Background
Methods
Data
Analysis
Method | How to usea
| Side effectsb
| When to returnb
| Protection from STIsa
|
---|---|---|---|---|
Pills or injectables | When to take | Initial side effects that may occur (such as nausea, weight gain, and breast tenderness) | Return to clinic if side effect appears | Method does not protect against STIs, including HIV |
What to do if forget | ||||
Condoms | Each can be only used once | Dual protection | ||
Intrauterine device (IUD) | Good for up to 5–12 years | Common side effects that may occur | Return to clinic 3–6 weeks post-insertion or after first menses | Method does not protect against STIs, including HIV |
Users should regularly check strings after each menstruation | Return to clinic if side effects continue | |||
Implants | Good for 3–5 years | Initial side effects that may occur (such as nausea, weight gain, breast tenderness) | Return to clinic if side effects continue | Method does not protect against STIs, including HIV |
Periodic abstinence or standard days method (SDM) | How to identify a woman’s fertile period | Method does not protect against STIs, including HIV | ||
No intercourse during woman’s fertile period without alternative method (condom) | ||||
Lactational amenorrhea method (LAM) | Must be exclusively (or near-exclusively) breastfeeding | Method does not protect against STIs, including HIV | ||
Not effective after menstruation begins again | ||||
Infant must be less than age 6 months |
Results
Description of Study Population
Variable | Category | % (Weighted N) |
---|---|---|
Client characteristics | ||
Client’s age | 14–24 | 26.6 (232) |
25–39 | 57.6 (502) | |
40–58 and don’t know | 15.8 (138) | |
Client’s education | No education | 49.3 (430) |
Primary and post-primary | 30.3 (264) | |
Secondary or more | 20.4 (178) | |
Fee paid for servicea
| 0–9 | 7.7 (67) |
10–499 | 14.4 (125) | |
500–999 | 46.6 (407) | |
1,000 or more | 31.3 (273) | |
Waiting time | No wait | 12.8 (111) |
Less than half hour | 29.4 (257) | |
Half hour to one hour | 19.8 (173) | |
One hour to 2 hours | 18.4 (161) | |
2 hours or more | 19.6 (171) | |
Client status | New client | 30.7 (268) |
Returning client | 69.3 (605) | |
Contraceptive method used | Pills | 24.8 (216) |
Progestin-only injection | 60.3 (526) | |
IUD or implantsb
| 14.9 (130) | |
Client left with a method | Yes | 94.0 (820) |
No | 6.0 (52) | |
Provider characteristics | ||
Provider category | Nurse or nurse assistantc
| 32.2 (281) |
Midwife and other | 67.8 (592) | |
Provider sex | Male | 18.2 (159) |
Female | 81.8 (713) | |
Provider years of education | 6–12 | 6.5 (56) |
13–16 | 58.2 (507) | |
17+ | 35.4 (309) | |
Provider training in family planning in the past 24 months | Yes | 45.1 (393) |
No | 54.9 (479) | |
Provider activities supervised | None | 20.7 (181) |
1–5 | 28.8 (251) | |
6 | 50.4 (440) | |
Provider has a job description | Yes | 57.8 (504) |
No | 42.2 (368) | |
Provider salary type | Monthly or daily salary | 63.7 (556) |
No regular salary but other compensation | 26.0 (227) | |
None | 10.2 (89) | |
Health facility characteristics | ||
Health facility type | Hospital/health center | 19.0 (166) |
Health post | 81.0 (706) | |
Locality | Urban | 52.1 (454) |
Rural | 47.9 (418) | |
Region | Northern | 18.0 (157) |
Dakar | 27.6 (241) | |
Thiès | 14.4 (126) | |
Central | 19.4 (169) | |
East | 4.4 (38) | |
South | 16.2 (142) | |
General structure equipment composite index | Low | 40.5 (353) |
Medium | 27.0 (235) | |
High | 32.6 (284) |
Family Planning Provider-Related Process
Family planning counseling | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Counseling on how to use method, side effects, and when to returna
| How to use methoda
| Side effectsb
| When to returnb
| Method protects from STIa
| |||||||
Variable | Category | % |
p-value | % |
p-value | % |
p-value | % |
p-value | % |
p-value |
Client’s age | 0.170 | 0.115 | 0.176 |
0.005
| 0.074 | ||||||
14–24 | 22.5 | 69.1 | 33.4 | 47.8 | 13.1 | ||||||
25–39 | 15.9 | 59.8 | 25.7 | 33.6 | 8.1 | ||||||
40–58 or don’t know | 17.1 | 62.1 | 31.6 | 31.9 | 4.5 | ||||||
Client’s education |
0.046
| 0.092 | 0.245 | 0.111 | 0.288 | ||||||
No education | 13.9 | 58.4 | 25.8 | 32.7 | 6.8 | ||||||
Primary & post primary | 22.2 | 66.5 | 29.9 | 40.5 | 10.8 | ||||||
Secondary or more | 21.0 | 67.0 | 33.6 | 42.4 | 11 | ||||||
Client status |
<0.001
|
<0.001
|
<0.001
|
<0.001
|
<0.001
| ||||||
New client | 38.1 | 89.2 | 53.9 | 60.8 | 18.1 | ||||||
Returning client | 8.9 | 50.8 | 18.0 | 27.0 | 4.8 | ||||||
Contraceptive method used |
0.013
|
<0.001
|
0.001
|
<0.001
| 0.547 | ||||||
Pills | 15.6 | 77.0 | 22.2 | 26.8 | 7.1 | ||||||
Progestin-only injection | 16.0 | 54.8 | 27.6 | 37.4 | 9.0 | ||||||
IUD or implantsc
| 29.0 | 70.3 | 45.2 | 54.5 | 11.4 | ||||||
Provider category | 0.586 | 0.186 | 0.592 | 0.707 | 0.063 | ||||||
Nurse or nurse assistant | 16.4 | 58.1 | 26.9 | 38.4 | 13.1 | ||||||
Midwife and other | 18.5 | 64.7 | 29.5 | 36.5 | 6.8 | ||||||
Provider sex | 0.955 | 0.158 | 0.789 | 0.257 |
0.039
| ||||||
Male | 18.1 | 56.3 | 27.4 | 42.7 | 16.1 | ||||||
Female | 17.8 | 64.0 | 29.0 | 35.9 | 7.2 | ||||||
Provider years of education | 0.972 | 0.513 | 0.401 | 0.770 | 0.267 | ||||||
6–12 | 18.4 | 52.9 | 37.7 | 31.8 | 2.3 | ||||||
13–16 | 18.2 | 64.0 | 29.8 | 36.7 | 10.3 | ||||||
17+ | 17.3 | 62.0 | 25.3 | 38.8 | 7.7 | ||||||
Provider training in family planning in the past 24 months | 0.644 | 0.789 | 0.740 | 0.394 | 0.862 | ||||||
No | 17.1 | 61.9 | 28.0 | 35.3 | 9.1 | ||||||
Yes | 18.8 | 63.2 | 29.5 | 39.3 | 8.6 | ||||||
Provider activities supervised | 0.646 | 0.127 | 0.277 | 0.125 | 0.105 | ||||||
None | 20.4 | 65.4 | 34.3 | 38.2 | 7.0 | ||||||
1–5 | 15.5 | 55.9 | 23.9 | 43.4 | 5.3 | ||||||
6 | 18.2 | 65.3 | 29.1 | 33.2 | 11.7 | ||||||
Provider has a job description | 0.814 | 0.478 | 0.803 | 0.618 | 0.550 | ||||||
No | 17.3 | 60.7 | 28.0 | 38.4 | 7.8 | ||||||
Yes | 18.2 | 64.0 | 29.2 | 36.2 | 9.6 | ||||||
Provider salary type | 0.346 | 0.340 | 0.740 | 0.532 |
0.003
| ||||||
Monthly or daily salary | 19.3 | 64.5 | 29.8 | 38.6 | 11.7 | ||||||
No regular salary but other compensation | 17.1 | 61.5 | 27.1 | 35.1 | 4.8 | ||||||
None | 10.7 | 53.8 | 25.7 | 32.8 | 1.4 | ||||||
Health facility type | 0.138 | 0.583 | 0.077 | 0.120 | 0.169 | ||||||
Hospital/health center | 13.9 | 64.4 | 22.7 | 31.5 | 5.9 | ||||||
Health post | 18.8 | 62.2 | 30.1 | 38.5 | 9.6 | ||||||
Locality | 0.295 |
<0.001
| 0.225 | 0.524 | 0.263 | ||||||
Urban | 19.7 | 70.1 | 31.3 | 35.8 | 7.1 | ||||||
Rural | 15.8 | 54.4 | 25.8 | 38.6 | 10.7 | ||||||
Region | 0.545 |
<0.001
| 0.179 |
0.010
| 0.339 | ||||||
Northern | 11.7 | 49.1 | 19.6 | 29.2 | 4 | ||||||
Dakar | 17.2 | 77.0 | 30.5 | 28.0 | 8.6 | ||||||
Thiès | 24.3 | 64.0 | 40.1 | 39.0 | 8.9 | ||||||
Central | 17.5 | 44.6 | 26.8 | 49.4 | 8 | ||||||
East | 24.0 | 43.1 | 34.6 | 26.9 | 7.3 | ||||||
South | 18.8 | 78.6 | 25.7 | 48.0 | 16 | ||||||
General structure equipment composite index | 0.127 | 0.373 | 0.093 | 0.005 | 0.842 | ||||||
Low | 13.3 | 64.7 | 23.1 | 28.5 | 7.8 | ||||||
Medium | 21.8 | 64.9 | 34.7 | 41.6 | 10 | ||||||
High | 20.2 | 58.1 | 30.7 | 44.2 | 8.4 | ||||||
Total
|
17.9
|
62.6
|
28.7
|
37.1
|
8.9
|
Counseled on how to use, side effects, and when to returna
| Counseled on method protection from STIb
| ||||
---|---|---|---|---|---|
Variable | Category | OR | C.I. | OR | C.I. |
Clients age (ref. = 14–24) | 25–39 | 0.7 | 0.4–1.3 | 0.7 | 0.4–1.4 |
40–58 & don’t know | 1.1 | 0.6–2.1 | 0.4* | 0.1–0.9 | |
Client’s education (ref. = secondary or more) | No education | 0.5 | 0.3–1.1 | 0.5 | 0.2–1.3 |
Primary & post primary | 1.0 | 0.5–1.8 | 1.1 | 0.4–2.7 | |
Client status (ref. = returning client) | New client |
6.1***
|
3.7–10.2
|
5.3***
|
2.8–10.2
|
Contraceptive method used (ref. = IUD or implants) | Pills | 0.6 | 0.3–1.4 | 1.2 | 0.4–3.4 |
Progestin-only injection | 0.7 | 0.4–1.4 | 1.8 | 0.8–4.3 | |
Provider category (ref. = midwife and other) | Nurse or nurse assistant | 0.8 | 0.4–1.4 | 1.4 | 0.6–3.3 |
Provider years of education (ref. = 17+) | 6–12 | 1.6 | 0.4–7.1 | 0.3 | 0.1–2.0 |
13–16 | 1.2 | 0.7–2.2 | 1.2 | 0.6–2.7 | |
Provider training in family planning in the past 24 months (ref. = no) | Yes | 1.5 | 0.8–2.7 | 0.8 | 0.4–1.9 |
Provider activities supervised (ref. = none) | 1–5 | 0.6 | 0.3–1.4 | 0.8 | 0.3–2.6 |
6 | 0.7 | 0.4–1.6 | 1.4 | 0.6–3.6 | |
Provider has a job description (ref. = no) | Yes | 0.9 | 0.4–1.8 | 1.4 | 0.6–2.9 |
Provider salary type (ref. = none) | Monthly or daily salary | 1.9 | 0.5–6.4 |
9.0*
|
1.4–58.0
|
No regular salary but other compensation | 1.7 | 0.5–5.5 | 3.9 | 0.6–24.5 | |
Health facility type (ref. = hospital/health center) | Health post | 1.6 | 0.9–2.9 | 1.0 | 0.4–2.4 |
Locality (ref. = urban) | Rural | 0.8 | 0.4–1.6 |
4.0**
|
1.4–11.6
|
Region (ref. = Northern) | Dakar | 1.0 | 0.2–4.0 | 2.1 | 0.5–8.4 |
Thiès | 1.9 | 0.6–6.1 | 2.0 | 0.4–9.1 | |
Central | 0.9 | 0.3–3.1 | 1.1 | 0.2–5.4 | |
East | 1.6 | 0.3–7.1 | 1.0 | 0.1–9.0 | |
South | 0.8 | 0.2–2.8 | 1.8 | 0.5–7.2 | |
General structure equipment composite index (ref. = low) | Medium | 1.8 | 0.7–4.7 | 0.5 | 0.2–1.3 |
High | 1.9 | 0.8–4.5 | 0.5 | 0.2–1.3 | |
Pseudo R2
| 0.17 | 0.19 |
Family Planning Client-Focused Outcomes
All users that are very satisfied N = 872 | Correct knowledge of all users N = 716 | ||||
---|---|---|---|---|---|
Variable | Category | (%) |
p-value | (%) |
p-value |
Client’s age | 14–24 | 82.1 | 0.312 | 51.5 | 0.181 |
25–39 | 83.1 | 60.3 | |||
40–58 & don’t know | 88.5 | 59.3 | |||
Client’s education | No education | 84.7 | 0.202 | 54.5 | 0.169 |
Primary & post primary | 85.3 | 57.6 | |||
Secondary or more | 78.9 | 64.6 | |||
Fee paid for service | 0–9 | 81.2 | 0.707 | ||
10–499 | 81.7 | ||||
500–999 | 83.3 | ||||
1000 or more | 85.8 | ||||
Waiting time | No wait | 96.5 |
<0.001
| ||
Less than half hour | 77.0 | ||||
Half hour to one hour | 81.1 | ||||
One hour to 2 hours | 88.4 | ||||
2 hours or more | 83.6 | ||||
Client status | New client | 84.1 | 0.859 | 53.9 | 0.222 |
Returning client | 83.5 | 59.5 | |||
Contraceptive method used | Pills | 78.4 | 0.090 | 57.6 | 0.469 |
Progestin-only injection | 85.3 | 56.3 | |||
IUD or implantsb
| 86.1 | 63.9 | |||
Client left with method | Yes | 85.1 |
<0.001
| ||
No | 62.3 | ||||
Provider category | Nurse or nurse assistant | 84.0 | 0.883 | 66.6 |
0.002
|
Midwife and other | 83.6 | 53.4 | |||
Provider sex | Male | 79.5 | 0.114 | 61.8 | 0.300 |
Female | 84.6 | 56.7 | |||
Provider years of education | 6–12 | 83.0 |
0.007
| 61.7 | 0.700 |
13–16 | 87.1 | 58.6 | |||
17+ | 78.2 | 55.7 | |||
Provider training in family planning in the past 24 months | Yes | 85.3 | 0.278 | 63.2 |
0.019
|
No | 82.4 | 53.6 | |||
Provider activities supervised | None | 73.5 |
<0.001
| 52.3 |
0.004
|
1–5 | 82.8 | 49.4 | |||
6 | 88.4 | 64.3 | |||
Provider has a job description | Yes | 88.6 |
<0.001
| 59.8 | 0.236 |
No | 76.9 | 54.9 | |||
Provider salary type | Monthly or daily salary | 91.6 |
<0.001
| 63.0 |
0.003
|
No regular salary but other compensation | 70.7 | 49.9 | |||
None | 67.6 | 46.2 | |||
Counseled on how to use method | Yes | 84.4 | 0.495 | 60.1 | 0.137 |
No | 82.5 | 53.8 | |||
Counseled on side effects of methoda
| Yes | 79.5 | 0.068 | 57.4 | 0.993 |
No | 85.3 | 57.5 | |||
Counseled on when to returna
| Yes | 81.6 | 0.249 | 57.4 | 0.983 |
No | 84.9 | 57.5 | |||
Counseled on whether method protects from STI | Yes | 66.8 | 0.165 | ||
No | 56.7 | ||||
Health facility type | Hospital/health center | 79.8 | 0.084 | 58.8 | 0.756 |
Health post | 84.6 | 57.5 | |||
Locality | Urban | 85.0 | 0.316 | 57.5 | 0.922 |
Rural | 82.3 | 57.9 | |||
Region | Northern | 58.9 |
<0.001
| 44.9 |
<0.001
|
Dakar | 87.9 | 64.6 | |||
Thiès | 75.0 | 53.4 | |||
Central | 94.5 | 46.7 | |||
East | 91.5 | 61.0 | |||
South | 96.7 | 78.1 | |||
General structure equipment composite index | Low | 79.3 |
0.020
| ||
Medium | 85.3 | ||||
High | 87.8 |
Variable | Category | Very satisfied Model Ia
| Very satisfied Model IIa
| Correct knowledgeb
| |||
---|---|---|---|---|---|---|---|
OR | C.I. | OR | C.I. | OR | C.I. | ||
Clients age (ref. = 14–24) | 25–39 | 0.9 | 0.5–1.6 | 0.9 | 0.6–1.6 | 1.4 | 0.9–2.2 |
40–58 & don’t know | 1.9 | 0.8–4.4 | 1.8 | 0.7–4.3 | 1.3 | 0.7–2.3 | |
Client’s education (ref. = secondary or more) | No education |
2.1*
| 1.2–3.9 |
2.1*
| 1.2–3.8 | 0.7 | 0.4–1.2 |
Primary & post primary |
2.0*
| 1.0–3.7 |
2.0*
| 1.1–3.7 | 0.9 | 0.5–1.5 | |
Fee paid for service (ref. = 1000 or more) | 0–9 | 1.3 | 0.6–3.0 | 1.4 | 0.6–3.1 | ||
10–499 | 0.9 | 0.4–2.0 | 1.0 | 0.4–2.2 | |||
500–999 | 0.9 | 0.5–1.6 | 1.0 | 0.6–1.8 | |||
Waiting time (ref. = 2 hours or more) | No wait |
5.4*
| 1.2–24.0 |
5.7*
| 1.3–25.2 | ||
Less than half hour | 0.8 | 0.4–1.4 | 0.8 | 0.4–1.4 | |||
Half hour to one hour | 1.0 | 0.5–2.1 | 1.1 | 0.5–2.2 | |||
One hour to 2 hours | 1.2 | 0.5–3.0 | 1.2 | 0.5–2.8 | |||
Client status (ref. = returning client) | New client | 1.2 | 0.6–2.4 | 1.1 | 0.6–2.2 | 0.7 | 0.5–1.1 |
Contraceptive method used (ref. = IUD or implants) | Pills | 1.1 | 0.5–2.7 | 1.1 | 0.5–2.6 | 1.1 | 0.6–2.0 |
Progestin-only injection | 1.4 | 0.7–2.9 | 1.4 | 0.6–3.0 | 0.9 | 0.5–1.6 | |
Client left with method (ref. = no) | Yes |
3.9**
| 1.5–10.4 |
3.7**
| 1.4–10.0 | ||
Provider category (ref. = midwife and other) | Nurse or nurse assistant | 1.0 | 0.6–1.9 | 1.1 | 0.6–1.9 |
2.1**
| 1.3–3.2 |
Provider years of education (ref. = 17+) | 6–12 |
3.6*
| 1.2–10.3 |
2.9*
| 1.0–8.3 | 1.7 | 0.8–3.7 |
13–16 |
3.8***
| 2.2–6.6 |
3.4***
| 1.9–6.1 | 1.1 | 0.8–1.7 | |
Provider training in family planning in the past 24 months (ref. = no) | Yes | 1.5 | 0.9–2.6 | 1.5 | 0.9–2.5 |
1.7**
| 1.2–2.5 |
Provider activities supervised (ref. = none) | 1–5 | 1.0 | 0.6–2.0 | 1.2 | 0.7–2.3 | 0.7 | 0.4–1.2 |
6 | 0.9 | 0.5–1.6 | 0.9 | 0.5–1.7 | 1.1 | 0.7–1.9 | |
Provider has a job description (ref. = no) | Yes | 1.1 | 0.6–1.9 | 1.1 | 0.6–1.9 | 1.0 | 0.6–1.5 |
Provider salary type (ref. = none) | Monthly or daily salary | 2.0 | 0.9–4.5 | 2.0 | 0.9–4.6 | 1.3 | 0.7–2.5 |
No regular salary but other compensation | 0.9 | 0.4–1.8 | 0.9 | 0.4–1.8 | 1.3 | 0.7–2.5 | |
Counseled on how to use method (ref. = no) | Yes | 1.3 | 0.8–2.2 | 1.3 | 0.8–2.2 | ||
Counseled on side effects of methoda (ref. = yes) | No |
2.6**
| 1.5–4.6 | ||||
Counseled on when to returna (ref. = yes) | No |
2.0*
| 1.2–3.5 | ||||
Counseled on whether method protects from STI (ref. = no) | Yes | 1.2 | 0.6–2.3 | ||||
Health facility type (ref. = hospital/health center) | Health post | 1.5 | 0.8–2.8 | 1.4 | 0.8–2.6 | 0.7 | 0.5–1.1 |
Locality (ref. = urban) | Rural | 0.9 | 0.5–1.7 | 1.0 | 0.5–1.8 | 1.3 | 0.8–2.0 |
Region (ref. = Northern) | Dakar |
5.3***
| 2.1–12.9 |
4.8***
| 1.9–11.9 |
3.0**
| 1.4–6.3 |
Thiès |
2.8*
| 1.2–6.6 |
2.5*
| 1.1–5.9 | 1.9 | 1.0–3.7 | |
Central |
10.7***
| 3.6–32.3 |
11.5***
| 3.7–36.3 | 1.3 | 0.6–2.6 | |
East |
5.2*
| 1.4–19.0 |
4.6*
| 1.3–16.6 | 2.0 | 0.8–4.9 | |
South |
12.3***
| 3.4–45.4 |
13.9***
| 3.7–52.5 |
4.2***
| 1.9–9.2 | |
General structure equipment composite index (ref. = low) | Medium | 0.9 | 0.5–1.7 | 0.9 | 0.5–1.5 | ||
High | 1.0 | 0.5–2.0 | 1.0 | 0.5–1.9 | |||
Pseudo-R
b
| 0.25 | 0.25 | 0.09 |