Factors Affecting Continuity And Success Of Community-Based Reproductive Health Service Programme In Rural Community Of Northeast Ethiopia

Abstract

Objective: To assess opportunities and threats towards the continuity and success of Community based reproductive health service programme in Northeast Ethiopia.
Design: Community based comparative cross sectional study.
Setting: Two districts of Amhara region, Ethiopia, classified as strong and weak
community based reproductive health programme areas.
Subjects: Seven hundred and ninety two women aged 15-49 years residing in the
selected districts of Amhara region. Community based reproductive health workers,
programme coordinators and field supervisors were used as informants of qualitative
data collection.
Main outcome measure: Current use of modern contraceptive methods.
Results: Strong versus weak programme areas: knowledge about modern contraceptive
method (MCM), was (90% and 86.8%), [OR (95% CI) = 2.87(1.68,4.91)], ever use of MCM
(61.1 % and 29.7%), [OR (95% CI) = 3.71(2.72, 5.07)] and current use of MCM (54.8%
versus 19.7%), [OR (95% CI) = 4.95(3.53,6.95)]. Method interruption was significantly
higher, 37.6% in weak than 10.9% in strongly performing programme area. Causes of
defaulting in strong versus weak programme areas were: wanted more pregnancy (4%
and 39.5%), fear of contraceptives\' side effects (16% and 31.6%) and lack of method
of choice (20% and 2.6%). Type of religion, husband approval, awareness of service
existence and client satisfaction remained to be the predictors of current use of MCM
in multivariate analysis. Qualitative study findings were found coherent with the
quantitative results.
Conclusion: Type of religion, husband approval, client satisfaction and awareness of
service existence were the predictors of modern contraceptive methods utilisation in
the study population.

East African Medical Journal Vol. 85 (10) 2008: pp. 487-499