Factors related to autonomy and discontinuation of use of natural family planning for women in Liberia and Zambia
Kambic, R.T.; Gray, R.H.
American Journal of Obstetrics and Gynecology 165(6 Part 2): 2060-2062
1991
ISSN/ISBN: 0002-9378 PMID: 1755471 DOI: 10.1016/s0002-9378(11)90582-1Document Number: 316557
As part of the evaluation of natural family planning (NFP) demonstration programs conducted in Liberia and Zambia from 1983-88, the factors associated with autonomous use, method discontinuation, and unplanned pregnancy were explored. There were 39 pregnancies recorded among the 1055 NFP acceptors in Liberia and 180 unplanned pregnancies among the 2709 acceptors in Zambia. A total of 144 Liberian and 465 Liberian women discontinued NFP use because of pregnancy or personal reasons. In both countries, housewives and women who were breastfeeding were less likely to become autonomous NFP users, while women who received a medium number of teacher-client visits per month and those who registered after the program had become established were more likely to become autonomous users. Similarly, women who registered later in both programs and had a medium or high number of home visits were less likely to discontinue method use. In Liberia, urban women were 7 times more likely than their rural counterparts to discontinue NFP. In Zambia, women over 35 years of age and those who were breastfeeding were significantly more likely to continue NFP use. The relative risk of an unplanned risk was greatest, in Zambia, among nonbreastfeeding women and, in Liberia, among urban women and, unexpectedly, women with a medium intensity of visits. Parity, maternal education, and birth spacing versus limiting intentions were not significantly predictors of outcome in either country. Although women who entered the NFP programs late in their development were more likely to become autonomous users and less likely to discontinue to experience unplanned pregnancy, no factor was consistently associated with all measures of NFP use in both programs.