Impact of maternal and child health services on early post-partum modern contraceptive uptake in Pakistan: A quantitative analysis
The initiation of post-partum contraception is crucial for the health of mothers and their children. The early acceptance and uptake of modern contraceptive methods among women can be significantly boosted by the provision of maternal and child healthcare (MCH) services. This study examined whether the utilization of MCH services increases women’s early adoption of modern contraceptive methods. The data were taken from the Pakistan Demographic and Health Survey (2017 – 2018) for currently married women aged 15 – 49 years, and a multinomial logistic regression model was used to analyze the data. The results reveal that the richest women were twice as likely (relative risk ratio [RRR] = 2.14, p < 0.001) to use modern contraceptive methods and 4 times more likely (RRR = 4.16, p < 0.001) to use traditional contraceptive methods than the poorest women. Similarly, women with media exposure were more likely (RRR = 1.43, p < 0.001) to use modern contraceptive methods in comparison with their counterparts. Notably, women aged 30 – 34 years (RRR = 2.08, p < 0.001) were more likely to use modern contraceptives. Expanding MCH services, focused on addressing wealth disparities, media exposure, and education levels, is crucial. In addition, regional and age-specific barriers to contraceptive use should be tackled, particularly in underserved areas such as Balochistan and among younger reproductive age groups.
Ahmed, S., Choi, Y., Rimon, J.G., Alzouma, S., Gichangi, P., Guiella, G., et al. (2019). Trends in contraceptive prevalence rates in sub-Saharan Africa since the 2012. London summit on family planning: Results from repeated cross-sectional surveys. The Lancet Global Health, 7(7):904-911. https://doi.org/10.1016/S2214-109X(19)30200-1
Alhassan, R.K., Owusu-Agyei, S., Ansah, E.K., Gyapong, M., Ashinyo, A., Ashinyo, M.E., et al. (2020). Trends and correlates of maternal, newborn and child health services utilization in primary healthcare facilities: An explorative ecological study using DHIMSII data from one district in the Volta region of Ghana. BMC Pregnancy and Childbirth, 20:543. https://doi.org/10.1186/s12884-020-03195-1
Bansal, A., Shirisha, P., Mahapatra, B., & Dwivedi, L.K. (2022). Role of maternal and child health services on the uptake of contraceptive use in India: A reproductive calendar approach. PloS One, 17(6):e0269170. https://doi.org/10.1371/journal.pone.0269170
Bellizzi, S., Mannava, P., Nagai, M., & Sobel, H.L. (2020). Reasons for discontinuation of contraception among women with a current unintended pregnancy in 36 low and middle-income countries. Contraception, 101(1):26-33. https://doi.org/10.1016/j.contraception.2019.09.006
Chishtie, J., Chishtie, F., & Jaglal, S. (2021). Exploring knowledge translation practices in a global health program: case study on the establishment of the Pakistan National Maternal, Neonatal, and Child Health Program. Journal of Public Health, 29:215-228. https://doi.org/10.1007/s10389-019-01115-y
Das, J.K., Padhani, Z.A., Jabeen, S., Rizvi, A., Ansari, U., Fatima, M., et al. (2020). Impact of conflict on maternal and child health service delivery-how and how not: A country case study of conflict affected areas of Pakistan. Conflict and Health, 14:1-16. https://doi.org/10.1186/s13031-020-00271-3
Dixit, P., Dwivedi, L.K., & Gupta, A. (2017). Role of maternal and child health care services on postpartum contraceptive adoption in India. SAGE Open, 7(3):21582440177. https://doi.org/10.1177/2158244017733515
Dutamo, Z., Assefa, N., & Egata, G. (2015). Maternal health care use among married women in Hossaina, Ethiopia. BMC Health Services Research, 15:365. https://doi.org/10.1186/s12913-015-1047-1
Iqbal, S., Maqsood, S., Zakar, R., Zakar, M.Z., & Fischer, F. (2017). Continuum of care in maternal, newborn and child health in Pakistan: Analysis of trends and determinants from 2006 to 2012. BMC Health Services Research, 17:189. https://doi.org/10.1186/s12913-017-2111-9
Jejeebhoy, S.J., Santhya, K.G., & Zavier, A.J.F. (2019). Demand for contraception to delay first pregnancy among young married women in India. Studies in Family Planning, 45(2):183-201. https://doi.org/10.1111/j.1728-4465.2014.00384.x
Kumar, P., Sharma, H., & Mawkhlieng, D.R. (2020). Do family planning advice and maternal health care utilization change course in contraception usage? A study based on Bihar, India. Clinical Epidemiology and Global Health, 8(3):693-697. https://doi.org/10.1016/j.cegh.2020.01.004
Kumar, G., & Reshmi, R.S. (2022). Availability of public health facilities and utilization of maternal and child health services in districts of India. Clinical Epidemiology and Global Health, 15:101070. https://doi.org/10.1016/j.cegh.2022.101070
Stenberg, K., Watts, R., Bertram, M.Y., Engesveen, K., Maliqi, B., Say, L., et al. (2021). Cost-effectiveness of interventions to improve maternal, newborn and child health outcomes: A WHO-CHOICE analysis for Eastern sub-Saharan Africa and South-East Asia. International Journal of Health Policy and Management, 10(11):706. https://doi.org/10.34172/ijhpm.2021.07
Seiber, E.E., Hotchkiss, D.R., Rous, J.J., & Berruti, A.A. (2005). Maternal and child health and family planning service utilization in Guatemala: Implications for service integration. Social Science and Medicine, 61(2):279-291. https://doi.org/10.1016/j.socscimed.2004.11.068
Sharrow, D., Hug, L., You, D., Alkema, L., Black, R., Cousens, S., et al. (2022). Global, regional, and national trends in under-5 mortality between 1990 and 2019 with scenario-based projections until 2030: A systematic analysis by the UN Inter-agency Group for Child Mortality Estimation. Lancet Glob Health, 10(2), e195-e206. https://doi.org/10.1016/S2214-109X(21)00515-5
Stover J, Ross J (2010). How increased contraceptive use has reduced maternal mortality. Matern Child Health J, 14(5):687-695. https://doi.org/10.1007/s10995-009-0505-y
Owusu, S.A., Owusu, R.A., & Hampshire, K. (2021). Maternal and non-maternal caregivers’ practices in drug administration to children during illness. Child Care in Practice, 27(3):295-309. https://doi.org/10.1080/13575279.2019.1664986
Woldemicael, G., & Tenkorang, E.Y. (2010). Women’s autonomy and maternal health-seeking behavior in Ethiopia. Maternal and Child Health Journal, 14(6):988-998. https://doi.org/10.1007/s10995-009-0535-5