Skip to main content

Table 2 Main findings of the included studies

From: The unmet needs for modern family planning methods among postpartum women in Sub-Saharan Africa: a systematic review of the literature

Authors Findings (multivariate analysis) Highlights of the study Reasons for non-use of FP (if stated)
Abera et al. 2015 [41] Age (CI: 1.04–6.04, p < 0.001)
Resumption of menses (CI:5.85–14.63; p < 0.0001)
Postpartum period (CI: 2.51–9.30; p = 0.034)
Antenatal care* service (CI: 2.57–17.00; p = 0.001)
Postnatal care** service (CI: 1.01–2.61; p = 0.042)
97.15% of postpartum women had a good intention about PPFP (51.1% for spacing and 46.1% for limiting)
71.4% had resumed sexual activity
Postpartum Contraceptive use (48.4%)
Low perceived risk of pregnancy (49.0%)
Husband not living at home (16.8%)
Medical problem (11.6%)
Fear of side effect (7.7%)
Spousal disapproval (6.3%)
Religion (4.7%)
Abraha et al. 2017 [42] Women’s education (secondary, CI:1.29–14.00; p = 0.02 and tertiary, CI:1.14–25.45; p = 0.03)
Menses resumption (CI:3.14–13.39; p < 0.001)
Problems with previous contraceptive use (CI:0.16–0.72; p = 0.05)
Resumption of sexual activity (CI:3.74–24.27; p < 0.001)
Prenatal and postnatal FP counselling (CI:2.67–12.28; p < 0.001)
PNC service (CI:1.15–4.87; p = 0.02)
48% of postpartum women used modern contraceptives
28.9% had resumed sexual activity at 3-week postpartum
Absence of menses (65.7%)
Fear of side effect (11.10%)
A single mother (7.80%)
Spousal disapproval (7.20%)
Abraha et al. 2018 [43] Knowledge of modern contraceptives (CI: 1.69, 15.82)
Postpartum resumption of sexual activity (CI: 1.34, 3.92)
Husband's approval of FP (CI: 2.02, 5.57)
84.3% of postpartum women intended to utilise modern contraceptives, of which 83.3% were for spacing and 6.7% for limiting
Only 43.7% of respondents attended PNC, that percentage was 98.1% for ANC
Not stated
Achwoka et al. 2018 [56] Age (CI: 1.00–1.61; p = 0.05)
Women's education (CI:1.01–1.04; p = 0.004)
Assisted delivery in a health facility (CI:1.06–1.49; p = 0.008)
PF discussion during PNC (CI: 1.10–1.42; p = 0.001)
PF discussion during ANC/ PNC (CI: 1.18–1.51; p < 0.001)
77% of the participants needed PPFP, 30% of whom were not currently using any modern FP
Only 63% of last pregnancies were desired
Not stated
Gebremedhin et al. 2018 [44] Marriage (CI: 0.03–0.22)
Menses resumption (CI: 1.37–3.41)
Postpartum period (CI: 1.18–4.75)
History of previous PF use (CI: 0.07–0.18)
39.10% of participants did not know the number of children they wish to have
54.5% were not counselled about FP during their ANC
Not stated
Dona et al. 2018 [45] Return of menses (CI: 1.47–3.81)
FP communication with husband (CI: 1.09–2.41)
ANC (CI: 1.23—3.01)
PNC (CI: 1.23- 2.94)
Postpartum contraceptive use was at 31.7%
68.7% of participants delivered their last birth at home
Resumption of menses (46%)
Distance to the health facilities (38%)
Husband’s disapproval (19%)
Lack of their preferred methods (11%)
Berta et al. 2018 [46] Resumption of menses (CI: 2.33–6.35)
Resumption of sex (CI: 1.80–5.58)
Postpartum period (CI: 1.11–5.55) Knowledge on FP (CI: 2.23–11.24)
Husband’s approval (CI: 1.16–3.82)
Participants’ reproductive intention was for 41.8% for spacing and 33.7% for limiting Non-menstruating (30.9%)
Side effects (11.1%)
Husband's disapproval (10.6%)
Breastfeeding (14.3%)
Bwazi et al. 2014 [54] Women's education (p = 0.004)
Age (p = 0.050)
Side effects (p = 0.001)
Knowledge of the PPFP services (p < 0.001)
Duration of lactation amenorrhoea (p < 0.001)
Sexual activity resumption (p < 0.001)
Desired number of children (p = 0.020)
Number of children (Primiparous) (p < 0.001)
Clarity of FP information (p = 0.014)
Husband's approval (p < 0.001)
Husband’s assistance (p < 0.001)
Spousal discussion on FP (p < 0.001)
Counselling on FP (p = 0.026)
23% of women had five or more children
38% of women and 33% of their husbands wanted five or more children
22.2% had at least one abortion
Menstruating women (11.40%)
Unwilling to use FP (5.20%)
Fear of infant death (22%)
A single mother (3%)
Thindwa et al. 2019 [55] Age (CI: 1.8–9.9)
Parity (CI: 1.8–39.5)
Partner of unknown HIV-status (CI: 1.2–4.0)
41.8% of respondents had an unplanned index pregnancy among whom 35% had an unmet need for FP, and 65% had a contraceptive failure
49.6% of women who did not desire any future child were not using contraception
Not stated
Chinaeke et al. 2019 [51] Disclosure of women’s HIV status to their partner/relative (CI: 1.2–3.3; p = 0.01)
Mentor Mother (CI:0.3–0.8; p < 00.01)
FP counselling (CI: 1.1–4.8; p = 0.03)
87.5% of the postpartum women had received FP counselling
49.9% of respondents were not using modern contraceptive methods
Not stated
Embafrash and Mekonnen 2019 [59] Postpartum period (CI: 4.24–15.71)
Low perception of pregnancy risk (CI: 1.04–3.09)
Rural residence (CI: 2.57–19.95)
Unmet need for contraception was 36.7% of which spacing was 29.6% and limiting 7.1%
74.8% of respondents had resumed sexual intercourses and 23.7% of them were denied of PF counselling by health providers
Non-menstruating (69.6%)
Side effects (13.5%)
Abstinence (8.7%)
Husband's disapproval (5.2%)
Breastfeeding (4.5%)
Religion (2.4%)
Refusal to remove implants by health providers
Idowu et al. 2015 [52] Postpartum family planning awareness (CI: 0.0084–0.276; p < 0.001) 46% of respondents had an unmet need for spacing and 56% for limiting Lack of awareness (17%)
Fear of side effects (17.4%)
Distance to the health facility (13%) Husband's disapproval (15%)
Preferred method not available (13.1%)
Low perceived risk of pregnancy (12.7%); Poverty (12.3%)
Iliyasu et al. 2018 [53] Women’s education (CI:1.03–6.69; p = 0.043)
Baby’s age/postpartum period (CI:1.06–3.49; p = 0.031)
Resumption of sexual intercourse (CI:0.088–0.38; p = 0.001)
Resumption of menses (CI:0.21–0.75; p = 0.004)
67.9% of women resumed sexual activity two months of delivery, of whom 34.4% were not using any modern contraceptive methods
33% were in polygamous unions
Not stated
Keesara et al. 2018 [57] Qualitative study and the themes are presented 88% of interviewed women were on contraceptive methods by three-months postpartum Fear of side-effects
Husband's disapproval (25%)
Fear of infertility
Tegegn et al. 2017 [47] Knowledge of Lactational Amenorrhea Method (CI: 4.10, 15.02; p = 0.001)
Low women's education (CI: 1.22–7.57; p = 0.017)
ANC service (CI:1.11–5.79; p = 0.050)
PNC service (CI:2.13–6.19; p = 0.0001)
44% of respondents had an unmet need for contraception of which 43% for limiting and 57% for spacing
The current infant was unwanted by 7.9% of participants
Low perceived risk of pregnancy (47%)
Fear of side effect (16%)
Abstinence (9%)
Lack of their preferred Method (8%)
Mengesha et al. 2015 [48] Urban residence (CI: 2.93–11.63)
Husband’s education (CI: 1.49–5.97)
PNC services (CI: 1.06–4.52)
Assisted delivery by health provider (CI: 1.01–3.51)
Postpartum contraception use was 10.3% of which 30.1% was for limiting
Home delivery was at 81.1%
Not stated
Gejo et al. 2019 [49] Women's education (CI: 0.09–0.74)
Sex resumption (CI: 1.53–11.52)
Menses resumption (CI: 3.07–23.23)
Postpartum period (CI: 0.11–0.64)
73.9% of respondents were on contraception (85.29% of them for spacing and 7.72% for limiting) Absence of menses (32.29%)
Absence of spouse (20.8%)
Sileo et al. 2015 [58] Women’s education (CI: 1.05–3.95; P = 0.04)
Prior use of contraceptives (CI: 1.42–83.05; p = 0.02)
discussion on contraceptive use with partner (CI: 1.34—2.44; p < 0.001)
74.8% of participants were not using any effective contraceptive method
63.5% reported being victims of emotional abuse and 45.8% of physical abuse
Not stated
Abraha et al. 2018 [50] Wealth (CI:1.1–3.2; p < 0.001)
Partner/husband's education (CI: 1.1–2.6; p < 0.001)
PNC service (CI:1.9–4.3; p < 0.001)
Distance to the health facility (CI: 2.7–4.6; p < 0.01)
ANC service (CI: 1.9–4.2); p < 0.01)
49.3% attended the four ANC visits recommended by WHO
96.90% of respondents and 68.1% of their partners had tested for HIV
13.5% had complications during the puerperium period
Not stated
  1. ANC  antenatal care, PNC postnatal care