Availability of long-acting and permanent family-planning methods leads to increase in use in conflict-affected northern Uganda: Evidence from cross-sectional baseline and endline cluster surveys

Humanitarian assistance standards require specific attention to address the reproductive health (RH) needs of conflict-affected populations. Despite these internationally recognised standards, access to RH services is still often compromised in war. We assessed the effectiveness of our programme in...

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Bibliographic Details
Published in:Global public health 2013-03, Vol.8 (3), p.284-297
Main Authors: Casey, Sara E., McNab, Shanon E., Tanton, Clare, Odong, Jimmy, Testa, Adrienne C., Lee-Jones, Louise
Format: Article
Language:English
Subjects:
Adolescent
Adult
Altruism
Cluster Analysis
Confidence Intervals
Conflict
Cross-Sectional Studies
Family planning
Family Planning Services - methods
Female
Health policy
Health Services Accessibility
Health Services Needs and Demand
humanitarian aid
Humanitarianism
Humans
Middle Aged
Odds Ratio
Population
Public health
Reproductive Health
Sampling
Surveys
Surveys and Questionnaires
Uganda
War
Warfare
Women
Young Adult
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Summary:Humanitarian assistance standards require specific attention to address the reproductive health (RH) needs of conflict-affected populations. Despite these internationally recognised standards, access to RH services is still often compromised in war. We assessed the effectiveness of our programme in northern Uganda to provide family planning (FP) services through mobile outreach and public health centre strengthening. Baseline (n=905) and endline (n=873) cross-sectional surveys using a multistage cluster sampling design were conducted in the catchment areas of four public health centres in 2007 and 2010. Current use of any modern FP method increased from 7.1% to 22.6% (adjusted odds ratio [OR] 3.34 [95% confidence interval (CI) 2.27-4.92]); current use of long-acting and permanent methods increased from 1.2% to 9.8% (adjusted OR 9.45 [95%CI 3.99-22.39]). The proportion of women with unmet need for FP decreased from 52.1% to 35.7%. This study demonstrates that when comprehensive FP services are provided among conflict-affected populations, women will choose to use them. The combination of mobile teams and health systems strengthening can make a full range of methods quickly available while supporting the health system to continue to provide those services in challenging and resource-constrained settings.
ISSN:1744-1692
1744-1706
DOI:10.1080/17441692.2012.758302