Egypt Family Planning Method Mix Indicates Shifting toward Hormonal Contraceptives

Ghada Wahby; Hend Sabry; Madiha Abdel-Razik; Marwa Rashad Salem; Fayrouz EL Aguizy

doi:10.3889/oamjms.2021.7512

Authors

Ghada Wahby Department of Public Health and Community Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
Hend Sabry Department of Public Health and Community Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
Madiha Abdel-Razik Department of Public Health and Community Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
Marwa Rashad Salem Department of Public Health and Community Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
Fayrouz EL Aguizy Department of Public Health and Community Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt

DOI:

https://doi.org/10.3889/oamjms.2021.7512

Keywords:

Family planning, Intra uterine device, Oral contraceptives, Family planning method –Mix, Incentives, Health system research

Abstract

BACKGROUND: The study is of practical importance for policy makers and family planning (FP) program managers as the profile of FP method-mix with a shift from a mechanical method as intrauterine devices (IUD) to hormonal methods such as oral contraceptives (OCs) and injectables predicts a critical situation for maternal and child health and reflects shortcomings in FP service delivery program.

AIM: The purpose of the current study was to identify reasons for the progressive shift from IUD to OCs in Egypt.

METHODS: The study is an-operations research conducted at four levels of the Ministry of Health and Population/FP (MOHP/FP) service delivery: Central (headquarter, HQ), governorate, district, and service delivery points. It included five of MOHP/United Nations Fund for Population Activities-Contraceptive Security Project governorates that represent, urban governorates, Lower Egypt, and Upper Egypt. Both qualitative data in-depth interviews with MOHP/HQ staff, Two Focus Group Discussions with FP Health Directorates staff and nurses in the five governorates, and quantitative data through a self-administered questionnaire for 607 service providers (SP).

RESULTS: There was a consensus on the actual shift from IUD to OCs use. Reasons were the absence of incentives for healthcare providers for IUD insertion services (64%) and improper training of physicians (45%), and the availability of OCs all time.

CONCLUSION: The three articulating issues that lead to shifting from IUD to OCs are: Unsatisfactory training and incentive systems for SPs and the clients’ choice of OCs for independent use/autonomy, and availability of OCs all the times at a reasonable cost in both the public and private sectors.

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