Assessing the knowledge, attitudes, and practice of family planning among women aged 21- 45 in Kiziba refugee camp

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.