Far Eastern

University
Institute of Nursing

EVIDENCE BASED NURSING

Maria Jeanette Alessandra Sy

POSTPARTUM

1. What is the best method in educating couples about family planning method?

2. Would educating the husbands as well in family planning help in significantly utilizing
different available contraceptives?
PICO

Patient Intervention Comparison Outcome

Focus population
651 married men Social-cognitive Received neither Higher self-efficacy
aged 19–45 years intervention to letters nor counseling for IUD use by their
who had lived with influence wife
their wives in the contraceptive
same house during practices Reduced future rates
the 3 months prior to of unwanted
the study. pregnancy

811 married couples 6-month long family Received neither Significantly higher
planning education letters nor counseling level of willingness to
and monthly be actively involved
community in family planning
gatherings

ARTICLES:
1. Increasing male involvement in family planning decision making: trial of a social-cognitive
intervention in rural Vietnam
2. Couple based family planning education: changes in male involvement and contraceptive use
among married couples in Jimma Zone, Ethiopia

CRITICAL SUMMARY
Postpartum family planning information and services can prevent maternal and child morbidity
and mortality in low-resource countries, where high unmet need for PPFP remains despite
opportunities offered by routine postnatal care visits. Increasing male involvement in family
planning decision was a study done by Thu Ha et al., to further raise awareness on how a social-
cognitive intervention influences contraceptive practices among men living in rural communes in
Vietnam. Villages were allocated randomly to a control condition or to two rounds of
intervention with stage-targeted letters and interpersonal counseling. There were 651 eligible
married men in the 12 villages chosen. A significant positive movement in men's stage of
readiness for IUD use by their wife occurred in the intervention group, with a decrease in the
proportions in their no intention of changing their behavior for the foreseeable future stage from
28.6 to 20.2% and an increase in action/maintenance from 59.8 to 74.4%. Compared to the
control group who has not received any treatment, the intervention group showed higher pros,
lower cons and higher self-efficacy for IUD use by their wife as a contraceptive method. The
interventions given based on social-cognitive theory can increase men's involvement in IUD use
in rural Vietnam and should assist in reducing future rates of unwanted pregnancy. This is a
study that aims in raising awareness on how not only woman are supposed to receive an
education about family planning but the husband’s role is important as well. This report positive
movements in their stage of motivational readiness for their wife to use an intrauterine device
(IUD) compared to those who are stuck in the precontemplation of not using contraceptives.

In the second article, the study discusses on how male involvement has gained considerable
attention in family planning programs but the implementation thereof remains a challenge. The
researchers conducted an experiment on 811 married couples in Jimma Zone, southwest
Ethiopia. The intervention consisted of family planning education, given to both men and women
at the household level in the intervention arm, in addition to monthly community gatherings.
During the intervention period, households in the control group were not subject to particular
activities but had access to routine health care services. At the baseline, contraceptive use in both
control and intervention households were similar. After the intervention, they have observed
among men in the intervention arm a significantly higher level of willingness to be actively
involved in family planning compared to the men in the control arm. In addition, the difference
between spouses that discussed family planning issues was less reported within the control
group, both in the case of men and women respectively. In general, a significant, positive
difference in male involvement was observed. Concerning contraceptive use, there was change
observed among the intervention group who were not using contraception at baseline. This study
showed that family planning educational intervention, which includes both spouses and promotes
spousal communication, might be useful to foster contraceptive practice among couples. The
results also offer practical information on the benefits of male involvement in family planning as
a good way to increase contraceptive use. Thus, providing opportunities to reinforce family
planning education may strengthen the existing family planning service delivery system

Both studies are thoroughly researched and well thought as it involves both couple in order to
grasp a baseline knowledge and maintain a good family management and size. At the individual
level, knowledge, attitudes, and behaviors of women and couples toward Postpartum Family
Planning will likely be influenced by a set of low-cost interventions which are very accessible in
their own nearby health centers. At the health service delivery level, the implementation of this
trial will probably require a shift in behavior and accountability of providers regarding the
systematic integration of Postpartum Family Planning into their clinical practice, as well as the
optimization of health service organization to ensure the availability of competent staff and
contraceptive supplies.

Reference:

1. Bui Thi Thu Ha, Rohan Jayasuriya, Neville Owen, Increasing male involvement in family
planning decision making: trial of a social-cognitive intervention in rural Vietnam, Health
Education Research, Volume 20, Issue 5, October 2005, Pages 548–556,
https://doi.org/10.1093/her/cyh013
2. Tilahun, T., Coene, G., Temmerman, M. et al. Couple based family planning
education: changes in male involvement and contraceptive use among married
couples in Jimma Zone, Ethiopia. BMC Public Health 15, 682 (2015).
https://doi.org/10.1186/s12889-015-2057-y