FAMILY PLANNING USE AMONG HIV POSITIVE MOTHERS
WHO in conjunction with United States department of Health and Human Services, Office (USDHSO) of Population Affairs defined family planning as a factor that allows individuals and couples to anticipate and attain their desired number of children, spacing and timing of their births, this is achieved through use of contraceptive methods and the treatment of involuntary infertility, (WHO April, 2016).
WHO has in its guidelines the traditional methods consisting of Lactation Amenorrhea Method (LAM) and Fertility Awareness Based (FAB). Current guide indicate that virtually all these methods are safe for nearly every person with HIV. FP services have been integrated into HIV care and treatment facilities just as the reverse is true; what is noticeable is the fact that there has not been a lot of information published focused to FP use among HIV positive clients, (WHO, 2008).
Globally four different analyses have confirmed that the importance to eMTCT effort of preventing unintended pregnancies in women with HIV is vital, and it was stated that moderate decrease in the number of pregnancy to HIV infected women ranging from 6% to 35% depending on the country, could result in numbers of averted HIV positive birth equivalent to those averted by Arts according to (WHO 2009).
In the same way another study demonstrated that adding family planning to PMTCT services in high-HIV prevalence countries could avert 71,000 child HIV infection compared with the 39000 HIV positive birth averted with PMTCT only (Janet Fleischman, 2006).
In some cases women with unintended pregnancies are more likely to carry out unsafe abortion, which predisposes them to infections such as puerperal sepsis; FP plays a key role in reducing such incidences, improving maternal health and minimizing the cost of caring for the child in case infected with HIV alongside prevention of unintended pregnancies; condoms specifically prevent against sexually transmitted infections including HIV cross and re-infection (WHO, 2009).
A third analysis in the same study suggested that recurrent levels of contraceptive use in sub Sahara Africa may be already preventing 173,000 (22%) of HIV positive birth annually, despite contraceptives not being widely available in sub Sahara Africa (WHO 2009)
According WHO (2009), If all women in the region who did not wish to get pregnant access contraceptive services, as many as an addition 160,000 HIV positive birth could be averted every year.
Access to FP services is vital as it was found in a study conducted by MOH in western Uganda that the married women in urban settings were twice as likely to use FP as those in the rural areas, women prefer getting at least one child before accepting using these methods because they may be assumed to be barren in case of no child, this is affected by age differences among women, yet by age 15, 14.2% are already sexually active (MoH 2009).
Elements of PMTCT program that could reach women and their partners outside ANC settings before they get infected thus; prevention of primary HIV infection in women before they become pregnant; prevention of unwanted pregnancy; preventing those already infected from infecting their infants and providing appropriate treatment, care and support to them and their children and families, (MOH 2012)
Implementing element 2 (prevention of primary HIV infection in women before they become pregnant) can be accomplished in two ways. One approach is to strengthen vertical family planning services; the other is to ingrate family planning services into HIV prevention, care and treatment services, (MoH PMTCT guidelines 2012).
Global family planning and HIV/AIDS program a funded though separate mechanism. While resources for HIV/Aids have dramatically increased in recent years, effort to strengthen international family planning program have been hampered by a decline in funds. In 2008 US$ 3600 million for HIV service went to the 15 PEPFAR focus countries compared to 67.5 million for family planning PEPFAR, report (2008).
