Antepartum perceptions of postpartum family planning in Albania

Introduction: Albania, a small Mediterranean nation, has undergone significant demographic change. Since 1955, Albanian TFR fell from 6.8 to 1.6. This occurred without use of modern methods of family planning (couples instead relying on withdrawal and abortion) and contributing to high rates of unwanted pregnancies. Recently, Jhpiego began training reproductive health providers in four cities in family planning. We evaluated this training, comparing anticipated family planning use in one of those cities (Tirana) with its neighbor (Durres). Methods: 242 women were surveyed from antenatal care clinics at maternity hospitals and polyclinics. Multivariate logistic models, controlling for age, education, rural/urban status and parity, were used to determine relationships between survey city and knowledge about, past use of, and anticipated use or family planning methods. Results: Evidence shows women in Tirana reported a higher rate of postpartum family planning counseling during ANC visits, 39.4%, than those in Durres, 18.5% (OR = 2.736; p = 0.0058). Additionally, 65.7% of women in Tirana planned to use a modern method of family planning postpartum, compared to only 38.2% of women in Durres (OR = 2.252; p = 0.0080). Furthermore, the methods specifically promoted by Jhpiego showed greater gains from ever use to anticipated use in Tirana than in Durres. Conclusion: Although other factors could contribute to a higher anticipated rate of postpartum family planning use in Tirana over Durres, it is likely that these results can be partly attributed to detailed postpartum family planning training for providers, as supported by Jhpiego's work in Albania.