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New Data From PMA2020/Uganda Reveal Improving Trends in Family Planning and Quality of Care

Data from the fifth and most recent round of the Performance Monitoring and Accountability 2020 (PMA2020) survey in Uganda show significant improvements in family planning use and access in the country since 2014. Modern contraceptive methods are increasingly popular among married Ugandan women and the quality of care for contraceptive services at facilities has improved.

Researchers at the Makerere University School of Public Health in Kampala, Uganda held a national data dissemination event, with over 75 attendees, on August 17, 2017 to present new results from the PMA2020 annual family planning survey. Dr. Fred Makumbi and Simon Peter Kibira, Co-Principal Investigators for the PMA2020 program in Uganda, presented these and other key findings, highlighting trends in contraceptive use, quality of care at facilities and new PMA2020 data on Sayana Press uptake.

Mr. Kibira called on family planning implementing partners to use the data to identify ways to improve services to reach potential family planning users. He explained, “No woman with unmet need for limiting or spacing [pregnancies] should be left behind.” 

Modern contraceptive methods increasingly popular among married Ugandan women

An increasing percentage of married women are using modern methods of contraception – nearly 1 in 3 married women (32.3%) in 2017, compared to 1 in 4 women (25.7%) three years ago. Among the various modern methods, highly effective long-acting reversible methods (LARCs) are gaining popularity among the married population. The PMA2020 survey identified an increase from 6.0% in 2014 to 10.6% in 2017 of married Ugandan women (ages 15-49 years) using LARCs, and an 8% jump in implant use (12.7% to 20.8%).

The PMA2020 survey, which trains and employs resident female data collectors to conduct household and facility surveys, added new questions on Sayana Press use during this round of data collection (2017) in Uganda.

Dr. Makumbi explains, “Sayana Press, the new, easy-to-use subcutaneous injectable contraceptive, was rolled out in the country just two years ago in March 2015, and the PMA2017/Uganda survey was able to detect that among married women using modern contraception, 6.3% are currently using Sayana Press.”

Quality of care for contraceptive services at facilities improves, stock-outs persist

The PMA2020 data show consistent improvements in the quality of care provided by both public and private health facilities. The survey measured quality via questions on whether users were counseled on side effects of family planning methods, if they received their method of choice and if the method was chosen by themselves or together with their partner or provider. All three indicators showed improvement since 2014. The percentage of clients who reported that they received counseling on side effects was 53.9% in 2014 and 57.5% in 2017. Nearly all clients (96.9%) received their method of choice, an improvement since 2014 when about 9 in 10 users did (91.7%). The percentage of users who decided on their current method on their own or jointly with their partner or provider rose from 88.9% to 93.6% in three years.

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While services are improving, commodity stock-outs at both private and public facilities remain an issue, particularly for pills. The 2017 data show that almost a fourth of public facilities (24.5%) and 1 in 8 private facilities (12.6%) were out of stock of pills. Male condoms were out of stock at 14.7% of private facilities. Most private facilities were not offering IUDs, implants, or Sayana Press, with only 9.5%, 12.6%, and 4.2% offering, respectively. Approximately 20% of public facilities were found to be offering Sayana Press.

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PMA2020 uses innovative mobile technology to support low-cost, rap­id-turnaround surveys to monitor key family planning and other health and development indicators on an annual basis. The program is implemented by local university and research organi­zations in 11 countries, deploying a cadre of female resident data collectors trained in mobile data collection. PMA2020/Uganda is led by the Makerere University’s School of Public Health at the Col­lege of Health Sciences (MakU/CHS/MakSPH), in collaboration with the Uganda Bureau of Statistics (UBoS) and the Ministry of Health. Overall direction and support is provided by the Bill & Melinda Gates Institute for Population and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health and funded by the Bill & Melinda Gates Foundation.

PMA2017/Uganda-R5, the fifth round of data collection in Uganda, used a two-stage cluster design with urban-rural and region as strata was used. For this survey round, a new set of 110 enumeration areas (EAs) were selected, adjacent to EAs used in the previous four rounds, drawn by UBoS from its master sampling frame. In each EA, households and health facilities were listed and mapped, with 44 households randomly selected. Households were surveyed and occupants enumerated. All eligible females age 15 to 49 were contacted and consented for interviews. The final sample (and completion rates) included 4,503 households (95.7%), 4,119 de facto females (96.0%) and 336 health facilities (96.3%). Data collection was conducted between April to May 2017.

Download the PMA2017/Uganda Round 5 data brief.

For more information visit http://pma2020.org/program-countries/uganda.

Thursday, August 17, 2017