Strengthening Family Planning with Community-based Nutrition Interventions in Ethiopia : A Qualitative Study

A small-scale, exploratory, and qualitative operational research study was conducted in early 2011 to capture and examine stakeholder perspectives on integrated family planning (FP) programs implemented through Ethiopia's health extension program (HEP). Qualitative indications are that various stakeholders on both the supply and the demand side perceive that specific community-based nutrition (CBN) activities also delivered within HEP serve to link nutrition, family planning, and other health issues in socially acceptable and qualitatively effective ways. Remarkable concordance of qualitative indicators of service delivery, uptake, and satisfaction was noted on both the supply and demand side of service delivery at the sites studied. Respondent reports suggested the following: (i) active and successful delivery of both CBN and FP activities; (ii) some challenges with record keeping, supervision, and supplies; (iii) strong uptake of services and messages; (iv) a highly positive community-level perception of service quality, even in a partially capacitated kebele (neighborhood); and (v) an engaged response by participants. Qualitative indicators of community-level HEP staff, volunteer performance, and community satisfaction were generally positive. However, gaps and challenges to improving integration and delivery of FP and CBN within HEPs and in achieving sustainability in scale-up of integrated programs include (i) increasing capacity to support implant removal, (ii) maintaining human resources for health within the health extension program, and (iii) addressing the needs of youth in general and out-of-school youth in particular. Recommendations for improved delivery of integrated FP and CBN programs are to explore ways to (i) step up planning and resourcing for contraceptive implant removal, (ii) reduce staff turnover at the health posts and health centers, (iii) strengthen integrative supportive supervision and management of CBN, (iv) enhance recruitment and training of youth as health workers, (v) target adolescents and out-of-school youth for FP and CBN, (vi) harmonize integrated FP and CBN messaging, (vii) harmonize donor support for integration, and (viii) measure the effectiveness of integration.

Bibliographic Details

Main Authors:	Sellen, Daniel, Sharif, Sharmin, Tefera, Bethlehem, Hyder, Ziauddin
Language:	English en_US
Published:	World Bank, Washington, DC 2012-06
Subjects:	ACCESS TO FAMILY PLANNING, ADOLESCENTS, AGED, AGRICULTURE, ANTENATAL CARE, BREAST FEEDING, BREASTFEEDING, CHILD HEALTH, CHILD MORTALITY, CHILD NUTRITION, CHILD SURVIVAL, CHILDBEARING, CIVIL SOCIETY ORGANIZATIONS, COMMUNITY HEALTH, COMPLEMENTARY FOOD, CONTRACEPTIVE PREVALENCE, CONTRACEPTIVE USERS, COUNSELING, DECENTRALIZATION, DEMAND FOR FAMILY PLANNING, DEVELOPMENT EFFORTS, DEVELOPMENT GOALS, DEVELOPMENT PLANS, DEWORMING, DIET, DISSEMINATION, EARLY DETECTION, EARLY MARRIAGE, EARLY MOTHERHOOD, ECONOMIC GROWTH, EQUIPMENT, FAMILIES, FAMILY HEALTH, FAMILY HEALTH INTERNATIONAL, FAMILY PLANNING, FAMILY PLANNING SERVICE, FERTILITY, FERTILITY RATE, FOCUS GROUP DISCUSSIONS, FOOD SECURITY, GENDER, GENDER ISSUES, GOVERNMENT SUPPORT, HARMFUL TRADITIONAL PRACTICES, HEALTH CARE DELIVERY, HEALTH CARE SERVICE DELIVERY, HEALTH CARE SERVICES, HEALTH CENTERS, HEALTH EDUCATION, HEALTH EXTENSION, HEALTH FOR ALL, HEALTH MESSAGES, HEALTH OFFICIALS, HEALTH OUTCOMES, HEALTH POSTS, HEALTH PROBLEMS, HEALTH PROGRAMS, HEALTH SECTOR, HEALTH SERVICE, HEALTH SERVICE PROVIDERS, HEALTH SERVICES, HEALTH STRATEGY, HEALTH WORKERS, HIV, HIV/AIDS, HOME VISITS, HOUSEHOLD LEVEL, HUMAN CAPACITY, HUMAN DEVELOPMENT, HUMAN HEALTH, HUMAN RESOURCES, HUSBANDS, HYGIENE, ILL HEALTH, ILLNESS, ILLNESSES, IMMUNIZATION, INCOME, INFANT, INFANTS, INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESSES, INTEGRATING FAMILY PLANNING, INTEGRATION, INTERNATIONAL COOPERATION, IODINE DEFICIENCY, IRON, KNOWLEDGE OF FAMILY PLANNING, LESS EDUCATED MOTHERS, LIMITED RESOURCES, LIMITING FAMILY SIZE, LOW BIRTH WEIGHT, LOW-INCOME COUNTRIES, MALARIA, MALNOURISHED CHILDREN, MALNUTRITION AMONG CHILDREN, MARRIED WOMEN, MATERNAL DEATHS, MATERNAL HEALTH, MATERNAL MORTALITY, MATERNAL MORTALITY RATIO, MILLENNIUM DEVELOPMENT GOAL, MINISTRY OF HEALTH, MODERN METHODS OF CONTRACEPTION, MORTALITY, MOSQUITO NETS, MOTHER, NATIONAL DEVELOPMENT, NATIONAL HEALTH SYSTEM, NATIONAL LEVEL, NATIONAL PLANS, NATIONAL POPULATION, NATIONAL POPULATION POLICY, NGOS, NUMBER OF CHILDREN, NUMBER OF HOUSEHOLDS, NUMBER OF WOMEN, NURSES, NUTRITION, NUTRITION PROGRAMS, OBESITY, ORAL CONTRACEPTIVES, PLAN OF ACTION, POLITICAL SUPPORT, POPULATION GROWTH, POPULATION INCREASE, POSTNATAL CARE, PREGNANCY, PREGNANT WOMEN, PREVENTIVE HEALTH CARE, PRIMARY HEALTH CARE, PRIMARY HEALTH CARE SERVICES, PRIMARY HEALTH SERVICES, PROGRESS, QUALITATIVE APPROACH, QUALITATIVE INFORMATION, QUALITY ASSURANCE, QUALITY OF SERVICES, QUANTITATIVE MEASURES, RELIGIOUS BELIEFS, REPRODUCTIVE HEALTH, RESPECT, RISK OF DEATH, RURAL AREAS, RURAL WOMEN, SAFE MOTHERHOOD, SANITATION, SCHOOL YOUTH, SCREENING, SERVICE DELIVERY, SERVICE DELIVERY POINTS, SERVICE PROVIDERS, SERVICE PROVISION, SERVICE QUALITY, SEXUALLY ACTIVE, SOCIAL MOBILIZATION, SPILLOVER, SUSTAINABLE POPULATION, TEENS, TRADITIONAL PRACTICES, TREATMENT SERVICES, UNFPA, UNINTENDED PREGNANCIES, UNMARRIED WOMEN, UNMET DEMAND, UNPLANNED BIRTHS, UNPLANNED PREGNANCIES, UNSAFE ABORTIONS, URBAN AREAS, USE OF CONTRACEPTIVES, USE OF FAMILY PLANNING, VACCINATION, VULNERABLE GROUPS, WASTE, WORKERS, YOUNG CHILD, YOUNG CHILDREN,
Online Access:	http://documents.worldbank.org/curated/en/2012/06/16510378/strengthening-family-planning-community-based-nutrition-interventions-ethiopia-qualitative-study https://hdl.handle.net/10986/13576
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