Patterns Of Use Of Long Acting And Permanent Family Planning Methods In Sub-Saharan Africa And Strategies To Promote Peoples Choice And Use Of The Methods

Sub-Saharan Africa has the highest total fertility rate in the world. In 2009 the average number of births per woman was 5.1 and the contraceptive prevalence rate was 22 %. As a result of these patterns, the region is growing at a faster rate of 2.3 %.per annum.48.8 million Women want to space or limit the number of children but only 21 million are currently using a contraceptive method. Less than 50 % of the women in the region who are using contraception are using permanent family planning methods. LAPM are underutilised in Sub- Saharan Africa despite many attempts being made to increase the uptake of the methods. The aim of this study was to explore and understand the patterns of use of long acting and permanent family planning methods (LA/PMs) in SAA with a specific focus on Malawi with a view of enabling individuals / couples in Malawi to consider the use of LA/PMs when making decisions about contraception. Methods Literature review was conducted on factors that affect the use and implementation of LAPMs and strategies to promote their choice and use. Materials published in English between 1980 and 2012 were searched. Documents were searched from Cochrane library, Medline and Science Direct. Google scholar was used as a search instrument where necessary. To facilitate data search, key words which included the following: family planning, contraception, unmet need, reproductive health, spacing, limiting, long term and permanent were used. A total of 110 articles were initially identified, and twenty-one of these met the inclusion criteria. Results Lack of trained providers; weak procurement of LAPMs commodities and supplies; individuals' knowledge of and attitudes towards LAPMs; social and cultural attitudes and practices and inadequate male involvement were identified as the main determinants of the choice and uptakeof LAPMs. The following strategies were employed to address these barriers: training of providers; public /private partnerships, LAPMs promotion, outreach and extension services and Integration of LAPMs services in other RH services. Conclusion There is great potential for increased LAPMs uptake in SSA as long as governments commit resources towards the implementation of the programme.msc_srhunpub1448_ethesesunpu