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      Attitudes and Practices of Healthcare Professionals and Clinical Medical Students on Contraception: A Cross-Sectional Study in Cape Coast, Ghana

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          Abstract

          Background

          Healthcare providers play a major role in the implementation of family planning policies. In Ghana, there has been a conscious effort to improve the knowledge of preservice and practicing health professionals on family planning. However, there have been concerns about the appropriateness of the attitudes and practices of these health cadres and, hence, their propensity to become barriers to the uptake of contraception in the general population. This study is aimed at assessing the attitudes and practices of healthcare workers and clinical-year medical students in contraceptives use, advocacy, and service provision.

          Methods

          A cross-sectional survey was conducted among health workers and clinical-year medical students from January 1 to June 30, 2018. Variables assessed included sexual activity status, previous and current contraceptive use, and satisfaction with contraceptive use among others. Data from 400 self-administered, structured questionnaires comprising close- and open-ended questions was entered in SPSS version 22 and analysed using same. The variables assessed were presented as means, frequencies, and percentages.

          Results

          About 58% of the respondents were sexually active. Half of the participants (50.2%) had used a form of contraception before, with condoms and other barrier methods being the most preferred (67.7%). However, only 18% of respondents were on a form of contraceptive at the time of the survey. Four out of five (82.6%) of the users of these contraceptives were satisfied with their past use. A little over half of the participants had discussed contraception with their partners. Over four-fifths of participants thought family planning was beneficial and were willing to encourage others to use a method of family planning. Majority (63.7%) of the participants had had formal training in family planning, but only 72 (18%) were actively involved in the provision of family planning services.

          Conclusions

          Although the attitudes of the health workers and trainees toward family planning were excellent generally, only a few were using a method of contraception at the time of the survey despite the fact that most of them were sexually active. There is a need to intensify communication on behaviour change towards contraception among health professionals and clinical-year medical students in order to strengthen their role as change agents in an effort to improve community uptake.

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          Most cited references25

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          Cluster sampling to assess immunization coverage: a review of experience with a simplified sampling method.

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            Estimating progress towards meeting women’s contraceptive needs in 185 countries: A Bayesian hierarchical modelling study

            Background Expanding access to contraception and ensuring that need for family planning is satisfied are essential for achieving universal access to reproductive healthcare services, as called for in the 2030 Agenda for Sustainable Development. Monitoring progress towards these outcomes is well established for women of reproductive age (15–49 years) who are married or in a union (MWRA). For those who are not, limited data and variability in data sources and indicator definitions make monitoring challenging. To our knowledge, this study is the first to provide data and harmonised estimates that enable monitoring for all women of reproductive age (15–49 years) (WRA), including unmarried women (UWRA). We seek to quantify the gaps that remain in meeting family-planning needs among all WRA. Methods and findings In a systematic analysis, we compiled a comprehensive dataset of family-planning indicators among WRA from 1,247 nationally representative surveys. We used a Bayesian hierarchical model with country-specific time trends to estimate these indicators, with 95% uncertainty intervals (UIs), for 185 countries. We produced estimates from 1990 to 2019 and projections from 2019 to 2030 of contraceptive prevalence and unmet need for family planning among MWRA, UWRA, and all WRA, taking into account the changing proportions that were married or in a union. The model accounted for differences in the prevalence of sexual activity among UWRA across countries. Among 1.9 billion WRA in 2019, 1.11 billion (95% UI 1.07–1.16) have need for family planning; of those, 842 million (95% UI 800–893) use modern contraception, and 270 million (95% UI 246–301) have unmet need for modern methods. Globally, UWRA represented 15.7% (95% UI 13.4%–19.4%) of all modern contraceptive users and 16.0% (95% UI 12.9%–22.1%) of women with unmet need for modern methods in 2019. The proportion of the need for family planning satisfied by modern methods, Sustainable Development Goals (SDG) indicator 3.7.1, was 75.7% (95% UI 73.2%–78.0%) globally, yet less than half of the need for family planning was met in Middle and Western Africa. Projections to 2030 indicate an increase in the number of women with need for family planning to 1.19 billion (95% UI 1.13–1.26) and in the number of women using modern contraception to 918 million (95% UI 840–1,001). The main limitations of the study are as follows: (i) the uncertainty surrounding estimates for countries with little or no data is large; and (ii) although some adjustments were made, underreporting of contraceptive use and needs is likely, especially among UWRA. Conclusions In this study, we observed that large gaps remain in meeting family-planning needs. The projected increase in the number of women with need for family planning will create challenges to expand family-planning services fast enough to fulfil the growing need. Monitoring of family-planning indicators for all women, not just MWRA, is essential for accurately monitoring progress towards universal access to sexual and reproductive healthcare services—including family planning—by 2030 in the SDG era with its emphasis on ‘leaving no one behind.’
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              Provider Bias in Family Planning Services: A Review of Its Meaning and Manifestations

              Provider bias, including bias regarding client age, parity, and marital status, persists as an important barrier to contraceptive choice and access. Newer approaches to mitigate bias that have moved beyond training and guideline development to more fundamental behavior change show promise.
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                Author and article information

                Contributors
                Journal
                Int J Reprod Med
                Int J Reprod Med
                IJRMED
                International Journal of Reproductive Medicine
                Hindawi
                2356-7104
                2314-5757
                2021
                22 March 2021
                : 2021
                : 6631790
                Affiliations
                1Department of Obstetrics and Gynaecology, University of Cape Coast, Cape Coast, Ghana
                2Ghana Health Service, Asante Mampong Municipal Hospital, Asante Mampong, Ashanti Region, Ghana
                3Department of Obstetrics and Gynaecology, Cape Coast Teaching Hospital, Cape Coast, Ghana
                4Department of Medical Education and IT, University of Cape Coast, Ghana
                5Princess Marie Louise Children's Hospital, Accra, Ghana
                6School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
                Author notes

                Academic Editor: Vikas Roy

                Author information
                https://orcid.org/0000-0003-1725-2944
                https://orcid.org/0000-0002-5366-3997
                https://orcid.org/0000-0003-3020-2159
                https://orcid.org/0000-0001-7861-7535
                https://orcid.org/0000-0002-0800-7448
                https://orcid.org/0000-0003-2321-387X
                https://orcid.org/0000-0003-2770-8968
                https://orcid.org/0000-0001-8293-6862
                https://orcid.org/0000-0003-1403-8141
                https://orcid.org/0000-0001-7090-8370
                Article
                10.1155/2021/6631790
                8012129
                7a34cebe-a7cf-4e1b-83c7-e8a7545e77b7
                Copyright © 2021 Evans Kofi Agbeno et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 28 October 2020
                : 8 March 2021
                : 15 March 2021
                Categories
                Research Article

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