Utilization of Postpartum Family Planning and Associated Factors among Postpartum Women Attending 5 Healthcare Facilities in a Rural District in Northern Uganda

Utilization of Postpartum Family Planning and Associated Factors among Postpartum Women Attending 5 Healthcare Facilities in a Rural District in Northern Uganda | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Utilization of Postpartum Family Planning and Associated Factors among Postpartum Women Attending 5 Healthcare Facilities in a Rural District in Northern Uganda Madira Emmanuel, Auma Anna Grace, Amir Kabunga, Mary Goretti Asiimwe, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5439114/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Postpartum family planning (PPFP) uptake in Sub-Saharan Africa remains low, with Uganda reporting a 35% utilization rate. Despite the availability of both short-term and long-acting methods, the use of PPFP in Alebtong a rural district in Northern Uganda, East Africa, is particularly low. This low utilization persists despite the district's high fertility rate and being the country’s lowest number of registered family planning users. Family planning is a crucial public health program that significantly improves maternal and child health, reduces mortality rates, and enhances community well-being Objective : To assess the level of utilization of PPFP and the contributing factors among postpartum women attending health facilities in a rural district of Northern Uganda. Methods : A descriptive cross-sectional study was conducted among 483 women within 12 months postpartum, recruited from five randomly selected health facilities between October and November 2022. Quantitative data was collected using interviewer-administered questionnaires. Data was analyzed using STATA version 17.0, with descriptive statistics and multivariate logistic regression performed at a 95% confidence interval to identify predictors of PPFP utilization. Results: The utilization of postpartum family planning was 41.61% (95% CI: 37.17 – 46.15). Independent predictors or contributing factors to PPFP utilization included education level (primary: APR: 0.753; 95% CI: 0.641-0.883; p=<0.001), partner’s age (APR: 1.203; 95% CI: 1.004-1.443; p=0.05), parity (APR: 0.755; 95% CI: 0.635-0.897; p=0.001), uncertainty about timing for next pregnancy (APR: 1.994; 95% CI: 1.09-3.646; p=0.03), and advice from friends about PPFP methods (APR: 1.358; 95% CI: 1.171-1.575; p=<0.001). Conclusion : Low utilization of PPFP among postpartum women is influenced by various factors. The Ministry of Health should prioritize improving access to PPFP services through both health facilities and community outreach. A multisectoral approach is essential to raise awareness, and enhance knowledge among women and the population, and contribute to the achievement of Sustainable Development Goals. Nursing Postpartum family planning Utilization Postpartum women Alebtong District Northern Uganda predictors and contributing factors Figures Figure 1 Introduction Globally, 121 million unintended pregnancies occur each year, with a rate of 64 per 1,000 women (1).This rate is significantly higher in Sub-Saharan Africa, where 62 out of every 1,000 pregnancies are unintended(2). Unintended pregnancies are closely linked to higher rates of maternal, infant, and child mortality(3). Family planning is a crucial public health program that significantly improves maternal and child health, reduces mortality rates, and enhances community well-being. It is a key metric for assessing the implementation of Sustainable Development Goal 3.7(4). However, postpartum women face the greatest unmet need for family planning, despite its critical intervention in saving mothers and children globally (5). Scaling up FP services is a cost-effective intervention to prevent maternal, infant, and child deaths globally, contributing to SDGs by reducing unintended pregnancies and preventing one-quarter to one-third of maternal deaths(6). Postpartum family planning (PPFP) is defined as the prevention of unintended pregnancy and closely spaced pregnancies through the first 12 months following childbirth(7,8). Postpartum family planning can be provided: Immediate postpartum (IPPFP): within 48 hours, early postpartum (EPPFP): within 48 hours up to 6 weeks, and extended postpartum (EPPFP) 6 weeks to one year after delivery(8). The World Health Organization (WHO) refers to family planning (FP) as a process that allows people to attain their desired number of children and determine the spacing of pregnancies, which is achieved through the use of family planning methods and treatment of infertility(9). The immediate postpartum period presents a critical window for contraception initiation, as fertility and sexual activity can resume shortly after childbirth. Medical evidence recommends maintaining an inter-pregnancy interval of at least 12 months to reduce obstetric and neonatal complications. Most contraceptive methods, including long-acting reversible options such as implants and intrauterine devices, can be safely initiated immediately postpartum. While the immediate post-delivery period offers an opportune time for family planning initiation, evidence suggests that women's contraceptive needs evolve throughout the first year postpartum, necessitating sustained access to services beyond the immediate postpartum period. This extended coverage is particularly important as many women may not access services immediately after delivery due to various barriers, including transportation costs, childcare responsibilities, and work commitments, which often result in low postpartum clinic attendance (10) (11,12). Importantly, after childbirth, the return of fertility can happen at any time; postpartum women may become pregnant before their menstrual cycles start up again (5). Even when they attend follow-up visits, it's possible that they could have conceived before the next appointment(11). As a result, postpartum women have a higher-than-average unmet need for family planning, which is the main factor in unintended pregnancies and maternal mortality (13) (14). Postpartum family planning helps improve maternal and newborn health outcomes by promoting healthy timing of pregnancy and spacing of birth among postpartum women (15,16). Offering modern contraceptive services as part of care increases the uptake of postpartum contraception and could decrease both unintended and too closely spaced pregnancies (17). Delays in early initiation of postpartum contraception can lead to unintended pregnancies and closely spaced pregnancies (18). These pose serious health risks to mothers and their infants, including pregnancy-related complications, self-induced abortion mortality, high rates of maternal and neonatal mortality and morbidity (19) (20) (5). In Sub-Saharan Africa, the use of PPFP remains the lowest at 37.41% among women of reproductive age (12). In Uganda, 35% of postpartum women actively take contraceptives (10), including both short and long-acting methods deemed safe and effective by the Ministry of Health (21). The Ugandan government planned to increase the rate of contraceptive use among women of reproductive age to 50% and reduce the unmet need for family planning to 10% by 2020 (22). However, contraceptive nonuse is estimated at 28% (23,24). Uganda's government has established five strategic priorities for strengthening family planning services by 2025: increasing the modern contraceptive prevalence rate (mCPR) from 30.4% to 39.6% while reducing unmet needs from 17% to 15%; allocating 10% of Maternal and Child Health resources to adolescent services; securing 50% of domestic reproductive health budget for family planning commodities; implementing DHIS2/Health Management Information System integration for data-driven decision-making; and improving counseling quality by raising the Method Information Index Plus (MII+) from 42% to 60%. These priorities build upon Uganda's commitments made at key international forums, including the 2012 London Summit on Family Planning, 2014 Uganda National Family Planning Conference, and 2019 ICPD Summit. The government also provides consistent financial support, pledging $5 million annually for reproductive health commodities and distribution systems (25,26). Studies across Uganda reveal significant variations in postpartum family planning (PPFP) utilization. At Hoima Regional Referral Hospital, only 27.5% of women aged 15-49 reported using PPFP services, with higher education levels and perceived health worker competence positively influencing uptake(27,28). Another qualitative study documented even lower utilization at 10% among surveyed mothers, despite high rates of antenatal care and facility-based deliveries. Key predictors of PPFP utilization consistently emerge across studies, including maternal age, educational attainment, wealth status, and breastfeeding practices (29–31). Multiple barriers impede uptake, such as fear of side effects, partner opposition, and misconceptions about breastfeeding and contraception. Additional factors influencing contraceptive nonuse include place of residence, quality of services, alcohol consumption, income levels, and age at first sexual intercourse(10,12,13,17). A scoping review emphasized the need for comprehensive family planning approaches, noting that unmet PPFP needs stem from complex interactions between individual socioeconomic circumstances and broader societal and institutional factors(32,33). Family planning is a cost-effective strategy for achieving Vision 2040 development objectives, reducing poverty, enhancing gender equity, mitigating HIV transmission, and reducing adolescent pregnancy and infant mortality rates. Uganda's universal healthcare policy and government funding fail to meet over 20% of the population's needs for family planning services, with rural women lagging behind urban ones and married women showing higher utilization. The lack of a robust commercial sector strains the system's resources, and the wealth gap is particularly stark, with contraceptive use among women in the lowest wealth quintile (22.5%) being nearly half that of women in the upper quintiles (>40%) (34,35). While these studies provide valuable insights, they do not compare predictors across geographic areas. Information indicates that postpartum women in northern Uganda, particularly in Alebtong district, rarely use postpartum family planning (36,37). Alebtong district has a high fertility rate (6.6-7.5 children) and very low registered FP users (38). To effectively direct limited public resources and accelerate progress toward achieving global targets, it is crucial to understand the factors that influence the uptake of PPFP. There is a lack of studies on postpartum family planning and its predictors in Alebtong District. Therefore, this study assessed the utilization of postpartum family planning and contributing factors among postpartum women attending 5 public health facilities in a rural district in Northern Uganda. Methods Study area Alebtong District is a rural district in Northern Uganda, with an estimated population of 266100 inhabitants. It is located about 387km north of Kampala the capital city of Uganda. It is one of the districts with a high fertility rate (6.6-7.5 children) in this rural subregion in Northern Uganda, with very low registered FP users in the country with postpartum family planning being the least utilized. The FP register system quantifies the family planning users in Uganda, it is derived from health facility registers that document annual contraceptive method distribution. This facility-based reporting system functions as a proxy measure for national family planning utilization. The study was conducted in several health facilities within Alebtong, the district has seven (7) health facilities. A total of five (5) health facilities across the district constituted the study sites. Participants were recruited from different health facilities within Alebtong District. They were postpartum women 12 months postpartum seeking maternal and child health services, including immunization and family planning services. Study design and period Between October and November 2022, we conducted a facility-based descriptive cross-sectional study among eligible postpartum women in Alebtong District, Northern Uganda. This report is written in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for cross-sectional studies(39). Study population The source population was women within 12 months postpartum attending health facilities within Alebtong District. To be eligible for the study, participants had to be 18 years or older within the reproductive age bracket (15-49 years) and the 12-month postpartum period. Cis-gender female, provided written informed consent to participate in the study and currently seeking maternal and child health services in the health facilities. Postpartum status was verified by checking the date of delivery on the immunization cards. Postpartum women who were very ill, and mentally incapacitated to comprehend the study objectives were excluded from this study. Sample size determination The sample size of 483 was calculated using the modified Kish- Leslie formula (1965) for a single population, with the prevalence of postpartum family planning estimated at 30% from a previous study(24). ; where, =the required sample size, p=proportion of women using postpartum family planning contraceptives, assumed to be 30% (20), q= the complementary probability of p (calculated as 1-p, or 0.202), d=the precision of 0.05, z= the standard normal value of z at 95%CI, deff=design effect (1.5 considered). Sampling techniques and procedures Five health facilities were randomly sampled (one health center IV, and 4 health center IIIs), and consecutive sampling was used to obtain the participants in the study. Participants who consented to participate signed the consent forms or provided thumb prints Unique codes were assigned to the participants and were assured of confidentiality. A completeness check was done by the research coordinator to ensure that all the questions in the tool were answered while in the field. Data Collection tools and procedures Participant enrolment was facilitated through the collaboration of midwives working at the health facilities, who were familiar with the mother’s seeking health care services at their respective centers. Two research assistants who were graduate midwives with an understanding of the services that take place during the postpartum period conducted the interviews. The weekly average client load for each health center was obtained from registry books, and the sample size for each facility was proportionally allocated based on this data. Data were collected through face-to-face interviews in a private space within the health facility using a pre-tested semi-structured questionnaire. The questionnaire was developed in English and translated into the local language, Lango. It collected information on socio-demographic factors (age, religion, marital status, education, income, and partner characteristics), health-related factors (parity, pregnancy outcomes, desired family size, and birth intervals), and postpartum family planning (PPFP). The primary outcome variable was the self-reported use of a postpartum family planning method. Variables The dependent variable for the study was the utilization of postpartum family planning. This was self-reported measure based on whether a respondent had used postpartum family planning within the 12-month postpartum period with a Yes or No response, and measured as a proportion. The independent variables included sociodemographic factors, individual factors, and health-facility-associated factors relating to postpartum family planning use. Operational definitions Postpartumin this study focuses on the time from birth up to 12 months. Postpartum family planning is the prevention of unintended and closely spaced pregnancies through the first 12 months following childbirth, Utilization is having used one of the various postpartum family planning methods within the 12 months postpartum period Statistical analysis A data entry screen with checks by the principal investigator was created in SPSS version 26.0 to ensure no missing and out-of-range values are entered within the data set. Data were exported and analyzed using STATA version 17. For descriptive analysis, data was summarized in simple frequencies and proportions. At the bivariate level, associations between the utilization of postpartum family planning and the independent variables were determined through univariate logistic regression and results were presented in a cross-tabulation with frequencies, percentages corresponding to 95% confidence intervals, and p-values. Variables found to have associations (p<0.2), and other plausible from the literature were further assessed by using multivariate modified Poisson regression analysis after careful examination of underlying assumptions to identify predictors of utilization of postpartum family planning method. The back elimination method was used to build the final model with only variables statistically Adjusted to significant associations (p<0.05). Adjusted prevalence ratio (APR), corresponding 95% confidence intervals, and p-values were reported. Ethical statement The study received ethical approval from the Gulu University Research Ethics Committee (approval number:(GUREC-2022-341. Verbal informed consent was obtained from all participants before the start of the study. Participants were informed of their right to withdraw from the study at any time and that their participation was voluntary. All data collected was kept confidential and anonymous. The ethical principles outlined in the Declaration of Helsinki were all adhered to. Study participants who required specific sexual and reproductive health services were counseled and referred to the appropriate service point. Results Participants Of the 483 anticipated participants, 483 (response proportion 100%) were eligible and were enrolled in the study. Socio-demographic characteristics of postpartum women attending health care facilities in Alebtong District, Northern Uganda. Overall, 483 postpartum women with the majority (51.2%, n=247) aged between 18-24 years were included in the final analysis. The majority of the participants were married (91.1%, n=440). In terms of religion, most of the participants were Anglicans (42.7%, n=206), while only a small proportion identified as Seventh-Day Adventists. Most of the participants had completed the primary level of education (67.7%, n=327). When it comes to occupation, most (70.6, n=341) of the participants reported that they were peasant farmers. In terms of income most (65.4%, n=316) had a monthly income of less than 50,000 Ugandan shillings (14 USD). Regarding the partner's age and education, the majority were aged between 25-34 (58.8%, n=284), and had completed primary-level education (64.4%, n=311) respectively. Table 1 summarizes the baseline characteristics of the study participants. Table 1. Socio-demographic characteristics of postpartum women attending health facilities in Alebtong District. Socio-demographics Frequency (n) Percentage (%) Mothers age 18-24 25-34 35-45 247 189 47 51.2 39.1 9.7 Religion Anglican Catholic Seventh Day Adventist Muslim Others 206 161 15 19 82 42.7 33.3 3.1 3.9 17.0 Marital status Married Not married 440 43 91.1 8.9 Education level No formal education Completed Primary Completed Secondary Post-secondary 79 327 61 16 16.4 67.7 12.6 3.3 Monthly income (Ugandan Shillings) 100,000 316 152 15 65.4 31.5 3.1 Partner’s age 18-24 25-34 >34 87 284 112 18.0 58.8 23.2 Partner’s Education No formal education Completed Primary Completed Secondary 28 311 110 5.8 64.4 22.8 Occupation Peasant farmer Businesswoman Formal employment 341 133 9 70.6 27.5 1.9 Individual and health-related characteristics of postpartum women in Alebtong District, Uganda Regarding partners having another spouse and parity, a majority (82.2%, n=397) did not have another spouse, and 46.0%, n=222 already had between 2-4 deliveries. In terms of living children and number of pregnancies lost, 43.9%, n=212 had between 3-4 children alive, and a majority (80.5%, n=389) had never experienced any pregnancy losses. Regarding the mode of last delivery and place, 88.0%, n=425 had a vaginal delivery without difficulties, and mostly facility-based deliveries (91.7%, n=443). More than half desired to have at least two or more children (67.3%, n=325). Regarding sensitization about IPPFP during antenatal, the majority reported that they were sensitized (74.3%, n=359), and most had ever used a family planning method before (76.6%, n=370). In terms of the timing of contraception, most (28.8%, n=139) preferred it at six months, and only a few preferred it within 48 hours (2.1%, n=10). The most preferred method of family planning was the injectables (41.4%, n=200), and the least preferred were the permanent methods i.e., bilateral tubal ligation and vasectomy (0.8%, n=4). Regarding receiving advice from a friend/family member about family planning, over half (57.6%, n=278) reported that they did so. The husbands were the main decision-makers in the choice of family planning (44.9%, n=217). The majority were within 2-5km from the health facility (55.9%, n=270). In terms of the availability of family planning methods at the facility and the attitude of the health workers towards them, 90.3%, n=436, reported that the methods were available, and the majority (81.8%, n=395) described the health workers as welcoming. Table 2 summarizes the individual and health-related characteristics. Table 2: Individual and health-related characteristics of postpartum women attending health facilities in Alebtong District. Factor Frequency (n) Percentage (%) Partner has another spouse Yes 86 17.8 No 397 82.2 Parity 1 186 38.5 2-4 222 46.0 >4 75 15.5 Number of children alive 1-2 195 40.4 3-4 212 43.9 >4 76 15.7 Number of pregnancies lost 1 81 16.8 2 and above 13 2.7 Never 389 80.5 Mode of last delivery Cesarean section 34 7.0 SVD with difficulties 24 5.0 SVD without difficult 425 88.0 Place of delivery Facility delivery 443 91.7 Home delivery 40 8.3 The desired number of children 1-2 158 32.7 >2 325 67.3 Sensitized about IPPFP during ANC Yes 359 74.3 No 124 25.7 Ever used any FP method Yes 370 76.6 No 113 23.4 Preferred timing of contraception Within 48 hours 10 2.1 At6 weeks 41 8.5 At 6 months 139 28.8 At one year 136 28.2 At 2 years 69 14.3 Undecided 88 18.2 Most preferred method of FP Pills 13 2.7 Injectables 200 41.4 Interval IUD 22 4.6 Implants 121 25.1 BTL/ vasectomy 4 0.8 Barrier methods 7 1.4 NA 116 24.0 Advise by friend/family member Yes 278 57.6 No 205 42.4 Who decides of FP choice Husband 217 44.9 Myself 49 10.1 Both of us 208 43.1 Healthcare Provider 9 1.9 Distance to nearest health facility 2-5km 270 55.9 6-10km 154 31.9 >10km 59 12.2 Availability of FP methods Yes 436 90.3 No 47 9.7 Health worker's attitude at the facility Welcoming 395 81.8 Unwelcoming 8 1.7 NA 80 16.6 Utilization of postpartum family planning among postpartum women attending health facilities in Alebtong District In this study, 201 out of 483 postpartum women ever used postpartum family planning 41.6% (95%CI; 37.17 – 46.15). Factors Associated with Postpartum Family Planning Use Among Women in Alebtong District, Northern Uganda Bivariable analysis revealed several factors significantly associated with postpartum family planning (PPFP) use. Maternal characteristics including age (p<0.001), education level (p=0.03), and parity (p<0.001) showed strong associations. Partner-related factors such as age (p=0.003) and polygamy status (p=0.004) also emerged as significant. Reproductive history, specifically the number of living children (p<0.001), played a role. Health system factors, including PPFP sensitization during antenatal care (p<0.001), availability of family planning methods (p<0.001), and healthcare workers' attitudes (p<0.001), were significant predictors. Additionally, prior use of any family planning method (p<0.001), method preferences (p<0.001), and peer advice (p=0.01) were associated with PPFP use. Tables 3 and 4 provide a comprehensive summary of these factors and their associations with PPFP utilization among postpartum women in Alebtong District, Northern Uganda. Table 3: Association of sociodemographic factors with use of postpartum family planning methods Characteristic Ever used PPFP P-value Yes n=201 (41.6%) No n=282(58.4%) Mothers age 18-24 75(37.3) 172(70.0) <0.001 25-34 100(49.8) 89(31.6) 35-45 26(12.9) 21(7.5) Religion Anglican 81(40.3) 125(44.3) 0.19 f Catholic 72(35.8) 89(31.6) Seventh Day Adventist 4(2.0) 11(3.9) Muslim 12(6.0) 7(2.5) Others 32(16.0) 50(17.7) Marital status Married 189(94.0) 251(89.0) 0.06 Not married 12(6.0) 31(11.0) Education level No formal education 21(10.5) 58(20.6) 0.03 Completed Primary 146(72.6) 181(64.2) Completed Secondary 28(14.0) 33(11.7) Post-secondary 6(3.0) 10(3.6) Monthly income (Ugandan shillings/$) 100,000 7(3.5) 8(2.8) Partner’s age 18-24 25(12.4) 62(22.0) 0.003 25-34 117(58.2) 167(59.2) >34 59(29.4) 53(18.8) Partner’s Education No formal education 10(5.0) 18(6.4) 0.13 Completed primary 120(59.7) 191(67.7) Completed Secondary 56(27.9) 54(19.2) Post-secondary 15(7.5) 19(6.7) Table 4 : Association of individual and health-related factors with the use of postpartum family planning methods Factor Ever used PPFP P value Yes n=201 (41.6%) No n=282(58.4%) Partner has another spouse Yes 62(12.0) 62(22.0) 0.004 No 177(88.1) 220(78.0) Parity 1 50(24.9) 136(48.2) 4 39(19.4) 36(12.8) Number of children alive 1-2 57(28.4) 138(48.9) 4 38(18.9) 38(13.5) Number of pregnancies lost 1 34(17.0) 47(16.7) 0.66 2 and above 7(3.5) 6(2.1) Never 160(79.6) 229(81.2) Mode of last delivery Cesarean section 18(9.0) 16(5.7) 0.19 Spontaneous vaginal delivery with difficulties 7(3.5) 17(6.0) Spontaneous vaginal delivery without difficult 176(87.6) 249(88.3) Place of delivery Facility delivery 189(94.0) 254(90.1) 0.12 Home delivery 12(6.0) 28(10.0) Occupation Peasant farmer 146(72.6) 195(69.2) 0.16 f Business woman 54(26.9) 79(28.0) Formal employment 1(0.5) 8(2.8) Desired number of children 1-2 57(28.4) 101(35.8) 0.09 >2 144(71.6) 181(64.2) Sensitized about PPFP during ANC Yes 196(97.5) 174(61.7) <0.001 No 5(2.5) 108(38.3) Ever used any FP method Yes 195(97.0) 164(58.2) <0.001 No 6(3.0) 118(41.8) Preferred timing of contraception Within 48 hours 5(2.5) 5(1.8) <0.001 At6 weeks 22(11.0) 19(6.7) At 6 months 76(37.8) 63(22.3) At one year 65(32.3) 71(25.2) At 2 years 25(12.4) 44(15.6) Undecided 8(4.0) 80(28.4) Advise by friend/family member Yes 129(64.2) 149(52.8) 0.01 No 72(35.8) 133(47.2) Decider on FP choice Husband 81(40.3) 136(46.2) 0.16 Myself 21(10.5) 28(10.0) Both of us 97(48.3) 111(40.0) Healthcare Provider 2(1.0) 7(2.5) Distance to nearest health facility 2-5km 111(55.2) 159(56.4) 0.92 6-10km 64(31.8) 90(32.0) >10km 26(12.9) 33(11.7) Availability of FP methods Yes 197(98.0) 239(84.8) <0.001 f No 4(2.0) 43(15.3) Health worker's attitude at the facility Welcoming 192(95.5) 203(72.0) <0.001 f Unwelcoming 3(1.5) 5(1.8) NA 6(3.0) 74(26.2) Predictors of Postpartum Family Planning Utilization Among Women Attending Health Facilities in Alebtong District, Northern Uganda Multivariate modified Poisson regression analysis revealed several factors influencing postpartum family planning (PPFP) utilization. Maternal age, PPFP awareness during antenatal care, and availability of family planning methods at health facilities were significant predictors. Women with primary (APR: 0.753; 95% CI: 0.641-0.883; p<0.001 ) and secondary education (APR: 0.719; 95% CI: 0.554-0.934) were less likely to use PPFP methods compared to those without formal education. Women with partners aged 25-34 years showed higher PPFP utilization (APR: 1.203; 95% CI: 1.004-1.443; p=0.05 ) than those with younger partners. Parity also played a role, with women having 2-4 children less likely to use PPFP (APR: 0.755; 95% CI: 0.635-0.897; p=0.001 ) compared to those with one child. Undecided pregnancy intentions positively influenced PPFP use (APR: 1.994; 95% CI: 1.09-3.646; p=0.03 ), as did receiving advice from friends (APR: 1.358; 95% CI: 1.171-1.575; p<0.001 ). Other socio-demographic, individual, and health-related factors, including healthcare workers' attitudes and prior family planning use, were not significantly associated with PPFP utilization. Table 5 : Predictors of Postpartum Family Planning Utilization Among Women Attending Health Facilities in Alebtong District, Northern Uganda Utilization of postpartum Family Planning methods Adjusted Prevalence Ratio P-value 95% Confidence Interval Education level No formal education 1.000 Completed Primary 0.753 <0.001 0.641-0.883 Completed Secondary 0.719 0.01 0.554-0.934 Post-secondary 0.898 0.60 0.601-1.342 Partner’s age <25 1.000 25-34 1.203 0.05 1.004-1.443 35 and above 1.045 0.79 0.755-1.447 Parity 1 1.000 2-4 0.755 0.001 0.635-0.897 5 and above 0.761 0.11 0.542-1.068 Preferred time for PPFP Immediately 1.000 At 6 weeks postpartum 1.022 0.95 0.512-2.040 At 6 months postpartum 0.996 0.99 0.531-1.867 At one year 1.192 0.58 0.642-2.213 At 2 years 1.481 0.22 0.796-2.755 Undecided 1.994 0.03 1.09-3.646 Ever been advised by a friend on FP methods Yes 1.000 No 1.358 <0.001 1.171-1.575 Discussion Postpartum family planning (PPFP) initiation within 12 months after childbirth is crucial for safe motherhood, reducing unintended pregnancies, and ensuring appropriate birth spacing, reducing morbidity and mortality risks (40). The postpartum period presents a high risk of conception due to the early return of fertility, underlining the importance of PPFP (41). This study aimed to determine the utilization and associated factors of PPFP among postpartum women in Alebtong District, Northern Uganda. In this predominantly rural setting, we found that approximately 5 in 12 postpartum women reported using PPFP, with a utilization rate of 41.6%. Our findings both align with and diverge from other studies, highlighting regional variations: This rate is higher than the national PPFP coverage of 35% in Uganda, but slightly lower than the 44% reported in a similar study conducted in Arba Minch town, South Ethiopia(23,27). A study in rural India, Kailali district, Nepal found a lower PPFP utilization rate of 32.8%(42). Much lower prevalences have been reported in Uganda (10%) and Ethiopia (20.7%) (30,43). In a systematic review, to assess postpartum family planning use and its determinants among women in LMICs of SSA, a pooled prevalence of 37.41% was reported, while research in urban Ethiopia, Addis Ababa reported a higher uptake of 71.8%(44,45) highlighting the potential impact of urbanization and healthcare access. Despite this relatively higher rate, PPFP uptake remains suboptimal, likely due to socio-cultural barriers, economic constraints, and limitations of the facility-based service delivery model(40,46,47). Additionally, research in Ethiopia's Tigray region emphasized the importance of immediate postpartum family planning counseling(48). These comparisons suggest the need for targeted, culturally sensitive interventions to address the unique challenges faced by postpartum women. Plans should involve community-based PPFP programs that integrate with other maternal and child health services, incorporating a deep understanding of local sociocultural contexts (49,50). The study indicates a higher utilization rate of PPFP than the national average but suggests further research on barriers to uptake and targeted interventions in Northern Uganda. Our study's findings stress the critical need for the Ugandan Ministry of Health to prioritize expanding access to postpartum family planning (PPFP) services at both health facility and community levels. This expansion is crucial for accelerating progress toward Sustainable Development Goal 3.7, which aims to ensure universal access to sexual and reproductive healthcare services by 2030, it identifies the need to solve problems such as insufficient funding for healthcare systems, lack of access to quality reproductive care including modern contraception and medically safe abortion that have led to high unwanted pregnancy rates and preventable maternal deaths. Investing in quality health care for all, including easy family planning access, helps slow population growth and improves lives. Very high populations facilitate disease transmission and hurt public health, especially in areas like Northern Uganda, where healthcare services are overburdened(51). PPFP utilization significantly increases with older maternal age with women aged 35 years and above having 2.23 higher odds of use compared to those below 34 years. This age-related trend aligns with a similar study conducted in Assiut Governorate Upper Egypt in which older women had 2.15 higher odds of using PPFP and is supported by the results of the EFHS-2021(52,53). The positive association between advanced maternal age and PPFP utilization can be attributed to increased exposure to childbirth, family planning use, and information, as suggested by different studies(44,54,55). This accumulated experience likely translates to enhanced knowledge about PPFP and its prompt use among older women. However contrary to this, a study conducted in Indonesia found the highest unmet need for PPFP among older women(56). Most literature on PPFP utilization found no significant association between age and PPFP use, especially in a study done in 68 districts in Uganda, and the Amhara region of Ethiopia (20.7%)(30,43). This highlights the potential influence of local contexts on PPFP utilization patterns. The age disparity in PPFP utilization noted in our study and others emphasizes the need for targeted interventions, and tailored approaches to improve PPFP in low- and middle-income countries(57). It is recommended that the Ugandan Ministry of Health disseminate PPFP information to reach women across all reproductive age categories achievable through diverse media platforms such as radio, television, newspapers, and community women's groups, an approach supported by evidence on successful PPFP interventions(58–60). Additionally, integrating PPFP services with other maternal and child health programs could enhance accessibility and utilization across age groups(61). Future research should explore the effectiveness of these targeted communication strategies and integrated service delivery models in improving PPFP utilization among younger women in the Ugandan context. PPFP utilization significantly increases with the level of education, in our study completion of primary education level had 2.33 higher odds of utilization. This is similar to a previous mixed method study at Muhoroni subcounty, Kisumu County, Kenya, which reported that women who had attained secondary education were more likely to use PPFP compared to those who had primary education(55). Similarly in 68 districts in Uganda, as study with 10% utilization of PPFP highlighted that the likelihood of using a modern FP method postpartum also increased, corresponding to increases of 30%, 50% and 60% among mothers with primary, secondary and higher than secondary education respectively compared to those mothers with no education(30). Clear as primary level of education being significantly associated with utilization in our study, most studies indicate significant association at secondary or higher level of education(45,62), this could be attributed to the fact that our study setting was rural and more under sourced in relation to education services. Education likely enhances awareness, knowledge, and decision-making skills regarding life events. Moreover, family planning is often included in school curricula as part of sex education, exposing women to various birth control methods and their benefits. These findings indicate the importance of collaboration between the Ugandan Ministry of Health and the Ministry of Education to emphasize reproductive health education at all educational levels. Such efforts could create effective awareness and optimize PPFP utilization among women. A study in Minch town, South Ethiopia indicated association with much higher levels of education such college (27). Contrary to our study, a study in Southeast Ethiopia indicated that the utilization of PPFP was higher among women whose partners had completed a secondary level of education than those with no formal education (63,64). This might be because partner education can enhance understanding of men's involvement in family planning and assist in contraception use. Furthermore, our study found that prior knowledge/information through friends about postpartum family planning services was associated with higher service utilization compared to those lacking such knowledge. This result corroborates findings from a systematic review in LMICs in SSA, where mothers knowledgeable about family planning likely used the services (45). Similarly several studies have shown that women who ever heard about modern FP methods, previous FP information, and FP use before index pregnancy were more likely to use (43) (40) (54) (44). Exposure to reproductive health information during antenatal care visits and health outreach campaigns likely equips mothers with the knowledge necessary to make informed decisions about family planning use(45,53,54). This is supported by evidence that limited knowledge of contraceptive methods contributes to the high unmet need among postpartum women for contraceptive methods (56). These findings highlight the need for a multi-sectoral approach to family planning. To boost awareness and improve knowledge among women of reproductive age, the Ugandan Ministry of Health should collaborate with other reproductive health stakeholders to enhance health service delivery. Such collaborative efforts could significantly impact family planning utilization rates and, consequently, improve maternal and child health outcomes. The economic hardship in Alebtong District, Northern Uganda with most participants living below the international poverty line of USD 1.9 per day significantly hinders postpartum family planning (PPFP) uptake, necessitating multifaceted interventions to address both economic and healthcare challenges. This is in line with recent literature on socioeconomic determinants of health in low- and middle-income countries(65). The opportunity costs of seeking healthcare, such as lost wages and transportation expenses, create substantial barriers for impoverished families (40,56,66). Low income often correlates with lower education levels, impacting health literacy and healthcare navigation abilities. To address these interlinked challenges, an all-inclusive approach combining income support programs, enhanced accessibility of family planning services through community outreach, financial literacy education, and community empowerment initiatives are proposed. This strategy, supported by evidence from integrated development programs and community-based family planning interventions, could potentially improve PPFP uptake and contribute to better maternal and child health outcomes in this vulnerable population (59,67). Our study reveals that postpartum mothers who were aware of the availability of family planning services had nearly five times higher odds of utilizing these services compared to those who were unaware. This finding aligns with previous research conducted in Nigeria which reported sub-optimal use of PPFP attributed to health-related factors including cost, difficulty accessing services, and procurement difficulties as the main challenges that clients face in obtaining PPFP(68). Similarly, Andualem et al. found a positive association between PPFP awareness and utilization in their study(64). The stronger association observed in our study suggests that awareness might play an even more crucial role in our specific context, possibly due to unique local factors or interventions. This relationship between awareness and utilization is further supported by studies in other settings, such as Iraq, where it is reported that women with good knowledge of PPFP are more likely to use PPFP services(31). The consistent positive association across these studies shows the critical importance of awareness in driving PPFP utilization(29). However, it's worth noting that awareness could be possibly created by counseling during ANC, delivery and postnatal care, and FP education after delivery at immunization, in several studies have been attributed to increased knowledge and thus utilization of PPFP services(54,69). These have been associated with increased uptake, especially in a study by Mohammed et al in which receiving information about PPFP from healthcare providers increased the likelihood of using the services(53). Our findings, in conjunction with these studies, highlight the need for comprehensive strategies that not only raise awareness but also address other potential barriers to PPFP utilization(60,61). The Ministry of Health in Uganda and other stakeholders should ensure continuous supply of family planning methods and targeted awareness campaigns, while future research should explore effective methods and factors influencing awareness and utilization in the precise context. Our study reveals that mothers who delivered before arriving at the hospital had significantly lower odds (0.16 times) of utilizing postpartum family planning (PPFP) services compared to those who delivered in the hospital. While direct comparisons are limited due to the scarcity of similar studies, this finding aligns with research suggesting that the place of delivery significantly influences postpartum care utilization(54) (62). For instance, studies by Tilahun et al have shown that giving birth outside a health facility can affect subsequent healthcare decisions based on postpartum and labor health outcomes(54,62). This delay in accessing PPFP services among mothers who deliver before reaching the hospital likely stems from the fact that most PPFP services are primarily provided within healthcare settings(31,49). Our findings reecho the need for the health sector to implement comprehensive strategies to ensure all expectant mothers receive skilled birth attendants and timely postpartum care, regardless of their delivery location. This could include developing digital tracking systems for pregnant women, strengthening emergency health units and referral systems, and extending PPFP services beyond traditional healthcare settings(61) (50). Furthermore, future research should explore innovative approaches to providing PPFP services to women who deliver outside of health facilities, potentially through community-based interventions or mobile health units(58,61). By addressing these gaps, we can work towards improving PPFP utilization rates and, ultimately, maternal and child health outcomes in our region. Study limitations and strength While providing valuable insights into postpartum family planning (PPFP) service utilization among 483 postpartum women, our study wasn’t without limitations. The reliance on self-reported data may have introduced social desirability and recall bias in PPFP service utilization reporting and recall bias for obstetric variables and postnatal care attendance, particularly for previous postpartum periods. To avoid potential biases, participants were thoroughly explained and encouraged to provide honest responses, and questions were centered on the most recent delivery. The study's strengths lie in its large sample size, robust dataset, and focus on the critical postpartum care period, despite its limitations. The identified factors provide valuable contextual insights and a solid foundation for future interventional studies. This study provides crucial data on PPFP utilization in our setting, potentially guiding targeted interventions to enhance maternal and child health outcomes despite constraints. Conclusions The study found a low 41.6% utilization of postpartum family planning among postpartum women attending health facilities in Alebtong District northern Uganda. Postpartum mothers aged 35 years above, who completed a primary level of education, had spontaneous vaginal delivery without difficulties, and had prior information on postpartum and immediate postpartum family planning were more likely to utilize postpartum family planning compared to their counterparts. Availability of postpartum and immediate postpartum family planning at health facilities likely resulted in utilization compared to when it was lacking. Recommendations Based on our findings and existing literature, we propose several recommendations to enhance postpartum family planning (PPFP) utilization in Uganda. Primarily, the Ministry of Health should prioritize expanding access to PPFP services at both health facility and community outreach levels, aligning with SDG target 3.7. This expansion should be coupled with a comprehensive communication strategy utilizing diverse media platforms to disseminate PPFP information across all reproductive age categories (68). Collaboration with the Ministry of Education is crucial to integrate reproductive health education at all educational levels, potentially addressing the lower PPFP utilization among younger women observed in our study. We advocate for a multisectoral approach, engaging various stakeholders to boost awareness and improve health service delivery. Ensuring a continuous supply of family planning methods at all health facility levels is essential for facilitating easy access and use(70) (71). Additionally, implementing a digital tracking system for pregnant mothers could help ensure skilled birth attendance care, regardless of location, addressing the lower PPFP utilization among women who deliver before reaching health facilities(72). Finally, strengthening emergency health units and referral teams for pregnant women could improve tracking of pregnant and postpartum women, potentially increasing their engagement with PPFP services(73). These evidence-based recommendations, if implemented, could significantly improve PPFP utilization rates in Uganda, contributing to better maternal and child health outcomes. DECLARATIONS Ethical Considerations and consent, assent to participate The research protocol was reviewed and approved by the Gulu University Research and Ethics Committee (GUREC-2022-341). Administrative clearance was obtained from the office of the District Health Officer, Alebtong District, and the participating health facility in charges. Written informed consent was obtained from postpartum women aged 18-49 years. The study was performed following the Declaration of Helsinki. Consent for publication Not applicable Data Availability The data sets used and/or analyzed during the study are available from the corresponding author upon reasonable request. Conflicts of Interest The authors declare that they have no competing interests. Funding This research received funding from Center for International Reproductive Health Training (CIRHT), University of Michigan. Authors Contribution Emmanuel Madira/ participated intopic development, protocol development, data collection, data analysis, and manuscript writing. Anna Grace Auma / participated in protocol writing, data collection, data analysis, manuscript writing, and reviewing. Amir Kabunga/ participated in protocol development, data collection, data analysis, and manuscript writing. Mary Goretti Asiimwe/ participated in protocol development, data collection, data analysis, and manuscript writing. Andrew Acobi / participated in protocol development, data collection, data analysis, and manuscript writing. Beth Namukwana / participated in topic development, protocol development, data collection, and manuscript writing. Ronald Izaruku / participated in protocol development, data collection, data analysis, and manuscript writing. Vicky Caroline Acayo / participated in data analysis, manuscript writing, and manuscript review. Peter Paul Opio / participated in data analysis, manuscript writing, and manuscript review. Opio Okaka Dokotum/ participated in protocol development, data collection, data analysis, and manuscript writing. Acknowledgments Special gratitude goes out to the Centre for Sexual and Reproductive Health, University of Michigan for funding this project and for the technical support, the management of the different health facilities and postpartum women in Alebtong District for their participation in this research study. 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Abiodun-Ojo OE, Alo OB, Akinyemi OO, Dele-Alonge OI, Maitanmi JO, Maitanmi BT. Awareness and Utilisation of Family Planning Among Postpartum Women in Ondo State, Nigeria. International Journal of Nursing, Midwife and Health Related Cases. 2024;12(1):1–15. Hackett K, Huber-Krum S, Francis JM, Senderowicz L, Pearson E, Siril H, et al. Evaluating the Implementation of an Intervention to Improve Postpartum Contraception in Tanzania: A Qualitative Study of Provider and Client Perspectives. Global Health: Science and Practice. 2020 Jun 30;8(2):270–89. Akamike IC, Okedo-Alex IN, Eze II, Ezeanosike OB, Uneke CJ. Why does uptake of family planning services remain sub-optimal among Nigerian women? A systematic review of challenges and implications for policy. Contracept Reprod Med. 2020 Oct 31;5(1):30. Tefera K, Abuye M. Postpartum Family Planning Utilization and Associated Factors among women who gave birth in the past 12 months, Hawassa Town, Southern Ethiopia: a community based cross-sectional study. International Journal of Women’s Health Care. 2020 Jun 22;5(2):51–9. Kananura RM, Birabwa C, Ssanyu JN, Kizito F, Kagaha A, Namutanba S, et al. Increasing coverage and uptake of voluntary family planning in urban areas of central-eastern Uganda: an implementation research study protocol [Internet]. Research Square; 2023 [cited 2024 Nov 11]. Available from: https://www.researchsquare.com/article/rs-1473029/v1 Mruts KB, Tessema GA, Gebremedhin AT, Scott J, Pereira G. The effect of family planning counselling on postpartum modern contraceptive uptake in sub-Saharan Africa: a systematic review. Public Health. 2022;206:46–56. Leight J, Hensly C, Chissano M, Safran E, Ali L, Dustan D, et al. The effects of text reminders on the use of family planning services: evidence from a randomised controlled trial in urban Mozambique. BMJ Global Health. 2022 Apr 1;7(4):e007862. Obssa A, Hailemichael A, Belayihun B, Teshome L, Mvuezolo JJN, Molla Y, et al. Point of care quality improvement approach increases immediate postpartum family planning uptake: A field report from Sululta district, Oromia, Ethiopia. Ethiopian Journal of Health Development [Internet]. 2021 [cited 2024 Nov 11];35(5). Available from: https://www.ajol.info/index.php/ejhd/article/view/219880 Additional Declarations The authors declare no competing interests. Supplementary Files DATACOLLECTIONTOOL.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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11:26:19","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-5439114/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5439114/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":69086359,"identity":"2107c9db-f322-4ce2-a698-62089dacbf4c","added_by":"auto","created_at":"2024-11-15 12:44:59","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":43626,"visible":true,"origin":"","legend":"\u003cp\u003epie chart showing postpartum family planning use by postpartum women in Alebtong District, Uganda\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-5439114/v1/60ee84b8a41a1df378a87fa6.png"},{"id":69086807,"identity":"ae2da48a-d6d4-4f45-a526-326e6418d81c","added_by":"auto","created_at":"2024-11-15 12:52:59","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1625192,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5439114/v1/47f80b0d-3391-476f-a1e3-26701c4aa83d.pdf"},{"id":69086358,"identity":"426db2ea-20cb-4c11-884c-7ec356c10016","added_by":"auto","created_at":"2024-11-15 12:44:58","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":28079,"visible":true,"origin":"","legend":"","description":"","filename":"DATACOLLECTIONTOOL.docx","url":"https://assets-eu.researchsquare.com/files/rs-5439114/v1/8d80e5d58ae5574d552cab23.docx"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eUtilization of Postpartum Family Planning and Associated Factors among Postpartum Women Attending 5 Healthcare Facilities in a Rural District in Northern Uganda\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eGlobally, 121 million unintended pregnancies occur each year, with a rate of 64 per 1,000 women\u0026nbsp;(1).This rate is significantly higher in Sub-Saharan Africa, where 62 out of every 1,000 pregnancies are unintended(2). Unintended pregnancies are closely linked to higher rates of maternal, infant, and child mortality(3).\u0026nbsp;Family planning is a crucial public health program that significantly improves maternal and child health, reduces mortality rates, and enhances community well-being. It is a key metric for assessing the implementation of Sustainable Development Goal 3.7(4). \u0026nbsp;However, postpartum women face the greatest unmet need for family planning, despite its critical intervention in saving mothers and children globally\u0026nbsp;(5). Scaling up FP services is a cost-effective intervention to prevent maternal, infant, and child deaths globally, contributing to SDGs by reducing unintended pregnancies and preventing one-quarter to one-third of maternal deaths(6).\u003c/p\u003e\n\u003cp\u003ePostpartum family planning (PPFP) is defined as the prevention of unintended pregnancy and closely spaced pregnancies through the first 12 months following childbirth(7,8). Postpartum family planning can be provided: Immediate postpartum (IPPFP): within 48 hours, early postpartum (EPPFP): within 48 hours up to 6 weeks, and \u0026nbsp;extended postpartum (EPPFP) 6 weeks to one year after delivery(8). The World Health Organization (WHO) refers to family planning (FP) as a process that allows people to attain their desired number of children and determine the spacing of pregnancies, which is achieved through the use of family planning methods and treatment of infertility(9). The immediate postpartum period presents a critical window for contraception initiation, as fertility and sexual activity can resume shortly after childbirth. Medical evidence recommends maintaining an inter-pregnancy interval of at least 12 months to reduce obstetric and neonatal complications. Most contraceptive methods, including long-acting reversible options such as implants and intrauterine devices, can be safely initiated immediately postpartum. While the immediate post-delivery period offers an opportune time for family planning initiation, evidence suggests that women's contraceptive needs evolve throughout the first year postpartum, necessitating sustained access to services beyond the immediate postpartum period. This extended coverage is particularly important as many women may not access services immediately after delivery due to various barriers, including transportation costs, childcare responsibilities, and work commitments, which often result in low postpartum clinic attendance\u0026nbsp;(10)\u0026nbsp;(11,12).\u003c/p\u003e\n\u003cp\u003eImportantly, after childbirth, the return of fertility can happen at any time; postpartum women may become pregnant before their menstrual cycles start up again\u0026nbsp;(5).\u0026nbsp;Even when they attend follow-up visits, it's possible that they could have conceived before the next appointment(11). As a result, postpartum women have a higher-than-average unmet need for family planning, which is the main factor in unintended pregnancies and maternal mortality\u0026nbsp;(13)\u0026nbsp;(14).\u003c/p\u003e\n\u003cp\u003ePostpartum family planning helps improve maternal and newborn health outcomes by promoting healthy timing of pregnancy and spacing of birth among postpartum women\u0026nbsp;(15,16). Offering modern contraceptive services as part of care increases the uptake of postpartum contraception and could decrease both unintended and too closely spaced pregnancies\u0026nbsp;(17). Delays in early initiation of postpartum contraception can lead to unintended pregnancies and closely spaced pregnancies\u0026nbsp;(18). These pose serious health risks to mothers and their infants, including pregnancy-related complications, self-induced abortion mortality, high rates of maternal and neonatal mortality and morbidity\u0026nbsp;(19)\u0026nbsp;(20)\u0026nbsp;(5).\u003c/p\u003e\n\u003cp\u003eIn Sub-Saharan Africa, the use of PPFP remains the lowest at 37.41% among women of reproductive age\u0026nbsp;(12). In Uganda, 35% of postpartum women actively take contraceptives\u0026nbsp;(10), including both short and long-acting methods deemed safe and effective by the Ministry of Health\u0026nbsp;(21). The Ugandan government planned to increase the rate of contraceptive use among women of reproductive age to 50% and reduce the unmet need for family planning to 10% by 2020\u0026nbsp;(22). However, contraceptive nonuse is estimated at 28%\u0026nbsp;(23,24).\u003c/p\u003e\n\u003cp\u003eUganda's government has established five strategic priorities for strengthening family planning services by 2025: increasing the modern contraceptive prevalence rate (mCPR) from 30.4% to 39.6% while reducing unmet needs from 17% to 15%; allocating 10% of Maternal and Child Health resources to adolescent services; securing 50% of domestic reproductive health budget for family planning commodities; implementing DHIS2/Health Management Information System integration for data-driven decision-making; and improving counseling quality by raising the Method Information Index Plus (MII+) from 42% to 60%. These priorities build upon Uganda's commitments made at key international forums, including the 2012 London Summit on Family Planning, 2014 Uganda National Family Planning Conference, and 2019 ICPD Summit. The government also provides consistent financial support, pledging $5 million annually for reproductive health commodities and distribution systems\u0026nbsp;(25,26).\u003c/p\u003e\n\u003cp\u003eStudies across Uganda reveal significant variations in postpartum family planning (PPFP) utilization. At Hoima Regional Referral Hospital, only 27.5% of women aged 15-49 reported using PPFP services, with higher education levels and perceived health worker competence positively influencing uptake(27,28). Another qualitative study documented even lower utilization at 10% among surveyed mothers, despite high rates of antenatal care and facility-based deliveries. Key predictors of PPFP utilization consistently emerge across studies, including maternal age, educational attainment, wealth status, and breastfeeding practices\u0026nbsp;(29–31). Multiple barriers impede uptake, such as fear of side effects, partner opposition, and misconceptions about breastfeeding and contraception. Additional factors influencing contraceptive nonuse include place of residence, quality of services, alcohol consumption, income levels, and age at first sexual intercourse(10,12,13,17). \u0026nbsp;A scoping review emphasized the need for comprehensive family planning approaches, noting that unmet PPFP needs stem from complex interactions between individual socioeconomic circumstances and broader societal and institutional factors(32,33).\u003c/p\u003e\n\u003cp\u003eFamily planning is a cost-effective strategy for achieving Vision 2040 development objectives, reducing poverty, enhancing gender equity, mitigating HIV transmission, and reducing adolescent pregnancy and infant mortality rates. Uganda's universal healthcare policy and government funding fail to meet over 20% of the population's needs for family planning services, with rural women lagging behind urban ones and married women showing higher utilization. The lack of a robust commercial sector strains the system's resources, and the wealth gap is particularly stark, with contraceptive use among women in the lowest wealth quintile (22.5%) being nearly half that of women in the upper quintiles (\u0026gt;40%)\u0026nbsp;(34,35).\u003c/p\u003e\n\u003cp\u003eWhile these studies provide valuable insights, they do not compare predictors across geographic areas. Information indicates that postpartum women in northern Uganda, particularly in Alebtong district, rarely use postpartum family planning\u0026nbsp;(36,37).\u0026nbsp;Alebtong district has a high fertility rate (6.6-7.5 children) and very low registered FP users\u0026nbsp;(38). To effectively direct limited public resources and accelerate progress toward achieving global targets, it is crucial to understand the factors that influence the uptake of PPFP. There is a lack of studies on postpartum family planning and its predictors in Alebtong District. Therefore, this study assessed the utilization of postpartum family planning and contributing factors among postpartum women attending 5 public health facilities in a rural district in Northern Uganda.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy area\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAlebtong District is a rural district in Northern Uganda, with an estimated population of 266100 inhabitants. It is located about 387km north of Kampala the capital city of Uganda. It is one of the districts with a high fertility rate (6.6-7.5 children) in this rural subregion in Northern Uganda, with very low registered FP users in the country with postpartum family planning being the least utilized. The FP register system\u0026nbsp;quantifies the family planning users in Uganda, it is derived from health facility registers that document annual contraceptive method distribution. This facility-based reporting system functions as a proxy measure for national family planning utilization.\u0026nbsp;\u0026nbsp;The study was conducted in several health facilities within Alebtong, the district has seven (7) health facilities. \u0026nbsp;A total of five (5) health facilities across the district constituted the study sites. Participants were recruited from different health facilities within Alebtong District. They were postpartum women 12 months postpartum seeking maternal and child health services, including immunization and family planning services.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy design and period\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBetween October and November\u0026nbsp;2022, we conducted a facility-based descriptive cross-sectional study among eligible postpartum women in Alebtong District, Northern Uganda. This report is written in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for cross-sectional studies(39).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy population\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe source population was women within 12 months postpartum attending health facilities within Alebtong District. To be eligible for the study, participants had to be 18 years or older within the reproductive age bracket (15-49 years) and the 12-month postpartum period. Cis-gender female, provided written informed consent to participate in the study and currently seeking maternal and child health services in the health facilities. Postpartum status was verified by checking the date of delivery on the immunization cards. Postpartum women who were very ill, and mentally incapacitated to comprehend the study objectives were excluded from this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSample size determination\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe sample size of 483 was calculated using the modified Kish- Leslie formula (1965) for a single population, with the prevalence of postpartum family planning estimated at 30% from a previous study(24).\u0026nbsp;; where,\u0026nbsp;=the required sample size, p=proportion of women using postpartum family planning contraceptives, assumed to be 30% (20), q= the complementary probability of p (calculated as 1-p, or 0.202), d=the precision of 0.05, z= the standard normal value of z at 95%CI, deff=design effect (1.5 considered).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSampling techniques and procedures\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFive health facilities were randomly sampled (one health center IV, and 4 health center IIIs), and consecutive sampling was used to obtain the participants in the study. Participants who consented to participate signed the consent forms or provided thumb prints Unique codes were assigned to the participants and were assured of confidentiality. A completeness check was done by the research coordinator to ensure that all the questions in the tool were answered while in the field.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Collection tools and procedures\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipant enrolment was facilitated through the collaboration of midwives working at the health facilities, who were familiar with the mother’s seeking health care services at their respective centers. Two research assistants who were graduate midwives with an understanding of the services that take place during the\u0026nbsp;postpartum period conducted the interviews. The weekly average client load for each health center was obtained from registry books, and the sample size for each facility was proportionally allocated based on this data. Data were collected through face-to-face interviews in a private space within the health facility using a pre-tested semi-structured questionnaire. The questionnaire was developed in English and translated into the local language, Lango. It collected information\u0026nbsp;on socio-demographic factors (age, religion, marital status, education, income, and partner characteristics), health-related factors (parity, pregnancy outcomes, desired family size, and birth intervals), and postpartum family planning (PPFP). The primary outcome variable was the self-reported use of a postpartum family planning method.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe dependent variable for the study was the utilization of postpartum family planning. This was self-reported measure based on whether a respondent had used postpartum family planning within the 12-month postpartum period with a Yes or No response, and measured as a proportion. The independent variables included sociodemographic factors, individual factors, and health-facility-associated factors relating to postpartum family planning use.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOperational definitions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePostpartumin this study focuses on the time from birth up to 12 months.\u003c/p\u003e\n\u003cp\u003ePostpartum family planning\u0026nbsp;is the prevention of unintended and closely spaced pregnancies through the first 12 months following childbirth,\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eUtilization is having used one of the various postpartum family planning methods within the 12 months postpartum period\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA data entry screen with checks by the principal investigator was created in SPSS version 26.0 to ensure no missing and out-of-range values are entered within the data set. Data were exported and analyzed using STATA version 17. For descriptive analysis, data was summarized in simple frequencies and proportions. At the bivariate level, associations between the utilization of postpartum family planning and the independent variables were determined through univariate logistic regression and results were presented in a cross-tabulation with frequencies, percentages corresponding to 95% confidence intervals, and p-values. Variables found to have associations (p\u0026lt;0.2), and other plausible from the literature were further assessed by using\u0026nbsp;multivariate modified Poisson regression analysis\u0026nbsp;after careful examination of underlying assumptions to identify predictors of utilization of postpartum family planning method. The back elimination method was used to build the final model with only variables statistically Adjusted to significant associations (p\u0026lt;0.05). Adjusted prevalence ratio (APR), corresponding 95% confidence intervals, and p-values were reported.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study received ethical approval from the Gulu University Research Ethics Committee (approval number:(GUREC-2022-341. Verbal informed consent was obtained from all participants before the start of the study. Participants were informed of their right to withdraw from the study at any time and that their participation was voluntary. All data collected was kept confidential and anonymous. The ethical principles outlined in the Declaration of Helsinki were all adhered to. Study participants who required specific sexual and reproductive health services were counseled and referred to the appropriate service point.\u003c/p\u003e"},{"header":"Results ","content":"\u003cp\u003e\u003cstrong\u003eParticipants\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOf the 483 anticipated participants, 483 (response proportion 100%) were eligible and were enrolled in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSocio-demographic characteristics of postpartum women attending health care facilities in Alebtong District, Northern Uganda.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOverall, 483 postpartum women with the majority (51.2%, n=247) aged between 18-24 years were included in the final analysis. \u0026nbsp;The majority of the participants were married (91.1%, n=440). In terms of religion, most of the participants were Anglicans (42.7%, n=206), while only a small proportion identified as Seventh-Day Adventists. \u0026nbsp;Most of the participants had completed the primary level of education (67.7%, n=327). When it comes to occupation, most (70.6, n=341) of the participants reported that they were peasant farmers. In terms of income most (65.4%, n=316) had a monthly income of less than 50,000 Ugandan shillings (14 USD). Regarding the partner\u0026apos;s age and education, the majority were aged between 25-34 (58.8%, n=284), and had completed primary-level education (64.4%, n=311) respectively. Table 1 summarizes the baseline characteristics of the study participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1. Socio-demographic characteristics of postpartum women attending health facilities in Alebtong District.\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"450\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 42.6667%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSocio-demographics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6667%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30.6667%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 42.6667%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMothers age\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e18-24\u003c/p\u003e\n \u003cp\u003e25-34\u003c/p\u003e\n \u003cp\u003e35-45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6667%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e247\u003c/p\u003e\n \u003cp\u003e189\u003c/p\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30.6667%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e51.2\u003c/p\u003e\n \u003cp\u003e39.1\u003c/p\u003e\n \u003cp\u003e9.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 42.6667%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eReligion\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eAnglican\u003c/p\u003e\n \u003cp\u003eCatholic\u003c/p\u003e\n \u003cp\u003eSeventh Day Adventist\u003c/p\u003e\n \u003cp\u003eMuslim\u003c/p\u003e\n \u003cp\u003eOthers\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6667%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e206\u003c/p\u003e\n \u003cp\u003e161\u003c/p\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30.6667%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e42.7\u003c/p\u003e\n \u003cp\u003e33.3\u003c/p\u003e\n \u003cp\u003e3.1\u003c/p\u003e\n \u003cp\u003e3.9\u003c/p\u003e\n \u003cp\u003e17.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 42.6667%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003cp\u003eNot married\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6667%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e440\u003c/p\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30.6667%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e91.1\u003c/p\u003e\n \u003cp\u003e8.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 42.6667%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation level\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eNo formal education\u003c/p\u003e\n \u003cp\u003eCompleted Primary\u003c/p\u003e\n \u003cp\u003eCompleted Secondary\u003c/p\u003e\n \u003cp\u003ePost-secondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6667%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e79\u003c/p\u003e\n \u003cp\u003e327\u003c/p\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30.6667%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e16.4\u003c/p\u003e\n \u003cp\u003e67.7\u003c/p\u003e\n \u003cp\u003e12.6\u003c/p\u003e\n \u003cp\u003e3.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 42.6667%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMonthly income (Ugandan Shillings)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026lt;50,000\u003c/p\u003e\n \u003cp\u003e50,000-100,000\u003c/p\u003e\n \u003cp\u003e\u0026gt;100,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6667%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e316\u003c/p\u003e\n \u003cp\u003e152\u003c/p\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30.6667%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e65.4\u003c/p\u003e\n \u003cp\u003e31.5\u003c/p\u003e\n \u003cp\u003e3.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 42.6667%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePartner\u0026rsquo;s age\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e18-24\u003c/p\u003e\n \u003cp\u003e25-34\u003c/p\u003e\n \u003cp\u003e\u0026gt;34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6667%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e87\u003c/p\u003e\n \u003cp\u003e284\u003c/p\u003e\n \u003cp\u003e112\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30.6667%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e18.0\u003c/p\u003e\n \u003cp\u003e58.8\u003c/p\u003e\n \u003cp\u003e23.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 42.6667%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePartner\u0026rsquo;s Education\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eNo formal education\u003c/p\u003e\n \u003cp\u003eCompleted Primary\u003c/p\u003e\n \u003cp\u003eCompleted Secondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6667%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003cp\u003e311\u003c/p\u003e\n \u003cp\u003e110\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30.6667%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e5.8\u003c/p\u003e\n \u003cp\u003e64.4\u003c/p\u003e\n \u003cp\u003e22.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 42.6667%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003ePeasant farmer\u003c/p\u003e\n \u003cp\u003eBusinesswoman\u003c/p\u003e\n \u003cp\u003eFormal employment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6667%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e341\u003c/p\u003e\n \u003cp\u003e133\u003c/p\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30.6667%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e70.6\u003c/p\u003e\n \u003cp\u003e27.5\u003c/p\u003e\n \u003cp\u003e1.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eIndividual and health-related characteristics of postpartum women in Alebtong District, Uganda\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eRegarding partners having another spouse and parity, a majority (82.2%, n=397) did not have another spouse, and 46.0%, n=222 already had between 2-4 deliveries. In terms of living children and number of pregnancies lost, 43.9%, n=212 had between 3-4 children alive, and a majority (80.5%, n=389) had never experienced any pregnancy losses. Regarding the mode of last delivery and place, 88.0%, n=425 had a vaginal delivery without difficulties, and mostly facility-based deliveries (91.7%, n=443). More than half desired to have at least two or more children (67.3%, n=325). Regarding sensitization about IPPFP during antenatal, the majority reported that they were sensitized (74.3%, n=359), and most had ever used a family planning method before (76.6%, n=370). In terms of the timing of contraception, most (28.8%, n=139) preferred it at six months, and only a few preferred it within 48 hours (2.1%, n=10). The most preferred method of family planning was the injectables (41.4%, n=200), and the least preferred were the permanent methods i.e., bilateral tubal ligation and vasectomy (0.8%, n=4). Regarding receiving advice from a friend/family member about family planning, over half (57.6%, n=278) reported that they did so. The husbands were the main decision-makers in the choice of family planning (44.9%, n=217). The majority were within 2-5km from the health facility (55.9%, n=270). In terms of the availability of family planning methods at the facility and the attitude of the health workers towards them, 90.3%, n=436, reported that the methods were available, and the majority (81.8%, n=395) described the health workers as welcoming. Table 2 summarizes the individual and health-related characteristics.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2: Individual and health-related characteristics\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eof postpartum women attending health facilities in Alebtong District.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"545\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFactor\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePartner has another spouse\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e17.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e397\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e82.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParity\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e186\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e38.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e2-4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e222\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e46.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e\u0026gt;4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e15.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of children alive\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e1-2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e195\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e40.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e3-4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e212\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e43.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e\u0026gt;4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e15.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of pregnancies lost\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e16.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e2 and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e2.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e389\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e80.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMode of last delivery\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eCesarean section\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e7.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eSVD with difficulties\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e5.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eSVD without difficult\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e425\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e88.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlace of delivery\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eFacility delivery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e443\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e91.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eHome delivery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e8.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eThe desired number of children\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e1-2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e158\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e32.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e\u0026gt;2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e325\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e67.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSensitized about IPPFP during ANC\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e359\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e74.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e124\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e25.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEver used any FP method\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e370\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e76.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e113\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e23.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePreferred timing of contraception\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eWithin 48 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e2.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eAt6 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e8.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eAt 6 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e139\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e28.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eAt one year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e136\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e28.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eAt 2 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e14.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eUndecided\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e18.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMost preferred method of FP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003ePills\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e2.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eInjectables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e200\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e41.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eInterval IUD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e4.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eImplants\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e121\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e25.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eBTL/ vasectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eBarrier methods\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e1.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e24.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdvise by friend/family member\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e278\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e57.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e205\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e42.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWho decides of FP choice\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eHusband\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e217\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e44.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eMyself\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e10.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eBoth of us\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e208\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e43.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eHealthcare Provider\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e1.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDistance to nearest health facility\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e2-5km\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e270\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e55.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e6-10km\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e154\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e31.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e\u0026gt;10km\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e12.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAvailability of FP methods\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e436\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e90.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e9.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHealth worker\u0026apos;s attitude at the facility\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eWelcoming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e395\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e81.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eUnwelcoming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.6593%;\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.3736%;\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32.967%;\"\u003e\n \u003cp\u003e16.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eUtilization of postpartum family planning among postpartum women attending health facilities in Alebtong District\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn this study, 201 out of 483 postpartum women ever used postpartum family planning 41.6% (95%CI; 37.17 \u0026ndash; 46.15).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFactors Associated with Postpartum Family Planning Use Among Women in Alebtong District, Northern Uganda\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBivariable analysis revealed several factors significantly associated with postpartum family planning (PPFP) use. Maternal characteristics including age (p\u0026lt;0.001), education level (p=0.03), and parity (p\u0026lt;0.001) showed strong associations. Partner-related factors such as age (p=0.003) and polygamy status (p=0.004) also emerged as significant. Reproductive history, specifically the number of living children (p\u0026lt;0.001), played a role. Health system factors, including PPFP sensitization during antenatal care (p\u0026lt;0.001), availability of family planning methods (p\u0026lt;0.001), and healthcare workers\u0026apos; attitudes (p\u0026lt;0.001), were significant predictors. Additionally, prior use of any family planning method (p\u0026lt;0.001), method preferences (p\u0026lt;0.001), and peer advice (p=0.01) were associated with PPFP use. Tables 3 and 4 provide a comprehensive summary of these factors and their associations with PPFP utilization among postpartum women in Alebtong District, Northern Uganda.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3: Association of sociodemographic factors with use of postpartum family planning methods\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristic\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 38.8618%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEver used PPFP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-value\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes n=201 (41.6%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo n=282(58.4%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMothers age\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003e18-24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e75(37.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e172(70.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003e25-34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e100(49.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e89(31.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003e35-45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e26(12.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e21(7.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eReligion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003eAnglican\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e81(40.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e125(44.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e0.19\u003csup\u003ef\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003eCatholic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e72(35.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e89(31.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003eSeventh Day Adventist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e4(2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e11(3.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003eMuslim\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e12(6.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e7(2.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003eOthers\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e32(16.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e50(17.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e189(94.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e251(89.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003eNot married\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e12(6.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e31(11.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation level\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003eNo formal education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e21(10.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e58(20.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.03\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003eCompleted Primary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e146(72.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e181(64.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003eCompleted Secondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e28(14.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e33(11.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003ePost-secondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e6(3.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e10(3.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMonthly income (Ugandan shillings/$)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003e\u0026lt;50,000(14$)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e137(68.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e179(63.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e0.45\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003e50,000-100,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e57(28.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e95(33.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003e\u0026gt;100,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e7(3.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e8(2.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePartner\u0026rsquo;s age\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003e18-24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e25(12.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e62(22.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.003\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003e25-34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e117(58.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e167(59.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003e\u0026gt;34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e59(29.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e53(18.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePartner\u0026rsquo;s Education\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003eNo formal education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e10(5.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e18(6.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003eCompleted primary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e120(59.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e191(67.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003eCompleted Secondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e56(27.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e54(19.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 36.0976%;\"\u003e\n \u003cp\u003ePost-secondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.8211%;\"\u003e\n \u003cp\u003e15(7.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e19(6.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0407%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e4\u003c/strong\u003e\u003cstrong\u003e: Association of individual and health-related factors with the use of postpartum family planning methods\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFactor\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEver used PPFP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes n=201 (41.6%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo n=282(58.4%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePartner has another spouse\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e62(12.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e62(22.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.004\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e177(88.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e220(78.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParity\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e50(24.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e136(48.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e2-4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e112(55.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e110(39.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u0026gt;4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e39(19.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e36(12.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of children alive\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e1-2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e57(28.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e138(48.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e3-4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e106(52.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e106(37.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u0026gt;4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e38(18.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e38(13.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of pregnancies lost\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e34(17.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e47(16.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.66\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e2 and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e7(3.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e6(2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e160(79.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e229(81.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMode of last delivery\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eCesarean section\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e18(9.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e16(5.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eSpontaneous vaginal delivery with difficulties\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e7(3.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e17(6.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eSpontaneous vaginal delivery without difficult\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e176(87.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e249(88.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlace of delivery\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eFacility delivery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e189(94.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e254(90.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eHome delivery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e12(6.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e28(10.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003ePeasant farmer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e146(72.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e195(69.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.16\u003csup\u003ef\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eBusiness woman\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e54(26.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e79(28.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eFormal employment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e1(0.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e8(2.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDesired number of children\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e1-2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e57(28.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e101(35.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u0026gt;2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e144(71.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e181(64.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSensitized about PPFP during ANC\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e196(97.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e174(61.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e5(2.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e108(38.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEver used any FP method\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e195(97.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e164(58.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e6(3.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e118(41.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePreferred timing of contraception\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eWithin 48 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e5(2.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e5(1.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eAt6 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e22(11.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e19(6.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eAt 6 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e76(37.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e63(22.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eAt one year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e65(32.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e71(25.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eAt 2 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e25(12.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e44(15.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eUndecided\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e8(4.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e80(28.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdvise by friend/family member\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e129(64.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e149(52.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e72(35.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e133(47.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDecider on FP choice\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eHusband\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e81(40.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e136(46.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eMyself\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e21(10.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e28(10.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eBoth of us\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e97(48.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e111(40.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eHealthcare Provider\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e2(1.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e7(2.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDistance to nearest health facility\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e2-5km\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e111(55.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e159(56.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.92\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e6-10km\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e64(31.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e90(32.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u0026gt;10km\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e26(12.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e33(11.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAvailability of FP methods\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e197(98.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e239(84.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003csup\u003ef\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e4(2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e43(15.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHealth worker\u0026apos;s attitude at the facility\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eWelcoming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e192(95.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e203(72.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003csup\u003ef\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eUnwelcoming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e3(1.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e5(1.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e6(3.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e74(26.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003ePredictors of Postpartum Family Planning Utilization Among Women Attending Health Facilities in Alebtong District, Northern Uganda\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMultivariate modified Poisson regression analysis revealed several factors influencing postpartum family planning (PPFP) utilization. Maternal age, PPFP awareness during antenatal care, and availability of family planning methods at health facilities were significant predictors. Women with primary (APR: 0.753; 95% CI: 0.641-0.883; \u003cem\u003ep\u0026lt;0.001\u003c/em\u003e) and secondary education (APR: 0.719; 95% CI: 0.554-0.934) were less likely to use PPFP methods compared to those without formal education. Women with partners aged 25-34 years showed higher PPFP utilization (APR: 1.203; 95% CI: 1.004-1.443; \u003cem\u003ep=0.05\u003c/em\u003e) than those with younger partners. Parity also played a role, with women having 2-4 children less likely to use PPFP (APR: 0.755; 95% CI: 0.635-0.897; \u003cem\u003ep=0.001\u003c/em\u003e) compared to those with one child. Undecided pregnancy intentions positively influenced PPFP use (APR: 1.994; 95% CI: 1.09-3.646; \u003cem\u003ep=0.03\u003c/em\u003e), as did receiving advice from friends (APR: 1.358; 95% CI: 1.171-1.575; \u003cem\u003ep\u0026lt;0.001\u003c/em\u003e). Other socio-demographic, individual, and health-related factors, including healthcare workers\u0026apos; attitudes and prior family planning use, were not significantly associated with PPFP utilization.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e5\u003c/strong\u003e\u003cstrong\u003e: Predictors of Postpartum Family Planning Utilization Among Women Attending Health Facilities in Alebtong District, Northern Uganda\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"645\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.6335%;\"\u003e\n \u003cp\u003eUtilization of postpartum Family Planning methods\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4969%;\"\u003e\n \u003cp\u003e\u0026nbsp;Adjusted Prevalence Ratio\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8012%;\"\u003e\n \u003cp\u003e\u0026nbsp;P-value\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0683%;\"\u003e\n \u003cp\u003e\u0026nbsp;95% Confidence Interval\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.6335%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation level\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4969%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8012%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0683%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.6335%;\"\u003e\n \u003cp\u003eNo formal education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4969%;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8012%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0683%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.6335%;\"\u003e\n \u003cp\u003eCompleted Primary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4969%;\"\u003e\n \u003cp\u003e0.753\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8012%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0683%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.641-0.883\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.6335%;\"\u003e\n \u003cp\u003eCompleted Secondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4969%;\"\u003e\n \u003cp\u003e0.719\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8012%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0683%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.554-0.934\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.6335%;\"\u003e\n \u003cp\u003ePost-secondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4969%;\"\u003e\n \u003cp\u003e0.898\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8012%;\"\u003e\n \u003cp\u003e0.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0683%;\"\u003e\n \u003cp\u003e0.601-1.342\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.6335%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePartner\u0026rsquo;s age\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4969%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8012%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0683%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.6335%;\"\u003e\n \u003cp\u003e\u0026lt;25\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4969%;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8012%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0683%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.6335%;\"\u003e\n \u003cp\u003e25-34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4969%;\"\u003e\n \u003cp\u003e1.203\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8012%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.05\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0683%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.004-1.443\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.6335%;\"\u003e\n \u003cp\u003e35 and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4969%;\"\u003e\n \u003cp\u003e1.045\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8012%;\"\u003e\n \u003cp\u003e0.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0683%;\"\u003e\n \u003cp\u003e0.755-1.447\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.6335%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParity\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4969%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8012%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0683%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.6335%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4969%;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8012%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0683%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.6335%;\"\u003e\n \u003cp\u003e2-4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4969%;\"\u003e\n \u003cp\u003e0.755\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8012%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0683%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.635-0.897\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.6335%;\"\u003e\n \u003cp\u003e5 and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4969%;\"\u003e\n \u003cp\u003e0.761\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8012%;\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0683%;\"\u003e\n \u003cp\u003e0.542-1.068\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.6335%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePreferred time for PPFP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4969%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8012%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0683%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.6335%;\"\u003e\n \u003cp\u003eImmediately\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4969%;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8012%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0683%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.6335%;\"\u003e\n \u003cp\u003eAt 6 weeks postpartum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4969%;\"\u003e\n \u003cp\u003e1.022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8012%;\"\u003e\n \u003cp\u003e0.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0683%;\"\u003e\n \u003cp\u003e0.512-2.040\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.6335%;\"\u003e\n \u003cp\u003eAt 6 months postpartum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4969%;\"\u003e\n \u003cp\u003e0.996\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8012%;\"\u003e\n \u003cp\u003e0.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0683%;\"\u003e\n \u003cp\u003e0.531-1.867\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.6335%;\"\u003e\n \u003cp\u003eAt one year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4969%;\"\u003e\n \u003cp\u003e1.192\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8012%;\"\u003e\n \u003cp\u003e0.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0683%;\"\u003e\n \u003cp\u003e0.642-2.213\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.6335%;\"\u003e\n \u003cp\u003eAt 2 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4969%;\"\u003e\n \u003cp\u003e1.481\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8012%;\"\u003e\n \u003cp\u003e0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0683%;\"\u003e\n \u003cp\u003e0.796-2.755\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.6335%;\"\u003e\n \u003cp\u003eUndecided\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4969%;\"\u003e\n \u003cp\u003e1.994\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8012%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.03\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0683%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.09-3.646\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.6335%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEver been advised by a friend on FP methods\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4969%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8012%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0683%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.6335%;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4969%;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8012%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0683%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.6335%;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4969%;\"\u003e\n \u003cp\u003e1.358\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8012%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0683%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.171-1.575\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Discussion","content":"\u003cp\u003ePostpartum family planning (PPFP) initiation within 12 months after childbirth is crucial for safe motherhood, reducing unintended pregnancies, and ensuring appropriate birth spacing, reducing morbidity and mortality risks\u0026nbsp;(40).\u0026nbsp;The postpartum period presents a high risk of conception due to the early return of fertility, underlining the importance of PPFP\u0026nbsp;(41). This study aimed to determine the utilization and associated factors of PPFP among postpartum women in Alebtong District, Northern Uganda. In this predominantly rural setting, we found that approximately 5 in 12 postpartum women reported using PPFP, with a utilization rate of 41.6%. Our findings both align with and diverge from other studies, highlighting regional variations: This rate is higher than the national PPFP coverage of 35% in Uganda, but slightly lower than the 44% reported in a similar study conducted in Arba Minch town, South Ethiopia(23,27). A study in rural India, Kailali district, Nepal found a lower PPFP utilization rate of 32.8%(42). Much lower prevalences have been reported in Uganda (10%) and Ethiopia (20.7%)\u0026nbsp;(30,43). In a systematic review, to assess postpartum family planning use and its determinants among women in LMICs of SSA, a pooled prevalence of 37.41% was reported, while research in urban Ethiopia, \u0026nbsp;Addis Ababa reported a higher uptake of \u0026nbsp;71.8%(44,45)\u0026nbsp;highlighting the potential impact of urbanization and healthcare access. Despite this relatively higher rate, PPFP uptake remains suboptimal, likely due to socio-cultural barriers, economic constraints, and limitations of the facility-based service delivery model(40,46,47). Additionally, research in Ethiopia\u0026apos;s Tigray region emphasized the importance of immediate postpartum family planning counseling(48). These comparisons suggest the need for targeted, culturally sensitive interventions to address the unique challenges faced by postpartum women. Plans should involve community-based PPFP programs that integrate with other maternal and child health services, incorporating a deep understanding of local sociocultural contexts\u0026nbsp;(49,50). The study indicates a higher utilization rate of PPFP than the national average but suggests further research on barriers to uptake and targeted interventions in Northern Uganda.\u003c/p\u003e\n\u003cp\u003eOur study\u0026apos;s findings stress the critical need for the Ugandan Ministry of Health to prioritize expanding access to postpartum family planning (PPFP) services at both health facility and community levels. This expansion is crucial for accelerating progress toward Sustainable Development Goal 3.7,\u0026nbsp;which aims to ensure universal access to sexual and reproductive healthcare services by 2030, it identifies the need to solve problems such as insufficient funding for healthcare systems, lack of access to quality reproductive care including modern contraception and medically safe abortion that have led to high unwanted pregnancy rates and preventable maternal deaths. Investing in quality health care for all, including easy family planning access, helps slow population growth and improves lives. Very high populations facilitate disease transmission and hurt public health, especially in areas like Northern Uganda, where healthcare services are overburdened(51).\u003c/p\u003e\n\u003cp\u003ePPFP utilization significantly increases with older maternal age with women aged 35 years and above having 2.23 higher odds of use compared to those below 34 years. This age-related trend aligns with a similar study conducted in Assiut Governorate Upper Egypt in which older women had 2.15 higher odds of using PPFP and is supported by the results of the EFHS-2021(52,53). The positive association between advanced maternal age and PPFP utilization can be attributed to increased exposure to childbirth, family planning use, and information, as suggested by different studies(44,54,55). This accumulated experience likely translates to enhanced knowledge about PPFP and its prompt use among older women. However contrary to this, a study conducted in Indonesia found the highest unmet need for PPFP among older women(56). \u0026nbsp;Most literature on PPFP utilization found no significant association between age and PPFP use, especially in a study done in 68 districts in Uganda, and the Amhara region of Ethiopia (20.7%)(30,43). This highlights the potential influence of local contexts on PPFP utilization patterns. The age disparity in PPFP utilization noted in our study and others emphasizes the need for targeted interventions, and\u0026nbsp;tailored approaches to improve PPFP in low- and middle-income countries(57). It is recommended that the Ugandan Ministry of Health disseminate PPFP information to reach women across all reproductive age categories achievable through diverse media platforms such as radio, television, newspapers, and community women\u0026apos;s groups, an approach supported by evidence on successful PPFP interventions(58\u0026ndash;60). Additionally, integrating PPFP services with other maternal and child health programs could enhance accessibility and utilization across age groups(61). Future research should explore the effectiveness of these targeted communication strategies and integrated service delivery models in improving PPFP utilization among younger women in the Ugandan context.\u003c/p\u003e\n\u003cp\u003ePPFP utilization significantly increases with the\u0026nbsp;level of education, in our study completion of primary education level had 2.33 higher odds of utilization. This is similar to a previous mixed method study at Muhoroni subcounty, Kisumu County, Kenya, which reported that women who had attained secondary education were more likely to use PPFP compared to those who had primary education(55). Similarly in 68 districts in Uganda, as study with 10% utilization of PPFP highlighted that the likelihood of using a modern FP method postpartum also increased, corresponding to increases of 30%, 50% and 60% among mothers with primary, secondary and higher than secondary education respectively compared to those mothers with no education(30). Clear as primary level of education being significantly associated with utilization in our study, most studies indicate significant association at secondary or higher \u0026nbsp;level of education(45,62), this could be attributed to the fact that our study setting was rural and more under sourced in relation to education services. Education likely enhances awareness, knowledge, and decision-making skills regarding life events. Moreover, family planning is often included in school curricula as part of sex education, exposing women to various birth control methods and their benefits. These findings indicate the importance of collaboration between the Ugandan Ministry of Health and the Ministry of Education to emphasize reproductive health education at all educational levels. Such efforts could create effective awareness and optimize PPFP utilization among women. A study in Minch town, South Ethiopia indicated association with much higher levels of education such college\u0026nbsp;(27). Contrary to our study, a study in Southeast Ethiopia indicated that the utilization of PPFP was higher among women whose partners had completed a secondary level of education than those with no formal education\u0026nbsp;(63,64). This might be because partner education can enhance understanding of men\u0026apos;s involvement in family planning and assist in contraception use.\u003c/p\u003e\n\u003cp\u003eFurthermore, our study found that prior knowledge/information through friends about postpartum family planning services was associated with higher service utilization compared to those lacking such knowledge. This result corroborates findings from a systematic review in LMICs in SSA, \u0026nbsp;where mothers knowledgeable about family planning likely used the services\u0026nbsp;(45). Similarly several studies have shown that women who ever heard about modern FP methods, previous FP information, and FP use before index pregnancy were more likely to use\u0026nbsp;(43)\u0026nbsp;(40)\u0026nbsp;(54)\u0026nbsp;(44). Exposure to reproductive health information during antenatal care visits and health outreach campaigns likely equips mothers with the knowledge necessary to make informed decisions about family planning use(45,53,54). This is supported by evidence that limited knowledge of contraceptive methods contributes to the high unmet need among postpartum women for contraceptive methods\u0026nbsp;(56). These findings highlight the need for a multi-sectoral approach to family planning. To boost awareness and improve knowledge among women of reproductive age, the Ugandan Ministry of Health should collaborate with other reproductive health stakeholders to enhance health service delivery. Such collaborative efforts could significantly impact family planning utilization rates and, consequently, improve maternal and child health outcomes.\u003c/p\u003e\n\u003cp\u003eThe economic hardship in Alebtong District, Northern Uganda with most participants living below the international poverty line of USD 1.9 per day significantly hinders postpartum family planning (PPFP) uptake, necessitating multifaceted interventions to address both economic and healthcare challenges. This is in line with recent literature on socioeconomic determinants of health in low- and middle-income countries(65). The opportunity costs of seeking healthcare, such as lost wages and transportation expenses, create substantial barriers for impoverished families\u0026nbsp;(40,56,66). Low income often correlates with lower education levels, impacting health literacy and healthcare navigation abilities. To address these interlinked challenges, an all-inclusive approach combining income support programs, enhanced accessibility of family planning services through community outreach, financial literacy education, and community empowerment initiatives are proposed. This strategy, supported by evidence from integrated development programs and community-based family planning interventions, could potentially improve PPFP uptake and contribute to better maternal and child health outcomes in this vulnerable population\u0026nbsp;(59,67).\u003c/p\u003e\n\u003cp\u003eOur study reveals that postpartum mothers who were aware of the availability of family planning services had nearly five times higher odds of utilizing these services compared to those who were unaware. This finding aligns with previous research conducted in Nigeria which reported sub-optimal use of PPFP attributed to\u0026nbsp;health-related factors including cost, difficulty accessing services, and procurement difficulties as the\u0026nbsp;main challenges that clients face in obtaining PPFP(68). Similarly, Andualem et al. found a positive association between PPFP awareness and utilization in their study(64). The stronger association observed in our study suggests that awareness might play an even more crucial role in our specific context, possibly due to unique local factors or interventions. This relationship between awareness and utilization is further supported by studies in other settings, such as\u0026nbsp;Iraq, where\u0026nbsp;it is reported that women with good knowledge of PPFP are\u0026nbsp;more likely to use PPFP services(31). The consistent positive association across these studies shows the critical importance of awareness in driving PPFP utilization(29). However, it\u0026apos;s worth noting that awareness could be possibly created by counseling during ANC, delivery and postnatal care, and\u0026nbsp;FP education after delivery at immunization, in several studies have been attributed to increased knowledge and thus utilization of PPFP services(54,69). These have been associated with increased uptake, especially in a study by Mohammed et al in which receiving information about PPFP from healthcare providers increased the likelihood of using the services(53). Our findings, in conjunction with these studies, highlight the need for comprehensive strategies that not only raise awareness but also address other potential barriers to PPFP utilization(60,61). The Ministry of Health in Uganda and other stakeholders should ensure continuous supply of family planning methods and targeted awareness campaigns, while future research should explore effective methods and factors influencing awareness and utilization in the precise context.\u003c/p\u003e\n\u003cp\u003eOur study reveals that mothers who delivered before arriving at the hospital had significantly lower odds (0.16 times) of utilizing postpartum family planning (PPFP) services compared to those who delivered in the hospital. While direct comparisons are limited due to the scarcity of similar studies, this finding aligns with research suggesting that the place of delivery significantly influences postpartum care utilization(54)\u0026nbsp;(62). For instance, studies by Tilahun et al have shown that giving birth outside a health facility can affect subsequent healthcare decisions based on postpartum and labor health outcomes(54,62). This delay in accessing PPFP services among mothers who deliver before reaching the hospital likely stems from the fact that most PPFP services are primarily provided within healthcare settings(31,49). \u0026nbsp;Our findings reecho the need for the health sector to implement comprehensive strategies to ensure all expectant mothers receive skilled birth attendants and timely postpartum care, regardless of their delivery location. This could include developing digital tracking systems for pregnant women, strengthening emergency health units and referral systems, and extending PPFP services beyond traditional healthcare settings(61)\u0026nbsp;(50). Furthermore, future research should explore innovative approaches to providing PPFP services to women who deliver outside of health facilities, potentially through community-based interventions or mobile health units(58,61). By addressing these gaps, we can work towards improving PPFP utilization rates and, ultimately, maternal and child health outcomes in our region.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy limitations and strength\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWhile providing valuable insights into postpartum family planning (PPFP) service utilization among 483 postpartum women, our study wasn\u0026rsquo;t without limitations. The reliance on self-reported data may have introduced social desirability and recall bias in PPFP service utilization reporting and recall bias for obstetric variables and postnatal care attendance, particularly for previous postpartum periods. \u0026nbsp;To avoid potential biases, participants were thoroughly explained and encouraged to provide honest responses, and questions were centered on the most recent delivery. The study\u0026apos;s strengths lie in its large sample size, robust dataset, and focus on the critical postpartum care period, despite its limitations. The identified factors provide valuable contextual insights and a solid foundation for future interventional studies. This study provides crucial data on PPFP utilization in our setting, potentially guiding targeted interventions to enhance maternal and child health outcomes despite constraints.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThe study found a low 41.6% utilization of postpartum family planning among postpartum women attending health facilities in Alebtong District northern Uganda. Postpartum mothers aged 35 years above, who completed a primary level of education, had spontaneous vaginal delivery without difficulties, and had prior information on postpartum and immediate postpartum family planning were more likely to utilize postpartum family planning compared to their counterparts. Availability of postpartum and immediate postpartum family planning at health facilities likely resulted in utilization compared to when it was lacking.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRecommendations\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBased on our findings and existing literature, we propose several recommendations to enhance postpartum family planning (PPFP) utilization in Uganda. Primarily, the Ministry of Health should prioritize expanding access to PPFP services at both health facility and community outreach levels, aligning with SDG target 3.7. This expansion should be coupled with a comprehensive communication strategy utilizing diverse media platforms to disseminate PPFP information across all reproductive age categories\u0026nbsp;(68).\u003c/p\u003e\n\u003cp\u003eCollaboration with the Ministry of Education is crucial to integrate reproductive health education at all educational levels, potentially addressing the lower PPFP utilization among younger women observed in our study. We advocate for a multisectoral approach, engaging various stakeholders to boost awareness and improve health service delivery. Ensuring a continuous supply of family planning methods at all health facility levels is essential for facilitating easy access and use(70)\u0026nbsp;(71).\u003c/p\u003e\n\u003cp\u003eAdditionally, implementing a digital tracking system for pregnant mothers could help ensure skilled birth attendance care, regardless of location, addressing the lower PPFP utilization among women who deliver before reaching health facilities(72). Finally, strengthening emergency health units and referral teams for pregnant women could improve tracking of pregnant and postpartum women, potentially increasing their engagement with PPFP services(73). These evidence-based recommendations, if implemented, could significantly improve PPFP utilization rates in Uganda, contributing to better maternal and child health outcomes.\u003c/p\u003e"},{"header":"DECLARATIONS","content":"\u003cp\u003e\u003cstrong\u003eEthical Considerations and consent, assent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe research protocol was reviewed and approved by the Gulu University Research and Ethics Committee (GUREC-2022-341). Administrative clearance was obtained from the office of the District Health Officer, Alebtong District, and the\u0026nbsp;participating health facility in charges. Written informed consent was obtained from postpartum women aged 18-49 years. The study was performed following the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data sets used and/or analyzed during the study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of Interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received funding from Center for International Reproductive Health Training (CIRHT), University of Michigan.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors Contribution\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEmmanuel Madira/\u0026nbsp;\u003c/strong\u003eparticipated intopic development, protocol development, data collection, data analysis, and manuscript writing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAnna Grace Auma\u003c/strong\u003e/ participated in protocol writing, data collection, data analysis, manuscript writing, and reviewing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAmir Kabunga/\u0026nbsp;\u003c/strong\u003eparticipated in protocol development, data collection, data analysis, and manuscript writing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMary Goretti Asiimwe/\u0026nbsp;\u003c/strong\u003eparticipated in protocol development, data collection, data analysis, and manuscript writing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAndrew Acobi\u003c/strong\u003e/ participated in protocol development, data collection, data analysis, and manuscript writing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eBeth Namukwana\u003c/strong\u003e/ participated in topic development, protocol development, data collection, and manuscript writing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRonald Izaruku\u003c/strong\u003e/ participated in protocol development, data collection, data analysis, and manuscript writing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eVicky Caroline Acayo\u003c/strong\u003e/ participated in data analysis, manuscript writing, and manuscript review.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePeter Paul Opio\u003c/strong\u003e/ participated in data analysis, manuscript writing, and manuscript review.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOpio Okaka Dokotum/\u003c/strong\u003e participated in protocol development, data collection, data analysis, and manuscript writing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSpecial gratitude goes out to the Centre for Sexual and Reproductive Health, University of Michigan for funding this project and for the technical support, the management of the different health facilities and postpartum women in Alebtong District for their participation in this research study. We also acknowledge the management and staff of Lira University particularly the faculty of nursing and midwifery for their support in terms of technical support towards the realization of this research project.\u003c/p\u003e\n\u003cp\u003ePre-Publication Support Service (PREPSS) supported the development of this manuscript by providing author training, as well as pre-publication peer-review and copy editing.\u003c/p\u003e\n\u003cp\u003eThis research was funded with support from Center for International Reproductive Health Training at University of Michigan (CIRHT-UM).\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eBearak J, Popinchalk A, Ganatra B, Moller AB, Tun\u0026ccedil;alp \u0026Ouml;, Beavin C, et al. Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990\u0026ndash;2019. 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Open Access Journal of Contraception. 2023 Dec 31;14:15\u0026ndash;21.\u003c/li\u003e\n \u003cli\u003eOchen AM, Chi PC. Family planning uptake and its associated factors among women of reproductive age in Uganda: an insight from the Uganda Demographic and Health Survey 2016 [Internet]. medRxiv; 2022 [cited 2023 Aug 5]. p. 2022.08.31.22279440. Available from: https://www.medrxiv.org/content/10.1101/2022.08.31.22279440v1\u003c/li\u003e\n \u003cli\u003eVandenbroucke JP, P VJ, Vandenbroucke JP, Elm E von, Erik von E, Elm E von, et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration. Translation to Russian. Digital Diagnostics. 2021 Aug 10;2(2):119\u0026ndash;69.\u003c/li\u003e\n \u003cli\u003eNugussa B, Solomon T, Tadelu H. Modern Postpartum Family Planning and Associated Factors Among Postpartum Women in a Rural District of Ethiopia, 2021: A Cross-Sectional Study. INQUIRY. 2023 Jan 1;60:00469580231153268.\u003c/li\u003e\n \u003cli\u003eNshisso LD. Lived Experiences of Congolese Women With Postpartum Family Planning Counseling in the United States [Internet] [PhD Thesis]. Walden University; 2024 [cited 2024 Oct 3]. Available from: https://search.proquest.com/openview/842c4927f14088de3929a3ec700bd7b0/1?pq-origsite=gscholar\u0026amp;cbl=18750\u0026amp;diss=y\u003c/li\u003e\n \u003cli\u003eJoshi AK, Tiwari DP, Poudyal A, Shrestha N, Acharya U, Dhungana GP. Utilization of Family Planning Methods Among Postpartum Mothers in Kailali District, Nepal. International Journal of Women\u0026rsquo;s Health. 2020 Jun 24;12:487\u0026ndash;94.\u003c/li\u003e\n \u003cli\u003eAshebir W, Tadesse T. Associated Factors of Postpartum Modern Contraceptive Use in Burie District, Amhara Region, Ethiopia. Journal of Pregnancy. 2020;2020(1):6174504.\u003c/li\u003e\n \u003cli\u003eTafa L, Worku Y. Family planning utilization and associated factors among postpartum women in Addis Ababa, Ethiopia, 2018. PLOS ONE. 2021 Jan 22;16(1):e0245123.\u003c/li\u003e\n \u003cli\u003eYemane TT, Bogale GG, Egata G, Tefera TK. Postpartum Family Planning Use and Its Determinants among Women of the Reproductive Age Group in Low-Income Countries of Sub-Saharan Africa: A Systematic Review and Meta-Analysis. International Journal of Reproductive Medicine. 2021;2021(1):5580490.\u003c/li\u003e\n \u003cli\u003eNibret Mihretie G, Simegn A, Dereje A, Gebrehana H, Getie A, Getnet B, et al. Postpartum Modern Contraceptive Utilization and Associated Factors Among Women Who Gave Birth in the Last 12 Months in Addis Zemen, South Gondar, Ethiopia: Community-Based Cross-Sectional Study. International Journal of Women\u0026rsquo;s Health. 2020 Dec 24;12:1241\u0026ndash;51.\u003c/li\u003e\n \u003cli\u003eOkoeguale J, Osagiede EF, Idumwonyi O, Ehigiegba AE. Factors influencing the use of modern contraceptives amongst postpartum women in a rural tertiary hospital in South-South Nigeria. African Journal of Reproductive Health. 2022 Apr 24;26(1):15\u0026ndash;23.\u003c/li\u003e\n \u003cli\u003eSilesh M, Lemma T, Abdu S, Fenta B, Tadese M, Taye BT. Utilisation of immediate postpartum family planning among postpartum women at public hospitals of North Shoa Zone, Ethiopia: a cross-sectional study. BMJ Open. 2022 Feb 1;12(2):e051152.\u003c/li\u003e\n \u003cli\u003eAbbasi Y, Shaikh SR, Memon KN. Barriers and missed opportunities towards immediate and early post-partum family planning methods in Pakistan. The Professional Medical Journal. 2020 Jul 10;27(07):1448\u0026ndash;53.\u003c/li\u003e\n \u003cli\u003eKabra R, Pradhan P, Hyder MKA, Pokhrel T, Aryal K, Jayathalika A, et al. Gaps and evidences on programming postpartum family planning services in Nepal [Internet]. Gates Open Research; 2022 [cited 2024 Oct 3]. Available from: https://gatesopenresearch.org/articles/6-84\u003c/li\u003e\n \u003cli\u003eKulchar R, Edington T, Mangat S, Crites S, So B, Kim I, et al. Health System Comparative Analysis: The United States and Uganda. Intersect: The Stanford Journal of Science, Technology, and Society [Internet]. 2020 [cited 2024 Oct 7];14(3). Available from: https://ojs.stanford.edu/ojs/index.php/intersect/article/view/1937\u003c/li\u003e\n \u003cli\u003eCapmas E. Central agency for public mobilization and statistics. Annu Marriage Divorce Stat Gov eg[Cited 2022 Feb 4] Available from: https://censusinfo capmas gov eg/Metadata-en-v4. 2022;2.\u003c/li\u003e\n \u003cli\u003eMohammed HM, Zaky MA, Hany AM. Postpartum family planning among women attending maternal and child health centers in Assiut Governorate, Upper Egypt. J Egypt Public Health Assoc. 2024 Jun 10;99(1):13.\u003c/li\u003e\n \u003cli\u003eTilahun T, Bekuma TT, Getachew M, Oljira R, Seme A. Barriers and determinants of postpartum family planning uptake among postpartum women in Western Ethiopia: a facility-based cross-sectional study. Arch Public Health. 2022 Jan 12;80(1):27.\u003c/li\u003e\n \u003cli\u003eOoko L, Ngure K, Mativo N. FACTORS ASSOCIATED WITH UPTAKE OF POSTPARTUM FAMILY PLANNING METHODS IN RURAL KENYA. EAST AFRICAN MEDICAL JOURNAL. 2019;\u003c/li\u003e\n \u003cli\u003eWilopo SA, Setyawan A, Pinandari AW, Prihyugiarto T, Juliaan F, Magnani RJ. Levels, trends and correlates of unmet need for family planning among postpartum women in Indonesia: 2007\u0026ndash;2015. BMC Women\u0026rsquo;s Health. 2017 Nov 28;17(1):120.\u003c/li\u003e\n \u003cli\u003eChandrasekar A, Warren E, Free C, Mbogua J, Curtin E, Gazeley U, et al. mHealth interventions for postpartum family planning in LMICs: A realist review. PLOS Global Public Health. 2024 Jul 18;4(7):e0003432.\u003c/li\u003e\n \u003cli\u003eIbrahim WH, Hassan MM, Badia TS. Effect of WhatsApp\u0026rsquo;s counseling on improvement usage of family planning methods among postpartum women. Assiut Scientific Nursing Journal. 2023 May 1;11(37):228\u0026ndash;40.\u003c/li\u003e\n \u003cli\u003eTran NT, Seuc A, Tshikaya B, Mutuale M, Landoulsi S, Kini B, et al. Effectiveness of post-partum family planning interventions on contraceptive use and method mix at 1 year after childbirth in Kinshasa, DR Congo (Yam Daabo): a single-blind, cluster-randomised controlled trial. The Lancet Global Health. 2020 Mar 1;8(3):e399\u0026ndash;410.\u003c/li\u003e\n \u003cli\u003eSagiron E, Jarelnape A. Effects of community-based family planning education program on knowledge of family planning methods among married women in Khartoum state, Sudan [Internet]. 2022 [cited 2024 Oct 6]. Available from: https://www.researchsquare.com/article/rs-1402322/v2\u003c/li\u003e\n \u003cli\u003eZimmerman LA, Yi Y, Yihdego M, Abrha S, Shiferaw S, Seme A, et al. Effect of integrating maternal health services and family planning services on postpartum family planning behavior in Ethiopia: results from a longitudinal survey. BMC Public Health. 2019 Nov 4;19(1):1448.\u003c/li\u003e\n \u003cli\u003eDagnew GW, Asresie MB, Fekadu GA, Gelaw YM. Modern contraceptive use and factors associated with use among postpartum women in Ethiopia; further analysis of the 2016 Ethiopia demographic and health survey data. BMC Public Health. 2020 Dec;20(1):1\u0026ndash;9.\u003c/li\u003e\n \u003cli\u003eJima GH, Garbaba WB. Postpartum family planning utilization and associated factors among women who gave birth in the last 12 months prior to the study in Lode Hetosa District, South East Ethiopia. J Women\u0026rsquo;s Heal Care [Internet]. 2020 [cited 2024 Oct 7];9(3). Available from: https://www.researchgate.net/profile/Gebi-Jima/publication/344167092_Postpartum_Family_Planning_Utilization_and_\u003cbr\u003eAssociated_Factors_Among_Women_Who_Gave_Birth_in_the_Last_12_Months_\u003cbr\u003ePrior_to_the_Study_in_Lode_Hetosa_District_South_East_Ethiopia/links/5f57c9d09285\u003cbr\u003e1c250b9fbe3c/Postpartum-Family-Planning-Utilization-and-Associated-Factors-Among-Women-Who-Gave-Birth-in-the-Last-12-Months-Prior-to-the-Study-in-Lode-Hetosa-District-South-East-Ethiopia.pdf\u003c/li\u003e\n \u003cli\u003eAndualem G, Aklilu A, Belay G, Feyisa W, Alemnew F. Factors associated with utilization of modern postpartum family planing methods during the extended postpartum period among mothers who gave birth in the last 12 months at Injibara town, Northwest, Ethiopia: a cross-sectional study. Contracept Reprod Med. 2022 Dec 1;7(1):25.\u003c/li\u003e\n \u003cli\u003eAdde KS, Dickson KS, Amu H. Prevalence and determinants of the place of delivery among reproductive age women in sub\u0026ndash;Saharan Africa. PLOS ONE. 2020 Dec 31;15(12):e0244875.\u003c/li\u003e\n \u003cli\u003eAbiodun-Ojo OE, Alo OB, Akinyemi OO, Dele-Alonge OI, Maitanmi JO, Maitanmi BT. Awareness and Utilisation of Family Planning Among Postpartum Women in Ondo State, Nigeria. International Journal of Nursing, Midwife and Health Related Cases. 2024;12(1):1\u0026ndash;15.\u003c/li\u003e\n \u003cli\u003eHackett K, Huber-Krum S, Francis JM, Senderowicz L, Pearson E, Siril H, et al. Evaluating the Implementation of an Intervention to Improve Postpartum Contraception in Tanzania: A Qualitative Study of Provider and Client Perspectives. Global Health: Science and Practice. 2020 Jun 30;8(2):270\u0026ndash;89.\u003c/li\u003e\n \u003cli\u003eAkamike IC, Okedo-Alex IN, Eze II, Ezeanosike OB, Uneke CJ. Why does uptake of family planning services remain sub-optimal among Nigerian women? A systematic review of challenges and implications for policy. Contracept Reprod Med. 2020 Oct 31;5(1):30.\u003c/li\u003e\n \u003cli\u003eTefera K, Abuye M. Postpartum Family Planning Utilization and Associated Factors among women who gave birth in the past 12 months, Hawassa Town, Southern Ethiopia: a community based cross-sectional study. International Journal of Women\u0026rsquo;s Health Care. 2020 Jun 22;5(2):51\u0026ndash;9.\u003c/li\u003e\n \u003cli\u003eKananura RM, Birabwa C, Ssanyu JN, Kizito F, Kagaha A, Namutanba S, et al. Increasing coverage and uptake of voluntary family planning in urban areas of central-eastern Uganda: an implementation research study protocol [Internet]. Research Square; 2023 [cited 2024 Nov 11]. Available from: https://www.researchsquare.com/article/rs-1473029/v1\u003c/li\u003e\n \u003cli\u003eMruts KB, Tessema GA, Gebremedhin AT, Scott J, Pereira G. The effect of family planning counselling on postpartum modern contraceptive uptake in sub-Saharan Africa: a systematic review. Public Health. 2022;206:46\u0026ndash;56.\u003c/li\u003e\n \u003cli\u003eLeight J, Hensly C, Chissano M, Safran E, Ali L, Dustan D, et al. The effects of text reminders on the use of family planning services: evidence from a randomised controlled trial in urban Mozambique. BMJ Global Health. 2022 Apr 1;7(4):e007862.\u003c/li\u003e\n \u003cli\u003eObssa A, Hailemichael A, Belayihun B, Teshome L, Mvuezolo JJN, Molla Y, et al. Point of care quality improvement approach increases immediate postpartum family planning uptake: A field report from Sululta district, Oromia, Ethiopia. Ethiopian Journal of Health Development [Internet]. 2021 [cited 2024 Nov 11];35(5). Available from: https://www.ajol.info/index.php/ejhd/article/view/219880\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Center for International Reproductive Health Training (CIRHT), University of Michigan.","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Postpartum family planning, Utilization, Postpartum women, Alebtong District, Northern Uganda, predictors and contributing factors","lastPublishedDoi":"10.21203/rs.3.rs-5439114/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5439114/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003ePostpartum family planning (PPFP) uptake in Sub-Saharan Africa remains low, with Uganda reporting a 35% utilization rate. Despite the availability of both short-term and long-acting methods, the use of PPFP in Alebtong a rural district in Northern Uganda, East Africa, is particularly low. This low utilization persists despite the district's high fertility rate and being the country’s lowest number of registered family planning users. Family planning is a crucial public health program that significantly improves maternal and child health, reduces mortality rates, and enhances community well-being\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective\u003c/strong\u003e: To assess the level of utilization of PPFP and the contributing factors among postpartum women attending health facilities in a rural district of Northern Uganda.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: A descriptive cross-sectional study was conducted among 483 women within 12 months postpartum, recruited from five randomly selected health facilities between October and November 2022. Quantitative data was collected using interviewer-administered questionnaires. Data was analyzed using STATA version 17.0, with descriptive statistics and multivariate logistic regression performed at a 95% confidence interval to identify predictors of PPFP utilization.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e The utilization of postpartum family planning was 41.61% (95% CI: 37.17 – 46.15). Independent predictors or contributing factors to PPFP utilization included education level (primary: APR: 0.753; 95% CI: 0.641-0.883; p=\u0026lt;0.001), partner’s age (APR: 1.203; 95% CI: 1.004-1.443; p=0.05), parity (APR: 0.755; 95% CI: 0.635-0.897; p=0.001), uncertainty about timing for next pregnancy (APR: 1.994; 95% CI: 1.09-3.646; p=0.03), and advice from friends about PPFP methods (APR: 1.358; 95% CI: 1.171-1.575; p=\u0026lt;0.001).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: Low utilization of PPFP among postpartum women is influenced by various factors. The Ministry of Health should prioritize improving access to PPFP services through both health facilities and community outreach. A multisectoral approach is essential to raise awareness, and enhance knowledge among women and the population, and contribute to the achievement of Sustainable Development Goals.\u003c/p\u003e","manuscriptTitle":"Utilization of Postpartum Family Planning and Associated Factors among Postpartum Women Attending 5 Healthcare Facilities in a Rural District in Northern Uganda","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-11-15 12:44:54","doi":"10.21203/rs.3.rs-5439114/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2260712e-e485-4f86-b219-a082205d3f81","owner":[],"postedDate":"November 15th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":40150358,"name":"Nursing"}],"tags":[],"updatedAt":"2024-11-15T12:44:54+00:00","versionOfRecord":[],"versionCreatedAt":"2024-11-15 12:44:54","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5439114","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5439114","identity":"rs-5439114","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}