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Acceptability and utilization of family planning benefits cards by youth in slums in Kampala, Uganda

Authors
  • Nuwasiima, Afra
  • Nuwamanya, Elly
  • Babigumira, Janet U.
  • Nalwanga, Robinah
  • Asiimwe, Francis T.
  • Babigumira, Joseph B.
Type
Published Article
Journal
Contraception and Reproductive Medicine
Publisher
BioMed Central
Publication Date
Aug 05, 2019
Volume
4
Issue
1
Identifiers
DOI: 10.1186/s40834-019-0092-2
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundThis study was conducted to test the acceptability and utilization of family planning benefits cards (FPBCs) as incentives to increase family planning uptake among youth living in urban slums in Uganda.MethodsWe conducted a one-year pilot study with two sub-studies on acceptability and utilization of FPBCs. The acceptability study utilized a quantitative cross-sectional design and was part of a baseline household survey while the utilization study was a primary analysis of claims and clinic data. We performed descriptive analyses and analyses of the association between different variables using binary logistic regression.ResultsThe acceptability study included 280 eligible females. The majority were married (52%), Christian (87%), and aged 20 and above (84%). Acceptability of the program was high (93%). Seventy-two percent of females used the card at least once to access reproductive health services. Twenty-seven percent of female users discontinued family planning and 14% changed family planning methods during the study. Female users of short-term contraceptive methods were 11 times more likely to discontinue use of FPBCs compared to those who used long-term methods (adjusted OR = 10.9, P = 0.011). Participants in professional/managerial employment were 30 times more likely to discontinue compared to the unemployed (adjusted OR = 30.3, P = 0.015). Participants of parity equal to two were 89% less likely to discontinue use of FPBCs compared to those of parity equal to zero (adjusted OR = 0.1, P = 0.019).ConclusionFamily planning benefits cards, deployed as incentives to increase uptake of family planning, exhibited high acceptability and utilization by youth in urban slums in Uganda. There was evidence that use of short-term contraception methods, professional employment, and lower parity were associated with discontinuation of modern family planning methods after initial enrolment.Trial registrationMUREC1/7 No. 10/05–17. Registered 19th, July 2017.

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