Family Planning Utilization Among Model and Non Model Family Women Enrolled in Urban Health Extension Program in Addis Ababa, Ethiopia, 2015

Background:In 2003, the Ethiopian Federal Ministry of Health (FMOH) launched a new health care plan, the “Accelerated Expansion of Primary Health Care Coverage,” through a comprehensive Health Extension Program (HEP).Recognizing the huge gap between need and health care services available, the FMOH has focused on “providing quality promotive, preventive, and selected curative health care services in an accessible and equitable manner to reach all segments of the population, with special attention to mothers and children. Objective:To assess on family planning service utilization among model and non-model family women enrolled in urban health extension program of kirkos sub-city administration. Method:A cross sectional study design using a quantitative method was used .A total of 424 (212 model families and 212 non-model families) participated the study. Adjusted ORs that controls the confounding effects of other covariates were calculated using the multiple logistic regression models of SPSS version 16 statistical programs. Statistical significance was considered at P-value less than 0.05. Result:Large proportion study population 210(81.08%) [109(78.4%)) and 101 (84.1%),) model and non-model respectively] were they prefer to be informed by health professional and followed by other (like friend husband...) were 27(10.42%) [18(12.9%) and 9(7.5%) for model and non-model families respectively], media (radio and TV) were 15(5.79%) [5(3.59) and10 (8.33%) for model and non-model families respectively] with X2 =4.21, p value =0.000021. Conclusion:By this measurement the UHEP programs lacks the aspects expected to be done. FMOH should see the implementation strategies of UHEP on providing and upgrading family planning service.


Source Population
The study population was all women in kirkos sub-city administration. Target population Women in reproductive age group in model and non-model families that enrolled in urban health extension program in selected wereda of kirkos sub-city administration.

Data Collection Process
A structured anonymous closed questionnaire was developed by revising questionnaires developed for similar study and adapting it to the objectives of the present study to collect quantitative data.

Data Analysis
After collection of data the responses was coded and entered into a computer using EPI Info version 6.4 statistical programs, after data entry finished, 10% of the responses were randomly selected and checked for consistency of data entry. Then printed frequencies were used to check for outliers and clean data. Data is leaned accordingly and then exported to SPSS version 16.0 for further analysis.
To establish associations between dependent and independent variables, P values were used. Chi-square test was used to select associated independent variables for multiple logistic regressions. Adjusted ORs that controls the confounding effects of other covariates were calculated using the multiple logistic regression models of SPSS version 16 statistical programs. Statistical significance was considered at P-value less than 0.05.

Result Socio demographic status of study population
Among 422 respondents, 211(50%) were model family and 211(50%) were non model family women. Majority of the respondent (51.2% and 44.1% model and non model respectively) were found in age group of 25-34 and the mean age of model family was 33.39 and the mean age of non model was 31.29.Highest proportion of model family 49(23.2%) are found in first levels (elementary) of education while 16(7.6%) have first degree and above, for non model family about 73(34.3%) were secondary level completed, whereas only 2(0.9%) were can read and write. Majority of model and non model family 179(84.8%) and 160(75.1%) were married; and also only 2(0.9%) and 1(0.5%) were widowed, respectively.
Majority of the respondents model and non model (184(87.2%) and 183(85.9%) were orthodox respectively. About 57(27%) of model family have two children and 29(13.7%) were don't have child, while highest proportion of non model families women, 70(33.2%), don't have child and only 15(7.1%) were have more than three children.

Source of Information
From those that have heard about contraceptive , preferred source of information for contraceptive were, Radio,UHEP and Heath canter/heath professional 280(66.35%), 53(12.55%) and 52(12.32%) with respective order. 12(5.7%) of model family women were heard from health canter/health professional with OR=2.8 ( strong association ,i.e the contribution of health canter/health professional as a source of information much higher ),,131(62.1%) from radio with OR=1.8 ( strong association ,i.e the contribution of Radio as a source of information much higher ),13(6.2%) from TV, from UHEP 53(25.1%) with OR=0.38 (weak association/preventive ,i.e. the contribution of UHEP as a source of information much weaker than any other sources) and 2(0.94%) from other (like from their friend, husband and other). (As in indicated in figure 1.1).For non model family women the source of information were, 40(18.95%) from health canter/health professional 149(70.61%) from radio, , 3(1.42%) from TV, 14(6.2%) don't heard before. Contraceptive use and methods As indicated table 1.5 from those that have heard about family planning more in model than non model, 139(65.87%) and 120(60.9%),respectively ever use of contraceptive methods.
From those that are using one of contraceptive methods, large proportion model and non model (109(78.4%)) and 101 (84.1%), of were got advise from health professional to choose those methods respectively.

Discussion
Knowledge of family planning is a prerequisite to obtaining access to and using a suitable contraceptive method in a timely and effective manner. In this study 96.6% of total study population (100% and 93.36% for model and non-model family women respectively) have heard /informed about contraceptive, i.e. all models have knowledge about contraceptive than non-model families. Of these 65.9% of model and 57.8% non-model family spontaneously named at least one CP.Similarly 65.9% of model and 57.8% non-model family correctly identify at least one CP from the list of item.
The study has also indicated that radio, health professional/institution, TV, UHEP and other; were frequently reported as a source of information. While, the majority of respondent reported they prefer to hear more about CP from radio, UHEP and health professional/institution, if they are given choices, there choice mainly depends on reliability of the sources. In other word the source information were largely accounted by radio 280 (66.35%), by UHEP were 53(12.55%) (Which is for model families only) and by health professional/institution 52(12.24%).In addition there are no non model family women that have been informed