Objectives
By the end of this session, we will able to:
Define Family Planning
Describe the components of FP services
Identify contraceptive methods available in Ethiopia
Describe current contraceptive updates
Definition of family planning
Family planning is defined as the ability of
individuals and couples to anticipate and
attain their desired number of children and
the spacingand timingof their births
Benefits of FP and its Role in Achieving
National Development Goals
Health benefits
Social and economic benefits
Individual:
Family
Community
Global
Low FP service
Coverage
High rate of
Unwanted pregnancy
Unsafe Abortion
Family/
Population size
Increase
maternal Morbidity
High
MMR
Poverty
MigrationCSW
Environmental
Degradation
Ill HealthIll Health and Social Wellbeing
RH situation in Ethiopia
Family Planning
Early marriage
HIV/AIDS
Harmful Traditional Practices (HTPs)
Population and development
Ethiopian Population 1900-2020
(Past, Present, Future)0
20
40
60
80
100
120
1900192519401955196019701980199020002005201020152020
Millions
Indicator Value
Population in Millions 74 Million
Total fertility rate 4.8 (DHS 2011)
Infant mortality rate 59/1000 (DHS 2011)
Under five mortality rate88/1000(DHS 2011)
Maternal mortality ratio 590/100000-Lancet report
Antenatal coverage 34% (DHS 2011)
Contraceptive Prevalence rate28.6%(DHS 2011)
Health status indicators
Family Planning
0
10
20
30
40
50
60
NFFS1990 EDHS 2000 EDHS2005 EDHS 2011
5
8
15
28.6
36
34
25
44
49
53.6
percent
CPR
Unmet FP need
Total Demand
for FP
Family planning …
•Dramatic progress in meeting clients reproductive
intentions
–↑CPR
–↓Unmet need
•New MOH strategy for making services available and
accessible
–Health Development Army6%
36%
15%
34%
29%
25%
0%
10%
20%
30%
40%
50%
60%
2000 2005 2011
Umet need
CPR
Family planning by method
Method 2000
DHS
2005
DHS
2011 DHS
Any method 8.1 14.7 28.6
Modern method 6.3 13.9 27.3
Pill 2.5 3.1 0.3
IUCD 0.1 0.2 2.1
Injectables 3.1 9.9 20.8
Condom 0.3 0.2 0.2
Implants 0.0 0.2 3.4
PM N a 0.2 0.5
FP Methods available in Ethiopia
Natural Family Planning
Methods
Abstinence
Fertility awareness based
methods:
Standard Days Method
(SDM)
Rhythm (Calendar)
Method
Cervical Mucus (Billings
ovulation) Method
Sympto-thermal Method
Lactational Amenorrhea
Method (LAM),
Withdrawal Method
Modern Family Planning
Methods
Condoms/Diaphragms and
other barrier methods
Vaginal Contraceptive
Foam Tablet and Jellies
Emergency Contraceptives
Progestin-Only Pills
Combined Oral
Contraceptives
Injectable contraceptives
Implants
IUCD
Bilateral tubal ligation
Vasectomy
Effectiveness
Source: CCP and WHO, 2007.
Oral contraceptives
Percentage of women pregnant in first year of use
Rate during typical use
Rate during perfect use
Female condom
Female sterilization
Implants
DMPA
Spermicides
Diaphragm w/spermicides
Male condom
IUD (TCu-380A)
0 10 15 20 255 30
Most effective
and nothing to remember.
Effective but must be carefully
used.
Fewer side-effects:
Very effective but must
be carefully used.
More side-effects:
PillsInjectables
Fertility
awareness-
based
methods
Vaginal
metho
ds
Male and
female
condom
Fewer side-effects,
permanent:
More side-effects:
Implants
IUD
Fewer side-effects:
LAM
Female
sterilization
Vasectomy
Comparing methods
IMPORTANT!
Only condoms protect
against
both
pregnancy
andSTIs/HIV/AIDS
Contraceptive technology updates
Biphasic and Tri-phasic COC pills
Combined Patch
Combined Vaginal Ring
Levonorgestrel containing IUCD
Progestin-releasing IUCD
Mirena (Levonorgestrel Intrauterine System)/IUS: For
5 years
U-kare IUCD(Cu-375): For 5 years
Newer implants –Jadelle, Implanon, Sinoplant
BTL –laparascopic approach
Vasectomy-no-scalpel method
17
Transdermal patch/ Ortho-evra
Contains estrogen and progesterone
1 patch per week for 3 weeks followed by a week off
18
Vaginal ring/ Nuva ring
Contains estrogen & progesterone
Ring( 5 cm in diameter) in to the vagina for 3 weeks &
out the 4
th
week