Effect of integrating Family Planning with Maternal, Newborn and Child Health services on uptake of voluntary modern contraceptive methods in rural Pakistan: Protocol for a Quasi-experimental study (Preprint)

BACKGROUND Background: The uptake of the Modern Contraceptive Methods (MCM) cumulatively remains low at 25% of women reporting the use in Pakistan. The overarching interventions covering service delivery platforms at facility and community levels necessitates the integration and scaling up of Family Planning (FP) and Maternal Newborn Child Health (MNCH) services OBJECTIVE The main objective of the study is to evaluate the impact of an integrated FP-MNCH service delivery model to increase coverage of MCM in a rural Pakistan. Moreover, to measure the level of effectiveness of interventions on the uptake MCM. METHODS A Quasi-experimental sequential mixed methods study design with pre and post evaluation will be adopted to design and evaluate the integrated FP with MNCH service delivery model. The Interventions include. (1) Capacity Strengthening of Health Care Providers including technical trainings, training for Counseling of women attending immunization centers and ANC and PNC clinics and Provision of Job aids. (2)Counseling of women and girls attending ANC, postnatal and pediatrics clinics. (3)Ensure sustained Provision of Supplies and Commodities. (4)Community Engagement including establishment adolescent friendly spaces, and (5) use of District health Information Data (DHIS) data in decision making. Descriptive statistics will be used to estimate prevalence (proportions) and frequencies of outcome indicators. A univariate difference-in-difference (DID) analytical approach will be used to estimate the effect of the interventions. In additions, a Blinder-Oaxaca decomposition analysis will be conducted to identify and quantifying determinants of mCPR. RESULTS Ethical clearance for this project was sought from Ethical Review Committee (ERC) of Aga Khan University on 26th June, 2020. The project started in January 2021 and will be completed in September 2022. CONCLUSIONS This project will evaluate the impact of integrated family planning with maternal newborn and child health services. Furthermore, identify the drivers and barriers in uptake of modern contraceptive methods and simultaneously helps in modifying the interventional strategies that can be scales up through existing service delivery platforms within public and private sector according to local socio-cultural and health system context. CLINICALTRIAL clinicaltrials.gov NCT05045599: https://clinicaltrials.gov/ct2/show/NCT05045599

Download Full-text

Effect of Integrating Maternal and Child Health Services, Nutrition and Family Planning Services on Postpartum Family Planning Uptake at 6 Months Post-partum in Burkina Faso, Cote d’Ivoire and Niger: Protocol of a Longitudinal Quasi-experimental Study

10.21203/rs.3.rs-1094966/v1 ◽

2022 ◽

Author(s):

DENISE KPEBO ◽

Abou Coulibaly ◽

Maurice Yameogo ◽

Sujata Bijou ◽

Lazoumar Ramatoulaye ◽

...

Keyword(s):

Family Planning ◽

Child Health ◽

Health Services ◽

Maternal And Child Health ◽

Post Partum ◽

Child Health Services ◽

Family Planning Services ◽

Services Integration ◽

Quasi Experimental ◽

And Child Health

Abstract Background : Although several interventions integrating maternal, neonatal, child health and nutrition with family planning have been implemented and tested, there is still limited evidence on their effectiveness to guide program efforts and policy action,on health services integration. This study aims to assess the effectiveness of a service delivery model integrating maternal and child health services, nutrition and family planning services, compared with the general standard of care in Burkina Faso, Cote d'Ivoire, and Niger. Methods: This is a quasi experimental study with one intervention group and one control group of 3-4 health facilities in each country. Each facility was matched to a control facility of the same level of care and that had similar coverage on selected reproductive health indicators such as family planning and post-partum family planning. The study participants are pregnant women (with a 6 months pregnancy at maximum) coming for their first antenatal care visit. They will be followed up to 6 months after childbirth, and will be interviewed at each antenatal visit and also during visits for infant vaccines.The analyzes will be carried out by intention to treat, using generalized linear models (binomial log or log Poisson) to assess the effect of the intervention on the ratio of contraceptive use prevalence between the two groups of the study at a significance level of 5%, while taking into account the cluster effect and adjusting for potential confounding factors (socio-demographic characteristics of women, unevenly distributed at inclusion). Discussion :This longitudinal study, with the provision of family planning services integrated into the whole maternal care continuum, a sufficiently long observation time and repeated measurements, will make it possible to better appreciate the timeline and the factors influencing women's decision-making on the use of post-partum family planning services. The results will help in increasing the body of knowledge regarding the impact of maternal and child health services integration on the utilization of post-partum family planning, taking into account the specific context of sub-Saharan Africa French speaking countries where such information is very needed.

Download Full-text