Research consultancy

Research consultancy

FACTORS INFLUENCING FAMILY PLANNING USE AMONG HIV-POSITIVE MOTHERS OF CHILDBEARING AGE IN HOIMA DISTRICT

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

The World Health Organization (WHO) and the United States Department of Health and Human Services, Office of Population Affairs (USDHSO) define family planning (FP) as a means for individuals and couples to achieve their desired number of children, as well as control the spacing and timing of births. This is accomplished through contraceptive methods and treatment for involuntary infertility (WHO, April 2016).

Current WHO guidelines affirm that nearly all contraceptive methods—including traditional approaches like the Lactational Amenorrhea Method (LAM) and Fertility Awareness-Based (FAB) methods—are safe for people living with HIV. Despite the integration of FP services into HIV care programs, limited research has focused on FP utilization among HIV-positive individuals (WHO, 2008).

Globally, studies emphasize that preventing unintended pregnancies among HIV-positive women is critical to reducing mother-to-child transmission (MTCT). A moderate reduction in pregnancies (6%–35%, depending on the region) could avert as many HIV-positive births as antiretroviral therapy (ART) (WHO, 2009). Another study found that integrating FP into prevention of mother-to-child transmission (PMTCT) programs in high-prevalence regions could prevent 71,000 pediatric HIV infections—nearly double the impact of PMTCT alone (Fleischman, 2006).

Unintended pregnancies also increase risks such as unsafe abortions, maternal infections, and financial burdens for families managing HIV. Condom use, in particular, reduces HIV transmission and reinfection (WHO, 2009). In sub-Saharan Africa, existing contraceptive use already prevents 22% of HIV-positive births annually. Expanding FP access could avert an additional 160,000 infections yearly (WHO, 2009).

In Uganda, disparities exist in FP uptake: urban married women are twice as likely to use contraceptives as rural women (MoH, 2009). Cultural norms, such as the expectation to bear children early, further hinder FP adoption. PMTCT programs aim to address these gaps by preventing primary HIV infections, unintended pregnancies, and MTCT while providing care for affected families (MoH, 2012).

Despite the proven benefits, funding for FP remains disproportionately low compared to HIV programs. In 2008, PEPFAR allocated $3.6billion\ast \ast toHIVservicesin15focuscountriesbutonly\ast \ast$67.5 million to FP initiatives (PEPFAR, 2008).

1.2 Problem Statement

While FP barriers among the general population—such as socioeconomic status, education, rural-urban disparities, and partner attitudes—are well-documented, little research explores these factors among HIV-positive women (UDHS, 2011). In Uganda, 30% of women in the southwest use FP, compared to 52% of men in the north (UBOS & ICF International, 2011).

The lack of data on FP use among HIV-positive mothers in Hoima District raises concerns. Low FP uptake may lead to:

• Unintended pregnancies, worsening maternal health in immunocompromised women.
• Increased MTCT, infant mortality, and financial strain on families.

This study investigates the factors influencing FP use among HIV-positive mothers in Hoima to inform targeted interventions.

1.3 Purpose of the Study

To assess the determinants of FP use among HIV-positive mothers in Hoima District, identifying gaps and solutions to improve service uptake.

1.4 Specific Objectives

1. To examine socioeconomic factors affecting FP uptake among HIV-positive mothers at Azur Christian Health Centre IV.
2. To evaluate knowledge levels of FP methods among HIV-positive mothers.
3. To identify individual-related factors influencing FP utilization.

1.5 Research Questions

1. What socioeconomic factors influence FP uptake among HIV-positive mothers in Hoima?
2. How knowledgeable are HIV-positive mothers about FP methods?
3. What individual-level factors affect FP use in this population?

1.6 Justification for the Study

• Health workers: Findings will guide FP service improvements for HIV-positive women.
• Policymakers: Data will highlight funding and programmatic needs.
• Stakeholders (e.g., MoH, UNICEF, NGOs): Insights will support advocacy and interventions.
• Academic contribution: Serves as a reference for future research.
• Researcher: Fulfills diploma requirements in Nursing.

Key Improvements:

1. Conciseness: Removed redundant phrases while preserving key data.
2. Flow: Structured arguments logically (global → national → local context).
3. Clarity: Simplified complex sentences (e.g., “Elements of PMTCT” section).
4. Engagement: Used bold text for emphasis on critical statistics.