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  • Title: Missed opportunities: postpartum family planning in Kenya.
    Author: Bradley J.
    Journal: AVSC News; 1993 Oct; 31(3):7. PubMed ID: 12287110.
    Abstract:
    Interviews conducted in 1992 by the Association for Voluntary Surgical Contraception with 1000 Kenyan women revealed a strong unmet need for postpartum family planning services. 800 of the women were interviewed at prenatal and child welfare clinics; the remaining 200 subjects had just given birth in hospital maternity wards. 90% expressed a desire to use contraception in the postpartum period, despite the fact that the majority had never used a family planning method. 94% of the postpartum patients indicated a definite interest in receiving information on family planning, preferably before hospital discharge. However, only 20% were exposed to a family planning talk during their hospital stay and just 2% were discharged with a method. Study subjects expressed a reluctance to initiate discussions about family planning with a nurse or other health care worker, generally because of embarrassment or a lack of privacy, and instead waited for hospital staff to raise the topic. Maternity ward nurses indicated an awareness of the large demand for family planning information and methods, but expressed a lack of confidence in their own knowledge base. Clinic nurse identified lack of time and privacy as the major barriers to such counseling. The following recommendations were suggested by investigators to remedy this situation: 1) availability of family planning services throughout hospitals, not just in maternal-child health and family planning clinics; 2) training of maternity ward staff in family planning by hospital family planning staff; 3) greater initiative in raising the issue of family planning on the part of staff in hospitals and clinics; 4) availability of private space for family planning discussions; and 5) access to family planning literature for all women who attend clinics, regardless of the reason for the visit.
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