MGHD 2021

Introduction Family planning has been proffered as a critical factor in addressing the high maternal mortality occurring globally, especially in refugee settings. However, contraceptive uptake in refugee settings is still low even with efforts geared towards improving family planning practice among refugee communities. Therefore, our study was conducted to assess women’s family planning Knowledge, attitudes, and practice in Kiziba refugee camp, Rwanda. Methods A cross sectional quantitative study using paper-based surveys was conducted between May and June 2021. Random sampling method was used to select participants based on a list provided by UNHCR; information was collected through questionnaires during interview sessions with the study participants. The measures focused on family planning knowledge, attitudes, and practice among women aged 21 to 45 living in the camp. Quantitative analysis was conducted using SPSS (IBM, V.27). Chi square test with a cutoff at p=0.05 was used for association between variables. Results A total of 338 women were interviewed with a response rate of 100%. The overall knowledge score was 58.2% (SD ±15.1%), with only 17 (5.0%) respondents scoring 80% and above, denoting the good knowledge level. The knowledge level was strongly associated with the attitude statement “an unmarried woman who reveals she is on family planning will be discriminated against by the community in the camp”. The odds of having good knowledge among respondents who agreed were 2.917 times more than those who disagreed (95% Cl 1.058-8.040, p=0.038). Among the respondents, 29.6% were using contraceptives in the last three months prior to the study. The most commonly used and preferred methods were implants (n=49, 49.0%), pills (n=31, 31.0%), and injectables (n=15, 15.0%). Among the women using contraceptives, 28.0% discontinued and health issues (53.6%) were the major reason for discontinuation. Family planning utilization was strongly associated with religion after multivariate analysis. The odds of family planning practice among Adventist were 0.259 times lower (95% Cl 0.102-0.661, p=0.005), and among Pentecostal were 0.269 times lower (95% Cl 0.103-0.703, p=0.007). Conclusion and Recommendation Family planning knowledge and contraceptive utilization were low among the women who participated in the study. Therefore, revising existing family planning training curriculum and implementing evidence-based training programs might help to increase women’s knowledge on contraceptive types, their effectiveness, and usage. Continuous and effective family planning community mobilization and sensitization through radio programs, drama, and existing women group forums can help to address barriers to family planning practice. In addition, routine monitoring of family planning utilization through regular analysis of existing family planning records can help to understand potential reasons for family planning discontinuation which can guide decision making to improve service delivery and uptake.