Understanding the association between family planning and fertility reduction in Southeast Asia: a scoping review.

OBJECTIVES: We aimed to explore and understand the extent and type of evidence on fertility reduction and its association with family planning (FP) in Southeast Asia. DESIGN: Scoping review, following the methodological principles developed by Arksey and O'Malley and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines for reporting. DATA SOURCE: We searched PubMed/MEDLINE, ProQuest, EBSCO, Scopus, Web of Science, Google Scholar and reference lists of relevant articles between 1 January 2012 and 31 December 2022. Only open-access articles in English were considered. STUDY SELECTION: For inclusion, observational studies were selected for eligibility based on the original articles investigating the uptake of FP on women aged 15-49 years and its association with fertility decline in Southeast Asian (SEA) countries. DATA EXTRACTION AND ANALYSIS: Two reviewers screened the records independently for eligibility and extracted all data. The specific details of the studies, including data on the authors, year of publication, setting, study design, aims/objectives of the study, specific intervention, outcomes and main findings, were reported. RESULTS: We retrieved 615 articles and retained 12 articles included in the analysis. Of these, 11 were quantitative studies and 1 was qualitative study. The frequently reported strategy of FP was the use of contraception. FP not only allows women to control their birth by spacing and limiting their pregnancies but also delay their first childbirth by using contraceptive methods. CONCLUSION: Our review suggests that the FP programmes aiming at reducing fertility should have a specific focus on improving the uptake and continuation of FP services.

Antenatal care utilization on low birth weight children among women with high-risk births.

Background: Low birth weight (LBW) is a major public health problem in Indonesia, and is a leading cause of neonatal mortality. Adequate antenatal care (ANC) utilization would help to prevent the incidence of LBW babies. This study aims to examine the association between ANC utilization and LBW children among women with high-risk birth criteria. High-risk birth criteria consisted of 4T which were too young (mother's age <20 years old), too old (mother's age >35 years old), too close (age gap between children <2 years), and too many (number of children >2 children). Methods: This study utilized calendar data from the women's module from the 2017 Indonesia Demographic and Health Survey (IDHS), with the unit of analysis only the last birth of women of childbearing age (15-49), which numbered 16,627 women. From this number, analysis was done by separating the criteria for women with high-risk birth. Multivariate logistic regression analyses were employed to assess the impact of ANC and socio-demographic factors on LBW among women with high-risk birth criteria. Results: This study revealed that only among women with too many children criteria (>2 children), adequate ANC utilization was significantly associated with LBW of children, even after controlling for a range of socio-demographic factors (p < 0.05). In all four women criteria, preterm birth was more likely to have LBW than those infants who were born normally (above and equal to 2500 grams) (p < 0.001). Conclusions: According to WHO, qualified ANC standards have not been fully implemented, including in the case of ANC visits of at least eight times, and it is hoped that ANC with health workers at health facilities can be increased. There is also a need for increased monitoring of pregnant women with a high risk of 4T to keep doing ANC visits to reduce LBW births.