ill health,impact and long-term consequences of unwanted pregnancy that lead to unsafe abortion.Methods:A total of 120 women were selected using non-probability purposive sampling technique.The knowledge and practice of participants were assessed using the structured knowledge questionnaire and practice checklist followed by a community-based educational intervention to participants,which covered aspects such as meaning,purposes and criteria;steps of the procedure;and advantages and disadvantages of the necklace method.The methods of teaching were lecture cum discussion and demonstration.The collected data were analysed using SPSS version 21.Results:The levels of knowledge (t-14.571,P=0.023) and practice (t =14.571,P=0.026) significantly improved after administering the community-based educational intervention.Knowledge and practice positively correlated with each other (P < 0.05).Conclusions:Nurses play a vital role in educating women and creating awareness regarding modern and safe family planning methods.These methods are effective and essential to avoid unwanted pregnancy and thus greatly impact the health of women.

China’s Experience of Quality Care in Family Planning

Objective To evaluate and overview the experience of quality care of family planning of China.Methods The framework of quality care of China was summarized and analyzed, that was clients, technology and management triangle program system.Results The 8fundamental elements of quality care in China were presented： 1） policy environment of QoC, 2） comprehensive services, 3） choice of method, 4） IEC to policy-makers and providers, 5） technical competence, 6） interpersonal communications, 7） institutional guideline and regulation, 8） appropriate constella- tion of service.Conclusion FP sectors should prepare different constellations of service to meet their individual reproductive health need for different clients and develop institutional guide- line and regulation for FP service to follow up in practice. QoC should be a kind of standardized service process.

Male Involvement in Family Planning: An Integrative Review

Purpose: The purpose of this review was to identify evidence about determinants of male engagement in family planning. Methods: An integrative review was used to assess the determinants of male engagement in family planning. Data search was between 2014 and 2019 using Google Scholar, Scopus, Web of Science, Science Direct, Pub Med, Medline, CINAHL, EBSCO, Cochrane, and EBSCO host. A total of 14 articles met the eligibility criteria. Results: The fourteen reviewed articles were adopted with mixed method designs, randomized controlled trial, quazi-experimental, and survey. Themes were: determinant of male engagement in family planning, women perception of male enrolment in family planning, and methods to enhance male use of family planning. Conclusion: Religion, large family size, culture, fear of side effect, access and exposure to information, attitudes, norms and self-efficacy and interaction with a health care provider are determinants of male involvement in family planning use. Interventional programs by health care providers and intensive education to men will positively increase prevalence of family planning use. It’s recommended to involve religious leaders in education. Implication: More attention is needed at community and governmental level to identify strategies to promote gender equity, shared decision making, shared responsibility and positive participation of men, empowering women, and to increase effectiveness of male participation.

Women’s Perceptions and Attitudes Related to Family Planning Use among Poor Population in Rural Rwanda

INTRODUCTION: In 2012, Rwandan Government has declared family planning (FP) a national priority for poverty reduction and socioeconomic development. However, rural areas still contribute to higher fertility rates. OBJECTIVE: To explore factors to influence FP uptake in rural families. METHODS: This study used mixed (quantitative and qualitative) methods consisted of two separate surveys. The first survey (quantitative-based cross-sectional design) determined FP use in households while the second survey (qualitative-based design) identified socio-cultural factors which hindered FP uptake in households. In total, 119 households with women in reproductive age (15 - 45) were targeted in rural areas in Western province, Karongi District. The data collected during door-to-door visits using paper-based-questionnaires and administered through interviews. A database mask was designed under OnaCollect, then processed in SPSS software. The results were presented in tables of frequencies, the difference between proportions assessed using Chi-Square-test, the difference between means assessed using t-tests, significance at p = or <0.05, confidence level at 0.95, and a margin error of 0.09. RESULTS: Socio-cultural norms influenced no use of contraception (32.8%) or only promoted natural methods (12.6%). Social norms were religious in origin (38.5%) where Christianity (91.8%) discouraged modern methods (viewed as killing children) but encouraged using natural methods, preferably abstinence (73.3%). Cultural norms (17.9%) influenced families to have many children as resources of wealth, evidence of productivity, and a way to decrease parents’ workloads including assisting mothers in home-based activities such as cooking, and assisting fathers in farming activities such as keeping cows, goats and pigs. Other attitudes included gender-based issues (2.5%) mainly due to spousal disapproval (men dominated in taking FP decisions in families), whereas other non-users of modern methods (28.2%) feared side-effects. This study was registered with IRB: CMHS/IRB/097/2019. CONCLUSION: Religious, social, and cultural norms affect FP in rural areas. In order to accelerate FP uptake, men and religious leaders should be targeted as key partners who influence women’s choices.

Family Planning: The Right Way to Avoid Perpetuating Poverty

Introduction: Family planning is a practice that serves in what way to avoid poverty and improve social indicators. Objective: To present scientific evidence on Family Planning in the most complete dimension possible. Methodology: The research was carried out in electronic databases MEDLINE, LILACS, INDEX PSICOLOGY, GOOGLE ACADEMIC, CVSP, LIS, limited to the last 23 years. Those addressed pre-defined aspects of interest to the study proposal were selected planning, family, social aspect, conception, contraception, disease, health and the new approaches to the problem. For the present study in the end 38 articles were selected and 13 more used for discussion. Results: Family planning is one of the best ways to grow a nation and avoid perpetuating poverty in the population, thus improving social indicators.

Mental disorders and sociodemographic variables in pop-ulation assisted by the Family Health Program in Brazil

Objectives: This paper aims to estimate the associations between common mental disorders (CMD) as well as cases of alcohol abuse/dependence (ADD) with sociodemographic variables in population assisted by Family Health Program (FHP) in Santa Cruz do Sul, Southern Brazil. Methods: All residents over 14 years of age from 3 areas assisted by the FHP were invited to participate between 10 February 2006 to 10 February 2007. Results: Of 2921 participants, the prevalence estimates of suspected cases of CMD and ADD were 29.93% and 12.07%, respectively. Female, unfavorable employment situation, low schooling and low income showed a positive and independent association with CMD. Male, unfavorable employment situation and CMD showed an independent association with ADD. Conclusions: Groups with unfavorable socioeconomic conditions present the highest risk and should be taken into account when planning public mental health policies.

What Does Research Say for Improving the Efficiency of Lady Healthcare Workers in Pakistan? Review Article

Background: In Pakistan, the crucial role of Lady Health Workers (LHWs) cannot be over looked and must be supported. Their alliance position between the community and health system allows them to provide services to the most marginalised groups. However, LHWs face numerous challenges and issues resulting in reduced efficiency and effectiveness of LHW program. Aims: The study aims to identify the challenges highlighted in various studies that undermine the performance of LHWs and attempts to combine the recommendations of the studies for addressing these challenges. Methods: Literature search included articles from 2000 to 2024. PubMed and Google Scholar were the main search engines utilized. Initial search resulted in 1380 articles, out of which only those showing a link to the study title were included in the study. From the total articles searched, 55 were selected for writing this article. Results: Literature highlighted the importance of community selection, monitoring, monetary as well as non-financial incentives;trainings;availability of supervision, workload balance, monitoring;recognition, clarity on roles, resources and uninterrupted supply of logistics, support and embedment of LHWs in community and health system. Lack or poor quality of these aspects may lead to low performance of LHWs. Conclusions: This paper explores the extent of issues and challenges faced by LHWs in Pakistan. A number of interventions appear to be effective in improving the efficiency of LHWs in Pakistan. The review may serve as an essential resource for program planners and decision-makers in improving the effectiveness and efficiency of LHW programs.

Situational Analysis of Access to Essential Healthcare Services in Nigeria: Implication for Trans-Sectorial Policy Considerations in Addressing Health Inequities

Background: Socioeconomic factors influence health outcomes and the distribution of health resources within and between countries globally. In Nigeria, there are various socio-economic factors that have been reported to be responsible for health inequities across the different geopolitical zones. Objective: To assess health inequities in relation to socio-economic factors that affect access to essential health care services in Nigeria, using family planning, maternal care, and childcare as indicators. Method: The study involved a cross-sectional secondary analysis of data from the 2018 Nigeria Demographic and Health Survey (NDHS) and a literature review of transdisciplinary approaches to addressing health inequities. Result: The overall result from the findings suggests a strong influence of geographical and socioeconomic factors in the distribution of healthcare services. Specifically, family planning services were more readily available and accessible in the Southern zones of Nigeria than in the Northern zone of Nigeria, which could be attributed to socio-cultural, religious, and access-related barriers. Results also showed that access to most maternal and child health care services was often skewed towards the southern zones, which could be due to the presence of more healthcare workers who provide these services coupled with higher access to maternal care, hence a higher uptake and utilization of maternal care services. Also, children in the northern zones had lesser odds of receiving basic and age-appropriate vaccination than those in other regions, which could be attributed to the supply-side disparities that exist between the northern and southern regions. Conclusion: This study concludes that level of educational attainment, wealth quintiles, as well as financial barriers, are the major socio-economic factors that influence access to maternal and childcare services.

Reproductive Health Needs of Women Living with HIV/AIDS in Yaounde, Cameroon

The population plagued with the HIV/AIDS pandemic in Cameroon is young, a generation that may desire or control fertility. For those who may become pregnant, the desire to have children may not be there. We carried out this study to look at the picture of the reproductive health needs of women living with HIV/AIDS in our setting. In this cross-sectional non-analytic design that lasted for three years, we employed both qualitative and quantitative methods to collect data from them after receiving ethical clearance (N221/CM/2009) from the National Ethics Committee. Consenting HIV infected women who were attending the “HIV Day Care” clinics and those who delivered and were in the post partum wards in four of our major hospitals in Yaounde were enrolled. Interviews were individualized. We used both CSPro version 4.1 and Statistical Package for Social Sciences (SPSS) version 19.0 softwares for data analysis. Four hundred and fifteen (415) women were enrolled;the mean age was 29 ± 7.8 years;the most represented age group was 24 -29 years. They were single (36.14%), well educated (5 out of 10 had attained university level of education), 61.20% revealed that their partners knew their HIV status, 82.4% believed that screening for cancer of the cervix was necessary for their status and 47.70% would want to be screened for some or all STIs. About 36.86% had the desire to have children, 57.1% of those who delivered did not plan to have the pregnancies out of which 82% would have wanted a modern method of contraception but did not have (82% unmet needs). Modern contraceptive use was associated with age and individual characteristics such as level of education. It was 64.34% among women who had secondary level of education and below as against 35.66% among those who had high school level of education and above. Contraceptive use was also high among women who were unmarried as against those who were married (89.64% vs 10.36%). The desire to have children decreased as age increased (43.85% vs 18.79%) and was lower among married women compared to those who were single (13.01% versus 49.64%). These women were found to have high unmet needs for modern contraception and showed interest in STIs and cervical cancer screening.

Impact of Social Determinants of Health on the Choice and Use of Long Acting Reversible Contraceptives

Modern women have increased options for birth control with the development of Long Acting Reversible Contraceptives (LARCs). These methods are reliable, easy to use, and require less daily maintenance while providing contraception for an extended period of time. However, despite the surge of LARCs as contraceptive options, the prevalence of unintended pregnancies is still alarmingly high in the United States. As LARCs are the most effective reversible method of birth control at preventing pregnancy, and therefore the potential social, financial, and medical complications associated, we examined whether social determinants of health play a role in LARC usage. While parity and marriage do not seem to affect LARC utilization, increased research is needed to determine the effects of race. Age can affect the type of LARC implemented, as younger women prefer implants to intrauterine devices (IUDs). Insurance coverage was an apparent influencer of LARC usage, as low out-of-pocket costs translate to increased utilization. This is linked to socioeconomic status (SES), as lower SES is associated with decreased access to healthcare in general. Increased research is needed in order to draw conclusions about the effects of education, intimate partner violence, geographic location, and other SDH on LARC usage.

Health problems and utilization of health services among Forcibly Displaced Myanmar Nationals in Bangladesh

Background:Access to and utilization of health services have remained major challenges for people living in low-and middle-income countries,especially for those living in impaired public health environment such as refugee camps and temporary settlements.This study presents health problems and utilization of health services among Forcibly Displaced Myanmar Nationals(FDMNs)living in the southern part of Bangladesh.Methods:A mixed-method(quantitative and qualitative)approach was used.Altogether 999 household surveys were conducted among the FDMNs living in makeshift/temporary settlements and host communities.We used a grounded theory approach involving in-depth interviews(IDIs),focus group discussions(FGDs),and key informant interviews(KIIs)including 24 IDIs,10 FGDs,and 9 KIIs.The quantitative data were analysed with STATA.Results:The common health problems among the women were pregnancy and childbirth-related complications and violence against women.Among the children,fever,diarrhoea,common cold and malaria were frequently observed health problems.Poor general health,HIV/AIDS,insecurity,discrimination,and lack of employment opportunity were common problems for men.Further,61.2%women received two or more antenatal care(ANC)visits during their last pregnancy,while 28.9%did not receive any ANC visit.The majority of the last births took place at home(85.2%)assisted by traditional birth attendants(78.9%),a third(29.3%)of whom suffered pregnancy-and childbirth-related complications.The clinics run by the non-governmental organizations(NGOs)(76.9%)and private health facilities(86.0%)were the most accessible places for seeking healthcare for the FDMNs living in the makeshift settlements.All participants heard about HIV/AIDS.78.0%of them were unaware about the means of HIV transmission,and family planning methods were poorly used(45.2%).Conclusions:Overall,the health of FDMNs living in the southern part of Bangladesh is poor and they have inadequate access to and utilization of health services to address the health problems and associated factors.Existing essential health and nutrition support programs need to be culturally appropriate and adopt an integrated approach to encourage men’s participation to improve utilization of health and family planning services,address issues of gender inequity,gender-based violence,and improve women empowerment and overall health outcomes.

医院主导下实施计划行为理论为基础的家庭健康管理改善TIA患者的自我效能研究

目的探讨计划行为理论为基础实施医院主导的家庭健康管理方案对短暂性脑缺血发作(TIA)患者自我效能的影响。方法选取2021年1月至2023年1月治疗的TIA患者102例,按照随机数表法分为观察组和对照组,每组51例。对照组给予常规护理健康管理干预,观察组在对照组基础上给予以计划行为理论为基础实施医院主导的家庭健康管理干预,对比2组患者干预前、干预1个月后自我效能、疾病知识问卷、健康行为态度、健康行为及日常生活能力(ADL)评分。结果干预1个月后2组患者自我效能评分均高于干预前,且观察组高于对照组(P<0.05);干预1个月后2组患者疾病知识问卷评分均高于干预前,且观察组高于对照组(P<0.05);干预1个月后2组患者健康行为态度评分均高于干预前,且观察组高于对照组(P<0.05);干预1个月后2组患者健康行为评分均高于干预前,且观察组高于对照组(P<0.05);干预1个月后2组患者ADL评分均高于干预前,且观察组高于对照组(P<0.05)。结论TIA患者中应用以计划行为理论为基础实施医院主导的家庭健康管理,可建立其疾病正确认知及积极行为态度,提高自我效能及日常生活能力,促进防治疾病健康管理行为的实施。