الفهرس 
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Abstract
Awareness of the factors that may affect the time between giving birth and the first use of contraceptives leads to more efficient contraceptive use. Some of those factors are related to the woman’s characteristics, and some are household’s characteristics. The woman’s factors may include age, educational level, breastfeeding, body mass index, and media exposure These disparities in fertility and maternal mortality may be understood in the light of scholarship on theories of demographic and fertility transitions, which identify an established set of -economic factors such as income, female employment, literacy, and education as key determinants for fertility reduction, clearly linked through the adoption of contraception and/or family planning. In Egypt, physical and administrative factors play an insignificant role in shaping patterns of practice. Certain demographic, cultural, and reproductive factors act as barriers that limit use, increase discontinuation rates, and increase the unmet need for Identifying these barriers assists policymakers and decision-makers in determining where efforts should be made to promote service efficiency. Family planning service quality has been widely studied as an important target for improvement to increase acceptance and utilization of services. Training healthcare providers to provide a client-centered service, including expanded contraceptive method choices and comprehensive, effective, and accurate counseling is an important aspect of improving the quality of the service, which undoubtedly improves clients’ satisfaction. Worldwide, about 80 million untimely or unintended pregnancies occur each year, contributing to a high percentage of induced abortions, maternal morbidity and mortality, as well as infant mortality. It was estimated that 7.9% of all maternal deaths were due to abortion. Abortion-related deaths remain the fourth most important cause of maternal mortality after hemorrhage, hypertensive disorders, and sepsis. Thus, the establishment of a family planning policy is vital in women’s reproductive care to reduce the morbidity and mortality rate. The purpose of the current study was to identify the predictive factors influencing family planning practice among women in rural areas. A descriptive cross- sectional research design was used to carry out the present study. The study was conducted at three maternal and child health care centers (Kafr Tanbidi, Berkeit El Sabaa Al-Birr Al Sharqui, and Berkeit El Sabaa Al-Birr Al Gharbiin) located in the Menoufia Governor ate, Egypt. A convenient sample of 341 women (15–45 years old) who fulfilled the following criteria was selected. Throughout the course of the present study, data were collected using this instrument. The instrument was as follows: Instrument I: A structured interviewing questionnaire: It was used by the researcher based on a review of currently related literature (El-Masry et al., 2018) to obtain complete data concerning family planning practice. The instrument consisted of five parts: Part I: Social characteristics of the participating women included age, level of education, mothers’ working status, type of family, and income. Part II: The obstetrical history included gr-avidity, parity, number of living children, and when the last pregnancy occurred. Part III: Level of Knowledge of the studied women about family planning methods: It was developed by the researcher to assess the level of women’s knowledge about methods. It included ten questions about the definition of family planning, the purpose of using it, the recommended duration of birth spacing, the number of children couples should have, the eligible age for family planning, the different types of family planning methods, knowledge of short-term methods (condoms, inflatables, and pills),knowledge of long-acting reversible contraception (IUCDs and implants), knowledge of permanent methods (female sterilization and male sterilization) and the source of family planning information. Part IV: Family planning practice among the participating women: This included current use of the method, methods used for family planning, desire in future pregnancy, suggested duration of pregnancy spacing, and suggested causes of discontinuation of contraception use Part V: The predictive factors influencing family planning practice among women in rural areas such as, fear or experience of having side effects, limited knowledge and negative attitude towards contraceptive methods, sociology-demographic factors including women’s age, marital status, level of education and residence, physical barriers to access health facilities, a reproductive health-related factors associated with contraceptive use, including the ideal number of children, previous child loss, parity, and interpersonal factors such as husband discussion, and support, accessibility of the site, suitability of waiting time, comfort ability of waiting area, welcoming the woman politely, easily understandable information given during the counseling, respect of privacy during counselling and receiving service, available educational material (brochures, books...etc.), respect of woman method choice, affordable price of method, and women’s preference of currently method they use An approval from the Committee of Research and Ethics, Faculty of Nursing Menoufia University, was obtained on July 20, 2022. Approaches to ensure ethics were considered in the study regarding confidentiality and informed consent. The researcher introduced herself to the women and explained the purpose of the study in order to obtain their acceptance to be recruited in the study as well as their cooperation. The confidentiality of the participants was achieved by informing them that the information they provided during the study would be kept confidential and used only for statistical purposes. After finishing the study, the findings were presented as a group of data without any personal participant information remaining After explanation prior to enrollment in the study, informed consent was obtained from all women. Each woman was informed that participation in the study was voluntary and that she could withdraw from the study whenever she decided to do so. Each woman was allowed to freely refuse participation. They were free to ask any questions about the study’s details Upon the completion of data collection, each answer was coded and scored. The researcher coded the data into a coding sheet so that it could be prepared for computer use. Data were statistically analyzed using Statistical Package for the Social Sciences version 22, SPSS Inc., Chicago, IL, USA. The findings of this study answered the study question, ”What are the predictive factors influencing family planning practice among women in rural areas? The findings of the present study showed that predictive factors influencing family planning practice among women in rural areas are: ● The age of the participating women: about one-half of them (44.6%) were in the age group greater than 25 to 35 years old; nearly one-third of them (36.6%) were between 15 and 25 years old; and 18.8% were above the age of 35 to 45 years old, with a mean age of 28.29 ± 6.11 years. The age group ranges from 15 to 45 years old. Among the studied educational backgrounds, about 48.2% of them could read and write, while an equal percent (19.9% and 20.2%) had either secondary or university education, respectively, and 11.7% were illiterate. With regards to their occupation, 71.6% of the participating women were working, and only 28.4% were not working. According to the type of family, nearly two-thirds of the studied women (76.2%) lived in extended families. Among the participating women, almost all of them (90.6%) stated that they did not have enough income. ● It was also reported that 48.7% of the participating women had a good knowledge score, 39.3% had a fair knowledge score, and 12.0% had poor knowledge score Additionally, it shows that the total mean knowledge score was 15.21± 3.97 ● It illustrated that 50.0% of sources of information about family planning were from health care professionals, followed by television and family and friends. ● It illustrated that the most commonly used methods were IUDs (25.8%), followed by pills (11.1%), injectable methods (5.0%), condoms (3.2%), and others (1.5%). Only 28.4percent of women wanted to have future pregnancies. Meanwhile, pregnancy spacing should be between 3 and 5 years, according to 90.6% of women. Desire for pregnancy was the most commonly cited cause to discontinue (32.3%), followed by bleeding (5.9%), frequent forgetting (4.4%), and method failure (1.8%). ● It illustrates that 46.6% of them were already family planning users. While 53.4% were new users. ● It showed that desire for discontinue, followed by bleeding (5.9%), frequent forgetting (4.4%), others (2.3%) pregnancy was the most commonly cited cause (32.3%) to and method failure (1.8 ● It was displayed that 53.1%, 55.7%, 46.0%, 46.3%, 88.0%, 57.2%, 12.0%, 58.7%, 55.7% 50.7%, 44.0%, 73.3%, 61.6%, 29.3%, 90.6%, and 90.9%, respectively, of them reported that fear of having side effects, limited knowledge and negative attitude towards contraceptive methods, sociology-demographic factors, reproductive health-related factors associated with contraceptive use, interpersonal factors, easily understandable information given during the counseling, accessibility of the site suitability of waiting time, comfort ability of the waiting area, welcoming the woman politely, respect for privacy during counselling and receiving services, available educational materials, respect for women’s method choice, affordable price of method, physical barriers to access health facilities, and women’s preference for the current method they use were the predictive factors influencing family planning practice. According to the findings of the present study, it can be concluded that the predictive factors influencing family planning practice among the participating women in rural areas are fear of having side effects, limited knowledge and negative attitude towards contraceptive methods, sociology-demographic factors, reproductive health-related factors associated with contraceptive use, interpersonal factors, easily understandable information given during the counseling, accessibility of the site, suitability of waiting time, comfortability of the waiting area, welcoming the woman politely, respect for privacy during counselling and receiving services, available educational materials, respect for women’s method choice, affordable price of method, physical barriers to access health facilities, and women’s preference for the current FP method they use. Based on the findings of the current study, the following recommendations are Proposed Widespread information, education, and counselling activities are needed to increase demand for services Improvement in the communication skills of providers, together with good supervision of the health centers, are vital for strengthening the system. • Educational materials should be available for better counselling. • Privacy when providing services should be monitored and improved Encouraging higher education among girls is very important to increase and encourage family planning use in such rural areas • There is a need for education and encouragement for women to seek adequate and appropriate healthcare services in order to reduce the rate of maternal and child mortality. • Further research is required to investigate the causes of unmet needs