Introduction to family planning

1. Introduction to Family planning

2. Objectives
By the end of this session, we will able to:
Define Family Planning
Describe the components of FP services
Identify contraceptive methods available in Ethiopia
Describe current contraceptive updates

3. Definition of family planning
 Family planning is defined as the ability of
individuals and couples to anticipate and
attain their desired number of children and
the spacing and timing of their births

4. Benefits of FP and its Role in Achieving
National Development Goals
 Health benefits
 Social and economic benefits
 Individual:
 Family
 Community
 Global

5. Low FP service
Coverage
High rate of
Unwanted pregnancy
Unsafe Abortion
Family/
Population size
Increase
maternal Morbidity
High
MMR
Poverty
Migration CSW
Environmental
Degradation
Ill Health
Ill Health and Social Wellbeing

6. RH situation in Ethiopia
 Family Planning
 Early marriage
 HIV/AIDS
 Harmful Traditional Practices (HTPs)
 Population and development

7. Ethiopian Population 1900-2020
(Past, Present, Future)
0
20
40
60
80
100
120
1900 1925 1940 1955 1960 1970 1980 1990 2000 2005 2010 2015 2020
Millions

8. Indicator Value
Population in Millions 74 Million
Total fertility rate 4.8 (DHS 2011)
Infant mortality rate 59/1000 (DHS 2011)
Under five mortality rate 88/1000(DHS 2011)
Maternal mortality ratio 590/100000-Lancet report
Antenatal coverage 34% (DHS 2011)
Contraceptive Prevalence rate 28.6%(DHS 2011)
Health status indicators

9. CPR-Any methods
5
8
15
28.6
0
5
10
15
20
25
30
35
NFFS1990 EDHS 2000 EDHS2005 EDHS 2011

10. Family Planning
0
10
20
30
40
50
60
NFFS1990 EDHS 2000 EDHS2005 EDHS 2011
5
8
15
28.6
36 34
25
44
49
53.6
percent
CPR
Unmet FP need
Total Demand
for FP

11. Family planning …
• Dramatic progress in meeting clients reproductive
intentions
– ↑CPR
– ↓Unmet need
• New MOH strategy for making services available and
accessible
– Health Development Army
6%
36%
15%
34%
29%
25%
0%
10%
20%
30%
40%
50%
60%
2000 2005 2011
Umet need
CPR

12. Family planning by method
Method 2000
DHS
2005
DHS
2011 DHS
Any method 8.1 14.7 28.6
Modern method 6.3 13.9 27.3
Pill 2.5 3.1 0.3
IUCD 0.1 0.2 2.1
Injectables 3.1 9.9 20.8
Condom 0.3 0.2 0.2
Implants 0.0 0.2 3.4
PM N a 0.2 0.5

13. FP Methods available in Ethiopia
 Natural Family Planning
Methods
 Abstinence
 Fertility awareness based
methods:
 Standard Days Method
(SDM)
 Rhythm (Calendar)
Method
 Cervical Mucus (Billings
ovulation) Method
 Sympto-thermal Method
 Lactational Amenorrhea
Method (LAM),
 Withdrawal Method
 Modern Family Planning
Methods
 Condoms/Diaphragms and
other barrier methods
 Vaginal Contraceptive
Foam Tablet and Jellies
 Emergency Contraceptives
 Progestin-Only Pills
 Combined Oral
Contraceptives
 Injectable contraceptives
 Implants
 IUCD
 Bilateral tubal ligation
 Vasectomy

14. Effectiveness
Source: CCP and WHO, 2007.
Oral contraceptives
Percentage of women pregnant in first year of use
Rate during typical use
Rate during perfect use
Female condom
Female sterilization
Implants
DMPA
Spermicides
Diaphragm w/spermicides
Male condom
IUD (TCu-380A)
0 10 15 20 25
5 30

15. Most effective
and nothing to remember.
Effective but must be carefully
used.
Fewer side-effects:
Very effective but must
be carefully used.
More side-effects:
Pills Injectables
Fertility
awareness-
based
methods
Vaginal
metho
ds
Male and
female
condom
Fewer side-effects,
permanent:
More side-effects:
Implants
IUD
Fewer side-effects:
LAM
Female
sterilization
Vasectomy
Comparing methods
IMPORTANT!
Only condoms protect
against
both
pregnancy
and STIs/HIV/AIDS

16. Contraceptive technology updates
 Biphasic and Tri-phasic COC pills
 Combined Patch
 Combined Vaginal Ring
 Levonorgestrel containing IUCD
 Progestin-releasing IUCD
 Mirena (Levonorgestrel Intrauterine System)/IUS: For
5 years
 U-kare IUCD(Cu-375): For 5 years
 Newer implants – Jadelle, Implanon, Sinoplant
 BTL – laparascopic approach
 Vasectomy- no-scalpel method

17. 17
Transdermal patch/ Ortho-evra
 Contains estrogen and progesterone
 1 patch per week for 3 weeks followed by a week off

18. 18
Vaginal ring/ Nuva ring
 Contains estrogen & progesterone
 Ring( 5 cm in diameter) in to the vagina for 3 weeks &
out the 4th week

19. Newer implants
Implanon
19

20. Newer IUCD:
Mirena (Levonorgestrel Intrauterine System)/IUS