Postpartum Green Star family planning decision aid for pregnant adolescents in Tanzania: a qualitative feasibility study

Reproductive Health

Stella E. Mushy¹  Sebalda Leshabari¹  Eri Shishido²  Shigeko Horiuchi² 

[1] Community Health Nursing Department, School of Nursing, Muhimbili University of Health and Allied Sciences, P.O. Box 65004, Dar es Salaam, Tanzania;Department of Midwifery, Graduate School of Nursing Science, St. Luke’s International University, 10-1 Akashi-Cho, 104-0044, Chuo, Tokyo, Japan;

关键词: Decision aid;    Postpartum family planning;    Long-acting reversible contraception;    Intrauterine copper device;    Implants;    Rapid repeat pregnancy;    Adolescent mothers;    Pregnant adolescents;    Tanzania;   

DOI  :  10.1186/s12978-021-01216-6

来源: Springer

【 摘 要 】

BackgroundThe use of a decision aid in clinical settings has been beneficial. It informs and educates patients about the available treatment options that can help them reduce decision-making conflicts related to feeling uninformed compared with routine care. There is a scarcity of published data about using a decision aid during family planning counseling with postpartum women focusing on long-acting reversible contraception in Tanzania. Therefore, we developed a “postpartum Green Star family planning decision aid” and assessed its feasibility. The study outcomes were practicality, usefulness, and acceptability perceived by pregnant adolescents and nurses/midwives.MethodsWe used an exploratory qualitative in-depth interview involving six nurses/midwives with three or more years of experience in family planning services and 12 pregnant adolescents aged 15–19 years. Purposive sampling was used to select the participants, and selection relied on the saturation principle of data collection. We used a semi-structured interview guide translated into the Kiswahili language. Data were transcribed and analyzed following inductive content analysis.ResultsThe amount of information presented was just right, with the time of reading the data ranging from 20 min to 1 h. The study participants perceived the flow of information to be good, with small significant changes suggested. Kiswahili language was used and reported to be appropriate and well elaborated. However, a few words were told to be rephrased to reduce ambiguity. The nurses/midwives said that the decision aid included most of the vital information the participants wanted to know during their family planning counseling. Pregnant adolescents stated that the decision aid improved their knowledge and provided new details on the long-acting reversible contraception methods (intrauterine copper devices and implants) offered immediately after childbirth. The participants stated that the decision aid addressed long-acting reversible contraception methods’ benefits and side effects and dispelled myths and misconceptions. The study participants considered the decision aid helpful in complementing the family planning counseling offered and improving pregnant adolescents’ knowledge.ConclusionThe postpartum Green Star family planning decision aid was practical, useful, and acceptable in enhancing the objectivity of counseling about long-acting reversible contraception methods. It improved the knowledge of pregnant adolescents in Tanzania about the available contraception methods (i.e., the use of intrauterine copper devices and implants), which can be immediately used postpartum. Further research is needed to assess the effects of the decision aid on long-acting reversible contraception postpartum uptake among pregnant adolescents in Tanzania.

【 授权许可】

CC BY