Attitudes and Perceptions of Health Workers Towards Immediate Postpartum Family Planning at Soroti Regional Referral Hospital: A Qualitative Study

Abstract

Introduction: Unintended pregnancy among married women remains a great health burden in LMICs. Having successfully completed child birth, the World health organization guides that woman wait for not less than two to three years before attempting another pregnancy to reduce health risks for the mother and the baby. Whereas much is known about client related factors contributing to the low uptake of immediate postpartum family planning (IPPFP), little is known about health care workers (HCWs). This study sought to explore health workers’ attitudes and perceptions toward IPPFP at Soroti Regional Referral Hospital (SRRH). Methods: Sixteen (16) HCWs from the Department of Obstetrics and Gynecology at SRRH participated in this exploratory qualitative study. Purposive sampling was employed for recruitment. Data were collected through in-depth interviews and analyzed using hybrid thematic analysis to generate codes and themes. Results: Thematic analysis involving 16 study participants revealed that attitudes toward IPPFP were shaped by four major themes: willingness to provide services, professional experience, client influences, and provider Fears. Whereas many healthcare workers expressed willingness to offer IPPFP a majority reported conditional readiness dependent on training, availability of equipment, and adequate skills. Providers with prior exposure demonstrated greater confidence. The study is reported in accordance with Consolidated Criteria for Reporting Qualitative Research (COREQ). Perceptions were driven by three major themes: Perceived benefits, Barriers and Mutual aid. Participants highlighted several benefits of IPPFP, including prevention of unintended pregnancies, improved birth spacing, reduced missed opportunities for family planning, and enhanced maternal and child wellbeing. However, this study reveals previously undocumented system-level barriers such as only a few HCWs being trained, stock-outs, workload, and limited policy support, alongside sociocultural challenges including myths, misconceptions, religious beliefs, and the need for partner approval. Limited social support was also reported, although organizations such as JHPIEGO and Marie Stopes were recognized for supporting training and service delivery. Conclusion: Although linked to several considerations, most HCWs demonstrated positive attitudes toward IPPFP. This study reveals previously undocumented system-level barriers which must be addressed to enhance HCWs’ knowledge, confidence, and attitudes toward providing IPPFP services.