Inclusive Family Planning towards the Achievement of Agenda 2030: The Case of Slum Households in Yeka Sub-City Of Addis Ababa
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Date
2019-06
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Addis Ababa University
Abstract
The international community has long agreed that every individual has the right to health,
and that Reproductive Health including Family Planning is a fundamental right of all
people. The rights-based approach of Family Planning calls on providers and programs
to focus on the needs of hard-to-reach and marginalized groups, removing unnecessary
eligibility requirements that exclude clients based on age, marital status, etc. and
incorporating interventions at the policy, community, and individual levels.
Contraceptives are available in Ethiopia. Persistently high fertility rates indicate that
women fail to use effective contraceptives. Drivers for use of inclusive family planning
services need to be identified in order to enable more Ethiopian women to access and
utilize contraceptives. The Sustainable Development Goals Report 2018 shows that, in
some areas, the progress is insufficient to meet the Agenda‟s goals and targets by 2030.
This is especially true for the most disadvantaged and marginalized groups like urban
slums. Therefore, this study has examined the level of family planning utilization and the
drivers of inclusive family planning in urban slums. The study evaluated the approach and
contribution of family planning intervention model in enhancing the livelihood of urban
slums. The study was conducted in the slum area of woreda 4 with in Yeka sub-city of
Addis Ababa. For this purpose, 287 women of reproductive age group were selected from
the slum areas using multi-stage sampling technique and survey was conducted.
Descriptive method was employed to analyze the level of family planning utilization and
the drivers of inclusive family planning. In addition to the survey, key informant interview
and direct observation were also employed to further explore and triangulate the data
obtained about the drivers of inclusive family planning and to evaluate the family
planning intervention model. The study revealed that the level of family planning
utilization by the slum households was very low. The most important drivers of inclusive
family planning were found to be Media, Availability of facilities and family planning
methods, Individuals‟ behaviors and attitudes, Government support, donor support, nongovernmental and public–private partnerships and the Health Extension Program and
Youth friendly clinic (e.g. Privacy). The study revealed that there are a number of gaps
and challenges observed in the family planning intervention model some of which are lack
of training of service providers and Urban Health extension workers, lack of
accountability by the Urban Health extension workers, the Urban Health extension
Programme being not fit for purpose and doesn‟t capture the dynamics of social problem,
absence of multiple service delivery channels, lack of peer led approach at the facility,
very low policy support for community engagement in slum area, government not giving a
priority to FP which implies sectorial level marginalization besides to the community level
marginalization in the slum area and others. The study forwarded recommendations for
the government, policy makers, service providers and different partners working on FP to
consider and to work for better access and utilization of family planning and most
importantly for inclusive family planning service which will hasten the progress towards
the achievement of Agenda 2030.
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Keywords
Inclusive family planning, rights based approach, disadvantaged and marginalized groups, urban slums, family planning intervention model and agenda 2030