Perceptions, attitude and use of family planning services in post conflict Gulu district, northern Uganda.
BACKGROUND
Northern Uganda was severely affected by two decades of civil war that led to the displacement and encampment of an estimated 1.6 million inhabitants. The objective of this study was to assess community perspectives, attitude and factors that influence use of family planning (FP) services in post conflict Gulu district.


METHODS
We conducted a cross sectional study using multistage sampling technique. All three counties in the district were purposely selected. Two sub-counties per county and four parishes per sub-county were randomly selected. A total of 24 parishes (clusters) and 21 adult heads of households per cluster were randomly selected and interviewed. In total, 500 adults 117 males (23.4 %) and 383 females (76.6 %) were interviewed. We conducted 8 focus group discussions and 6 key informant interviews with family planning managers and service providers. Quantitative data were entered in EPI data and analyzed using STATA version 12. Qualitative data were analyzed manually using thematic content analysis.


RESULTS
Contraceptive prevalence rate was 47.5 %. Communities perceive FP as acceptable, beneficial and geographically, temporally and financially accessible. Factors associated with FP use included age 26-35 years (AOR 1.92, 95 % CI 1.18-3.10, p = 0.008), and 36-45 years (AOR 2.27, 95 % CI 1.21-4.25, p = 0.010), rural residence (AOR = 0.41, 95 % CI 0.24-0.71, p = 0.001), cohabitation (AOR = 2.77, 95 % CI 1.15-6.65, p = 0.023), and being a farmer (AOR 0.59, 95 % CI 0.35-0.97, p = 0.037). The main reason for non-use of family planning was fear of side effects 88.2 %. The main source of FP services was government health facilities 94.2 %.


CONCLUSIONS
Use of family planning is relatively high and communities view FP services as acceptable, beneficial and accessible. Family planning use is mainly determined by age, residence, occupation and marital status. Fear of side effects is the main impediment to FP use. There is need to increase awareness and effectively manage side effects of family planning in the settings.
Department of Community Health and Behavioural Sciences, Makerere University-School of Public Health, P.O Box 7072, Kampala, Uganda.
Christopher Garimoi
CG
Orach
St. Marys Hospital Lacor, 180, Juba Road, Gulu, Uganda.
George
G
Otim
Uganda Bureau of Statistics, 7186, Plot 9 Colville Street, Kampala, Uganda.
Juliet Faith
JF
Aporomon
International Health Sciences University, 7782, St. Barnabas Road, Kampala, Uganda.
Richard
R
Amone
Kyambogo University, Kampala, Uganda.
Stephen Acellam
SA
Okello
Gulu University, Faculty of Medicine, Kampala, Uganda.
Beatrice
B
Odongkara
Department of Community Health and Behavioural Sciences, Makerere University-School of Public Health, P.O Box 7072, Kampala, Uganda.
Henry
H
Komakech
Accessibility; Attitudes; Family planning services; Northern Uganda; Perceptions; Post conflict; Utilization