The influence of personal, family and community and religious and cultural factors on couples’ family planning decisions in Qatar and Islamic and/or Arabic societies

Abstract

Background: Family planning is important to foster maternity, infancy, and healthy children. A key goal in maternal child health is to improve the use of antenatal and postnatal services in a community. Both clinical practice and empirical literature indicate that many factors influence the use of family planning services. The Qatar National Health Strategy and Primary Health Care Corporation’s goals are to deliver healthcare that more effectively empowers patients and families in making decisions about their health and wellness. Couples who have an in-depth understanding and knowledge of the impact of family planning on maternal child health are positioned to make fully informed decisions. Health providers’ and educators’ knowledge of family planning’s impact is key in supporting families’ decisions regarding family planning.
Methods: Whittemore and Knafl’s framework was used to guide this integrative literature review. The search was conducted using five databases for peer-reviewed articles published between 2011 and 2022 as well as inclusion and exclusion criteria. The Mixed MethodsAppraisal Tool was used to assess the quality of the studies. Data was analyzed using a thematic framework. The socio-ecological model was adapted and modified for data synthesis.
Results: A couple’s participation in family planning is influenced by personal characteristics (knowledge, education, income), family and community (husband) as well as religion and culture. The influence of religion and husbands are paramount in decisions about family planning.
Conclusions: Understanding the factors that influence family planning decisions is essential to make informed decisions and provide effective interventions. Healthcare providers and program planners should consider these factors when developing strategies to improve couples’ access to and utilization of family planning. The development and implementation of such strategies will require the input of all stakeholders, the inclusion of champions, and attention to the local context as well as more broadly to Islamic and Arabic societies.

Keywords

Arabic / Contraception / Culture / Education / Family planning / Gender / Husband / Knowledge / Muslim / Qatar / Religion

References

[1] Wemakor A, Garti H, Saeed N, et al. Prevalence and determinants of unmet need for contraception in North Gonja District, Ghana. BMC Women’s Health. 2020; 20: 222. PMid:33023544 https://doi.org/10.1186/s12905-020-01077-4

[2] Duclos D, Cavallaro FL, Ndoye T, et al. Critical insights on the demographic concept of “birth spacing”: locating Nef in family well-being, bodies, and relationships in Senegal. Sexual & Reproductive Health Matters. 2019; 27(1): 1-10. PMid:31533565 https://doi.org/10.1080/26410397.2019.1581533

[3] Baqui AH, Ahmed S, Begum N, et al. Impact of integrating a postpartum family planning program into a community-based maternal and newborn health program on birth spacing and preterm birth in rural Bangladesh. Journal of Global Health. 2018; 8(2): 020406. PMid:30023053 https://doi.org/10.7189/jogh.08.020406

[4] Molitoris J, Barclay K, Kolk M. When and where birth spacing matters for child survival: an international comparison using the DHS. Demography. 2019; 56(4): 1349-70. PMid:31270780 https://doi.org/10.1007/s13524-019-00798-y

[5] Nausheen S, Bhura M, Hackett K, et al. Determinants of short birth intervals among married women: a cross-sectional study in Karachi, Pakistan. BMJ Open. 2020; 11(4): e043786. https://doi.org/10.1101/2020.08.13.20174110

[6] Abdi B, Okal J, Serour G, et al. “Children are a blessing from God”- a qualitative study exploring the socio-cultural factors influencing contraceptive use in two Muslim communities in Kenya. Reproductive Health. 2020; 17(1): 1-11. PMid:32245521 https://doi.org/10.1186/s12978-020-0898-z

[7] Sensoy N, Korkut Y, Akturan S, et al. Factors affecting the attitudes of women toward family planning. In ZO Amarin (Ed.), Family planning. IntechOpen. 2020. https://doi.org/10.5772/intechopen.73255

[8] World Health Organization. Programming Strategies for Postpartum Family Planning. Available from: https://www.who.int/publications/i/item/9789241506496 (Accessed Feb 12, 2022)

[9] World Health Organization. Family Planning/Contraception. Available from: https://www.who.int/news-room/fact-sheets/detail/family-planning-contraception (Accessed Jan 14, 2022)

[10] Arbab AA, Bener A, Abdulmalik M. Prevalence, awareness, and determinants of contraceptive use in Qatari women. Eastern Mediterranean Health Journal. 2011; 17(1): 11-18. PMid:21735796 https://doi.org/10.26719/2011.17.1.11

[11] United Nations Population Fund Agency. Family Planning. Available from: https://arabstates.unfpa.org/en/topics/family-planning (Accessed Nov 24, 2019).

[12] Royer PA, Olson LM, Jackson B, et al. “In Africa, there was no family planning. Every year you just give birth”: family planning knowledge, attitudes, and practices among Somali and Congolese refugee women after resettlement to the United States. Qualitative Health Research. 2020; 30(3): 391-408. PMid:31347453 https://doi.org/10.1177/1049732319861381

[13] Abdi B, Okal J, Serour G, et al. Muslim men’s perceptions and attitudes on family planning: a qualitative study in Wajir and Lamu counties in Kenya. Sexual & Reproductive Health Matters. 2021; 29(1): 303-13. PMid:33719937 https://doi.org/10.1080/26410397.2021.1893890

[14] Souza MTD, Silva MDD, Carvalho RD. Integrative review: what is it? How to do it? Einstein. 2010; 8: 102-6. PMid:26761761 https://doi.org/10.1590/s1679-45082010rw1134

[15] Whittemore R, Knafl K. The integrative review: updated methodology. Journal of Advanced Nursing. 2005; 52(5): 546-53. PMid:16268861 https://doi.org/10.1111/j.1365-2648.2005.03621.x

[16] Cooper HM. Synthesizing research: a guide for literature reviews. 3rd ed. Sage; 1998.

[17] Kilanowski JF. Breadth of the socio-ecological model. Journal of Agromedicine. 2017; 22(4): 295-7. PMid:28742433 https://doi.org/10.1080/1059924X.2017.1358971

[18] Alomair N, Alageel S, Davies N, Bailey JV. Factors influencing sexual and reproductive health of Muslim women: a systematic review. Reproductive Health. 2020; 17(1): 1-15. PMid:32138744 https://doi.org/10.1186/s12978-020-0888-1

[19] Zimmerman LA, Sarnak DO, Karp C, et al. Family planning beliefs and their association with contraceptive use dynamics: results from a longitudinal study in Uganda. Studies in Family Planning. 2021; 52(3): 241-58. PMid:34015142 https://doi.org/10.1111/sifp.12153

[20] Almalik M, Mosleh S, Almasarweh I. Are users of modern and traditional contraceptive methods in Jordan different? Eastern Mediterranean Health Journal. 2018; 24(4): 377-84. PMid:29972232 https://doi.org/10.26719/2018.24.4.377

[21] Mahadeen AI, Khalil AO, Hamdan-Mansour AM, et al. Knowledge, attitudes and practices towards family planning among women in the rural southern region of Jordan. Eastern Mediterranean Health Journal. 2012; 18(6): 567-72. PMid:22888612 https://doi.org/10.26719/2012.18.6.567

[22] Al Kindi RMA, Al Sumri HHA. Prevalence and sociodemo-graphic determinants of contraceptive use among women in Oman. Eastern Mediterranean Health Journal. 2019; 25(7): 495-502. PMid:31612981 https://doi.org/10.26719/emhj.18.064

[23] Rahman MM, Mostofa MG, Hoque MA. Women’s household decision-making autonomy and contraceptive behavior among Bangladeshi women. Sexual & Reproductive HealthCare. 2014; 5(1): 9-15. PMid:24472384 https://doi.org/10.1016/j.srhc.2013.12.003

[24] Adanikin AI, McGrath N, Padmadas SS. Impact of men’s perception on family planning demand and uptake in Nigeria. Sex-ual & Reproductive Healthcare. 2017; 14: 55-63. Mid:29195635 https://doi.org/10.1016/j.srhc.2017.10.002

[25] Jalu MT, Ahmed A, Hashi A, et al. Exploring barriers to reproductive, maternal, child and neonatal (RMNCH) health-seeking behaviors in Somali region, Ethiopia. PLOS ONE. 2019; 14(3): e0212227. PMid:30875382 https://doi.org/10.1371/journal.pone.0212227

[26] Pallangyo ES, Msoka AC, Brownie S, et al. Religious beliefs, social pressure, and stigma: rural women’s perceptions and beliefs about vasectomy in Pwani, Tanzania. PlOS ONE. 2020; 15(3): e0230045. PMid:32196511 https://doi.org/10.1371/journal.pone.0230045

[27] Dikmen HA, Cankaya S, Yilmaz SD. The attitudes of refugee women in Turkey towards family planning. Public Health Nursing. 2018; 36(1): 45-52. PMid:30264531 https://doi.org/10.1111/phn.12553

[28] Chouhan P, Saha J, Zaveri A. Covariates of fertility behavior among ever-married women in West Bengal, India: analysis of the national family health survey-4. Children & Youth Services Review. 2020; 113: 104956. https://doi.org/10.1016/j.childyouth.2020.104956

[29] Zhang Y, McCoy EE, Scego R, et al. A qualitative exploration of Somali refugee women’s experiences with family planning in the U.S. Journal of Immigrant & Minority Health. 2020; 22(1): 66-73. PMid:30941615 https://doi.org/10.1007/s10903-019-00887-5

[30] Abu Hani RA, Peleg R, Freud T, et al. Knowledge, attitudes and contraceptive use among Muslim Bedouin women in southern Israel. Health & Social Care in the Community. 2020; 29(4): 889-96. PMid:32757233 https://doi.org/10.1111/hsc.13122

[31] Wijerathna DMSG. Ethnic differences in desired birth spacing: a case study of the Maradana Grana Niladari division Colombo district. Sri Lanka Journal of Population Studies. 2017; 17: 39-50.

[32] Patra S, Singh RK. Addressing unmet need and religious barrier towards the use of family planning method among Muslim women in India. International Journal of Human Rights in Healthcare. 2015; 8(1): 22-35. https://doi.org/10.1108/IJHRH-06-2014-0010

[33] Sahu B, Hutter I. “Lived Islam” in India and Bangladesh: negotiating religion to realise reproductive aspirations. Culture, Health & Sexuality. 2012; 14(5): 521-35. PMid:22468853 https://doi.org/10.1080/13691058.2012.672652

[34] Gogoi M. Perception and practice of family planning: an anthropological study among the Assamese caste Hindus and Muslim population in Goalpara district, Assam. Research Journal of Pharmacy and Technology. 2019; 12(1): 324-30. https://doi.org/10.5958/0974-360x.2019.00059.3

[35] Fatma A, Kumar A. Religious beliefs, birth control and fertility behaviouramongMuslim marriedwomen ofMeerutcity. IndianJournal of Health & Wellbeing. 2021; 12(2): 240-2.

[36] Khalil SN, Alzahrani MM, Siddiqui AF. Unmet need and demand for family planning among married women of Abha, Aseer Region in Saudi Arabia. Middle East Fertility Society Journal. 2018; 23(1): 31-6. https://doi.org/10.1016/j.mefs.2017.07.004

[37] Ibrar M, Naqvi RH, Munir A. Attitude of the community towards birth spacing: a case study of District Swabi, Province Khyber Pakhtunkhwa, Pakistan. Putaj Humanities & Social Sciences. 2014; 21(1): 125-32. https://doi.org/10.7763/IJSSH.2015.V5.451

[38] Price M, Safadi R, Clements D. Reproductive health experiences of Syrian refugees residing in Jordan. Journal of Midwifery & Reproductive Health. 2020; 8(4): 2476-85. https://doi.org/10.22038/jmrh.2020.47901.1590

[39] Elfstrom KM, Stephenson R. The role of place in shaping contraceptive use among women in Africa. PLOS ONE. 2012; 7(7): e40670. PMid:22815784 https://doi.org/10.1371/journal.pone.0040670

[40] Ahmed AA, Mohamed AA, Guled IA, et al. Knowledge translation in Africa for 21st century integrative biology: the “know-do gap” in family planning with contraceptive use among Somali women. Omics: A Journal of Integrative Biology. 2014; 18(11): 696-704. PMid:25333614 https://doi.org/10.1089/omi.2014.0080

[41] Abdulahi M, Kakaire O, Namusoke F. Determinants of modern contraceptive use among married Somali women living in Kampala; a cross-sectional survey. Reproductive Health. 2020; 17: 72. PMid:32448285 https://doi.org/10.1186/s12978-020-00922-x

[42] Hosany AS, Hamilton RW. Family responses to resource scarcity. Journal of the Academy of Marketing Science. 2022; 51: 1351-81. PMid:35791312 https://doi.org/10.1007/s11747-022-00882-7

[43] Ş Sekerci YG, Yıldırım TA. The knowledge, attitudes and behaviours of Syrian refugee women towards family planning: sample of Hatay. International Journal of Nursing Practice. 2020; 26(4): e12844. PMid:32453486 https://doi.org/10.1111/ijn.12844

[44] Yücel U, Çiçeklioğ glu M, Öcek ZA, et al. Access to primary health care family planning services and contraceptive use in disadvantaged women: a qualitative study. European Journal of Contraception & Reproductive Health Care. 2020; 25(5): 327-33. PMid:32687422 https://doi.org/10.1080/13625187.2020.1795119

[45] Saelim J, Santibenchakul S, Jaisamrarn U. Comparison of the knowledge, attitudes toward, and practices of contraception between Thai Muslim women living in Bangkok and those living in the southernmost provinces of Thailand. Asian Biomedicine. 2016; 10(4): 351-9. https://doi.org/10.5372/1905-7415.1004.498

[46] Tarar MA, Muhammad A, Gondal ML, et al. Knowledge, attitude and contraceptive practice among agrarian & non-agrarian married women in rural areas of Dera Ghazi Khan-Pakistan. Pakistan Journal of Agricultural Sciences. 2020; 57(4): 1181-7. https://pakjas.com.pk/papers/3228.pdf

[47] Gele AA, Musse FK, Shrestha M, et al. Barriers and facilitators to contraceptive use among Somali immigrant women in Oslo: a qualitative study. PLOS ONE. 2020; 15(3): 1-15. PMid:32155181 https://doi.org/10.1371/journal.pone.0229916

[48] Raja Ariffin RN, Talib AMMA, Satar NM, et al. Muslim women’s marriage, pregnancy, abortion and spacing of children. Journal of Health Management. 2017; 19(4): 625-33. https://doi.org/10.1177/0972063417727621

[49] Sundararajan R, Yoder LM, Kihunrwa A, et al. How gender and religion impact uptake of family planning: results from a qualitative study in Northwestern Tanzania. BMC Women & Health. 2019; 19(99). PMid:31331306 https://doi.org/10.1186/s12905-019-0802-6

[50] Khan MN, Islam MM, Rahman MM, et al. Access to female contraceptives by Rohingya refugees, Bangladesh. Bulletin of the World Health Organization. 2021; 99(3): 201-8. PMid:33716342 https://doi.org/10.2471/BLT.20.269779

[51] Cıft T, Temur M, Korkmazer E, et al. Understanding of birth control methods behaviors within the Syrian refugee population in Turkey. Journal of Clinical and Analytical Medicine. 2019; 24: 58-61. https://doi.org/10.4328/JCAM.5842

[52] Asif MF, Pervaiz Z, Afridi JR, et al. Role of husband’s attitude towards the usage of contraceptives for unmet need of family planning among married women of reproductive age in Pakistan. BMC Women’s Health. 2021; 21(1): 163. PMid:33874926 https://doi.org/10.1186/s12905-021-01314-4

[53] Böttcher B, Abu-El-Noor M, Abu-El-Noor N. Choices and services related to contraception in the Gaza strip, Palestine: perceptions of service users and providers. BMC Women’s Health. 2019; 19(1): 104956. PMid:31856794 https://doi.org/10.1186/s12905-019-0869-0

[54] Ocak M, Ozmen EE. Opinions and attitudes of the local people towards family planning: Nyala/Sudan example. Annals of Clinical and Analytical Medicine. 2021; 12(supp 2): s131-7. https://doi.org/10.4328/ACAM.20396

[55] Packer CA, Rastagar SH, Chen M, et al. Factors associated with reported modern contraceptive use among married men in Afghanistan. Reproductive Health. 2020; 17: 64. PMid:32398075 https://doi.org/10.1186/s12978-020-0908-1

[56] Wong LP. An exploration of knowledge, attitudes, and behaviours of young multiethnic Muslim-majority society in Malaysia in relation to reproductive and premarital sexual practices. BMC Public Health. 2012; 12: 865. PMid:23057505 https://doi.org/10.1186/1471-2458-12-865

[57] Döner P, Şahin K. “This is not my decision; I have no alternative”. Perceptions and experiences of marriage age and family planning among Syrian women and men: a primary care study. Primary Health Care Research & Development. 2021; 22: e25. PMid:34092278 https://doi.org/10.1017/S1463423621000220

[58] Elmusharaf K, Byrne E, O’Donovan D. Social and traditional practices and their implications for family planning: a participatory ethnographic study in Renk, South Sudan. Reproductive Health. 2017; 14: 1-11. PMid:28095917 https://doi.org/10.1186/s12978-016-0273-2

[59] Pinter B, Hakim M, Seidman DS, et al. Religion and family planning. European Journal of Contraception & Reproductive Health Care. 2016; 21(6): 486-95. PMid:27681868 https://doi.org/10.1080/13625187.2016.1237631

[60] Osuafor GN, Mturi AJ. Do religious beliefs influence use of contraception among currently married women in Nigeria? Journal of Social Development in Africa. 2013; 28(1): 187-212.

[61] Lasong J, Zhang Y, Gebremedhin SA, et al. Determinants of modern contraceptive use among married women of reproductive age: a crosssectional study in rural Zambia. BMJ Open. 2020; 10(3): e030980. PMid:32234737 https://doi.org/10.1136/bmjopen-2019-030980

[62] Tigabu S, Demelew T, Seid A, et al. Socioeconomic and religious differentials in contraceptive uptake in western Ethiopia: a mixed-methods phenomenological study. BMC Women’s Health. 2018; 18: 85. PMid:29871621 https://doi.org/10.1186/s12905-018-0580-6

[63] Cox CM, Ahmed F, Mitchell A, et al. Decision making and communication about child spacing among Somali couples in Minnesota. Perspectives on Sexual & Reproductive Health. 2019; 51(2): 63-9. PMid:30977958 https://doi.org/10.1363/psrh.12100

[64] Kane S, Kok M, Rial M, et al. Social norms and family planning decisions in South Sudan. BMC Public Health. 2016; 16(1): 1183. PMid:27876018 https://doi.org/10.1186/s12889-016-3839-6

[65] Dal NA, Beydağ KD. Attitudes of married Muslim women regarding family planning methods during the COVID-19 pandemic in western Turkey. Journal of Religion and Health. 2021; 60(5): 3394-405. PMid:34403029 https://doi.org/10.1007/s10943-021-01387-3

[66] Shabaik SA, Awaida JY, Xandre P, et al. Contraceptive beliefs and practices of American Muslim women. Journal of Women’s Health. 2019; 28(7): 976-83. PMid:31120322 https://doi.org/10.1089/jwh.2018.7500

[67] International Islamic Center for Population Studies and Research. Family Planning and the Opinions of Contemporary Imams of Jurisprudence [Internet]. UNFPA in Egypt. Available from: https://egypt.unfpa.org/sites/default/files/pub-pdf/fp_from_islamic_prespective_manual

[68] Adulyarat M, Parisunyakul S, Senaratana W, et al. Culturally-sensitive maternity care needs of Muslim mothers in a rural community of the southernmost province in Thailand. Pacific Rim International Journal of Nursing Research. 2016; 20(4): 350-363.

[69] Usta J, Taleb R, El Harakeh S, et al. Predictors of contraception use among Syrian refugees in Lebanon: results from a cross-sectional study. Maternal & Child Health Journal. 2021; 25(4): 684-93. PMid:33247822 https://doi.org/10.1007/s10995-020-03098-9

[70] Guracho YD, Belay BY, Alemayehu A, et al. Women’s decision-making power on modern family planning use and its associated factors in Northwest Ethiopia. BioMed Research International. 2022; 1(8): 9060809. PMid:35865670 https://doi.org/10.1155/2022/9060809

[71] Al-Sheyab NA, Al-Nsour M, Khader YS, et al. Midwives and women’s perspectives on family planning in Jordan: Human rights, gender equity, decision-making and power dynamics. Heliyon. 2021; 7(8): e07810. PMid:34458635 https://doi.org/10.1016/j.heliyon.2021.e07810

[72] Bhatt N, Bhatt B, Neupane B, et al. Perceptions of family planning services and its key barriers among adolescents and young people in eastern Nepal: a qualitative study. PLOS ONE. 2021; 16(5): e0252184. PMid:34038439 https://doi.org/10.1371/journal.pone.0252184

[73] Truong S, Villar de Onis J, Lindley A, et al. Gender-informed family planning perceptions and decision-making in rural Chiapas, Mexico: a mixed-methods study. International Journal of Reproductive Medicine. 2020; 2020(1): 929143. PMid:32099840 https://doi.org/10.1155/2020/1929143

[74] Egeh AA, Dugsieh O, Erlandsson K, et al. The views of Somali religious leaders on birth spacing-a qualitative study. Sexual & Reproductive HealthCare. 2019; 20: 27-31. PMid:31084814 https://doi.org/10.1016/j.srhc.2019.02.003

[75] World Health Organization. AA-HA! Global Accelerated Action for the Health of Adolescents. Available from: https://www.who.int/initiatives/global-accelerated-action-for-the-health-of-adolescent (Accessed Jan 25, 2020).

[76] World Health Organization. Operational Framework for Primary Health Care: Transforming Vision into Action. Available from: https://www.who.int/publications/i/item/9789240017832 (Accessed Mar 3, 2020).