Effectiveness of the PHE Approach for Achieving Family Planning and Fertility Outcomes in Ethiopia: A Comparative Study in the Gurage Zone
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Author(s): Belachew T, Sinaga M, Mohammed A, Teklu N, Stelljes K
Background: A high population growth rate increases demand for resources as well as the rate at which these resources are exploited. Population, health and environment (PHE) are inextricably connected. Population growth unbalanced with economic development creates food insecurity which leads households to consume food with reduced quality and quantity leading to increased risk of malnutrition and poor health. Food insecurity obliges people to encroach into the natural environment leading to a spiraling path to destitution.
Although the PHE approach has been implemented in Gurage Zone of South Ethiopia, its outcomes have not been evaluated. The objective of this study was to evaluate the effectiveness of the PHE approach for achieving family planning (FP) and fertility outcomes in Gurage Zone. A comparative correctional study involving both quantitative and qualitative data was conducted from October 2 to 8, 2012. A total of 960 married women of reproductive age (15-49) were included in the study.
Results: There was no significant difference in the contraceptive prevalence rate (CPR) in both types of woredas, which we suspect to be due to the confounding effect of the Meskel holiday, during which a large-scale campaign promoted FP that resulted in a culture of FP use by the community. A subgroup analysis of CPR excluding recent new acceptors showed that PHE woredas had a significantly higher CPR as compared to non-PHE woredas. Within this sub-group, women in the PHE woredas were over four times more likely to use an FP method during the study period compared with women in the non-PHE woredas. (Women whose husbands support their use of FP were 17 times as likely to use an FP method.) This was increased to 20 times more likely when conducting a sub-group analysis for women who were not new acceptors.
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