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1.1     Background of study                                                                      

Family planning is defined having the number of children you want when you want them. It is achieved through use of contraceptive methods (FMOH, 2011).

Family planning is voluntary use of natural or modern contraceptive by individual or couples. This approach helps the users to have the number of children they want to have and to assure the wellbeing of children as well as parents. The goal of FP is to decrease the rapid growth of population so that if will be compatible with living standard of the people. It also contributes for the effort to create sustained and efficient use of countries resources (FMOH, 2011)

Family planning reduces the number of unintended and unwanted pregnancies and thereby saving women from high risk pregnancies and unsafe abortions (White and Speizer. 2007). Other benefits accruing from family planning methods include prevention of cancers, sexually transmitted infections (STIs) and infection with the Human Immunodeficiency Virus (HIV) (Moronkola, Ojedirin, and Amosu, 2006). Furthermore, investing in family planning as a component of good reproductive health has benefits that go beyond the obvious prevention of pregnancy and reduction of disease burden, the social and economic benefits for global development goals should not be overlooked (MacPhai, 2007).

There are traditional methods of family planning, which is divided in to withdrawal and rhythm, and there are modern family planning methods, which is divided in to three: long acting reversible contraceptive methods (IUCD and Implants); permanent contraceptive methods (Tubal ligation for females and vasectomy for male) and short-term contraceptive methods (oral pills, injectable, male and female condoms, foam tablet and cervical cup (Dieppe, 2011).

Intra uterine contraceptive devices [IUCD] and implants are long acting reversible contraceptive methods (LARCM); when removed, return to fertility is prompt (USAID, 2015). Modern family planning methods account for the majority of current global contraceptive practices; almost nine out of every ten contraceptive users rely on a modern method. Female sterilization, intra uterine device and oral pills account for more than two-third of all contraceptive practice worldwide (Dieppe, 2011).

Globally, female sterilization is the single most used method and alone accounts for one-third of all contraceptive use worldwide. The IUCD is used by (22%) of all contraceptive users and the oral pill by (14%). The use of modern contraceptive methods differs significantly between the developing and developed areas. In the developing areas modern methods account for much larger share of total contraceptive use (90%) than in the developed areas (70%) (USAID, 2015).

Currently, family planning becomes an important issue throughout the whole world. This is because of the unexpected and rapid population growth, as a result exposes to high maternal mortality and even the level of economic development and health care demands that uncontrolled fertility rate negatively effects on the family and the society as a whole (USAID, 2010). Starting from the 1960, family planning service has become the major worldwide activity to influence fertility in the year 1965 family planning was accepted as an issue by only 21 countries, but in less than two decades, to mean that in 1983, access to family planning method in its modern way was limited in only seven countries useable, it is less than 1% of the world’s population (USAID, 2010).

Family planning is a way of thinking and living that is adopted voluntarily, upon the basis of knowledge, attitudes and responsible decisions by individuals and couples, in order to promote the health and welfare of the family group and thus contribute effectively to the social development of a country (Park, 2013).

Worldwide contraceptives prevalence (the percent of couple currently using contraception) is estimated to have reached 58%. At 70%, the average level of use is higher in the more developed region than in the less developed regions, where average use is estimated at 55%.

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