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

2021 ◽  
Author(s):  
Zahid Memon ◽  
Sophie Reale ◽  
Wardah Ahmed ◽  
Rachael Spencer ◽  
Talib Lashari ◽  
...  
Keyword(s):  
Family Planning ◽  
Child Health ◽  
Service Delivery ◽  
Modern Contraceptive ◽  
Service Delivery Model ◽  
Contraceptive Methods ◽  
Rural Pakistan ◽  
Quasi Experimental ◽  
The Impact ◽  
And Child Health

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

scholarly journals Knowledge and Practice of Contraceptive Among Lactating Mothers Attending at Radda Maternal and Child Health and Family Planning Centre at Mirpur, Dhaka

2019 ◽  
Vol 17 (2) ◽  
pp. 40-46
Author(s):  
Mohammad Taslim Uddin ◽  
Shaibal Barua
Keyword(s):  
Family Planning ◽  
Child Health ◽  
Breast Feeding ◽  
Maternal And Child Health ◽  
Post Partum ◽  
Contraceptive Methods ◽  
Lactating Mothers ◽  
Child Spacing ◽  
Knowledge And Practice ◽  
And Child Health

Background: As a natural child-spacing method breast feeding is very effective during the early post partum period. In Bangladesh it is believed that conception occurs very rarely during post partum and lactation period. Mothers nurse their children for long period, believing this is an easy, practical and natural method to delay or prevent a subsequent pregnancy. Since child-spacing effect of breast feeding gradually diminishes over time depending on personal and social circumstances breast feeding women during lactation need contraceptive methods which must be effective and safe and must not affect lactation. Methods: A descriptive type of cross sectional study was carried out, from July 2012 to December 2012, among 110 lactating mothers at RADDA Maternal and Child Health (MCH) and Family planning Centre, Mirpur, Dhaka with the objective of assessing their knowledge and practice on contraceptive methods. Results: Out of 110 respondents, 92 respondents having 1-2 children (83.64%) 79.35% were practicing contraception and 20.5% were not practicing any method and rest of 18 respondents having >2 children (16.36%), 77.78% were practicing contraception and 22.22% were not practicing contraception. Of the 91 respondents having children 1-2, 75.4% had average and above average knowledge and the rest 8.1% had below average knowledge on contraceptive methods. Of the 19 respondents having >2 children, 16.3% had average and above average knowledge and the rest (0.2%) had below average knowledge on contraceptive methods. The difference between the two groups in respect of practice and knowledge of contraception were found statistically insignificant. Conclusion: The study shows significant relation between the knowledge and practice of contraceptive with number of the children. There is significant difference between the knowledge among primary and secondary educated mothers and the practice of contraception varied with their education levels. All the respondents had knowledge about contraceptive methods but 20.9% were not practicing any methods due to various reasons. Chatt Maa Shi Hosp Med Coll J; Vol.17 (2); Jul 2018; Page 40-46

scholarly journals The effect of Women’s decision-making autonomy on family Planning acces in Senegal in 2017

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
N M Sougou ◽  
O Bassoum ◽  
M M M M Leye ◽  
A Tal-Dia
Keyword(s):  
Decision Making ◽  
Family Planning ◽  
Contraceptive Method ◽  
Contraceptive Use ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
Modern Contraceptive Method ◽  
Significant Difference ◽  
Modern Contraceptive Use ◽  
The Impact

Abstract Background The impact of access to decision-making on women’s health in the choice of fertility control has been highlighted by research. The aim of this study was to analyze the impact of access to decision-making for women’s health on access to family planning in Senegal in 2017. Methods The analyses of this study had been done on the Individual Records file of Senegal’s Demographic Health Survey 2017. This data covered 8865 women aged 15 to 49 years. The propensity scores matching method had been done. The variable access to the decision was considered as the variable of interest. Matching was done using variables that were not modified by the effect of the treatment. These were religion and socio-economic level. The outcome variables were modern contraceptive use, the existence of unmet needs and the type of modern contraceptive method used. Significance was at 5%. The condition of common support had been respected. The analysis was done with the STATA.15 software. Results Six percent (6.26%) of women could decide about their health on their own. Access to decision-making increased significantly with the woman’s age (p < 0.05). Fifteen percent (15.24%) women used a modern contraceptive method. Women using a contraceptive method were more numerous in the group with access to decision-making (29.43%) with a significant difference with the other group of 8% (p < 0.05). After matching, there was no significant difference between women in terms of modern contraceptive use and the existence of unmet needs. There was a significant difference in the type of contraceptive method used between the two groups of women. These differences were 23.17% for Intra Uterine Device, 52.98% for injections, 08.9% for implants and 10.79% for condoms. Conclusions Access to decision-making for health would facilitate women’s access to long-acting contraceptive methods. These findings show the importance of implementing gender transformative interventions in improving access to family planning. Key messages Access to decision-making for health would allow better access to modern contraceptive methods, especially those with a long duration of action. Better consideration of gender disparity reduction could improve access to family planning in Senegal.

scholarly journals Why World Vision supports healthy timing and spacing of pregnancies to improve maternal and child health: a faith-based perspective

2017 ◽  
Vol 4 (2) ◽  
pp. 75-79
Author(s):  
Adrienne Allison ◽  
Eloho E. Basikoro
Keyword(s):  
Family Planning ◽  
Child Health ◽  
Birth Spacing ◽  
Birth Intervals ◽  
Child Stunting ◽  
Faith Based ◽  
World Vision ◽  
Infant And Child Mortality ◽  
The Impact ◽  
And Child Health

World Vision, A Christian humanitarian organization, began to support Birth Spacing in 2007.  After new data were published in 2008 that measured the impact of the length of the preceding birth-to-pregnancy (birth to conception) interval on maternal, infant and child mortality and child stunting, World Vision adopted the term “Healthy Timing and Spacing of Pregnancy” as their approach to family planning.  This term refocused family planning to emphasized the health benefits for mothers, children, families and communities, of using contraception to time and space births.  The data are explained and the consequences of shorter and longer birth intervals are outlined.

scholarly journals The effect of enhanced public–private partnerships on Maternal, Newborn and child Health Services and outcomes in Nairobi–Kenya: the PAMANECH quasi-experimental research protocol

BMJ Open ◽  
2014 ◽  
Vol 4 (10) ◽  
pp. e006608 ◽  
Author(s):  
Pauline Bakibinga ◽  
Remare Ettarh ◽  
Abdhalah K Ziraba ◽  
Catherine Kyobutungi ◽  
Eva Kamande ◽  
...  
Keyword(s):  
Public Health ◽  
Child Health ◽  
Health Services ◽  
Health Facilities ◽  
Public Private Partnerships ◽  
Quality Healthcare ◽  
Newborn And Child Health ◽  
Quasi Experimental ◽  
The Impact ◽  
And Child Health

IntroductionRapid urbanisation in Kenya has resulted in growth of slums in urban centres, characterised by poverty, inadequate social services and poor health outcomes. The government's initiatives to improve access to quality healthcare for mothers and children are largely limited to public health facilities, which are few and/or inaccessible in underserved areas such as the slums. The ‘Partnership for Maternal, Newborn and Child Health’ (PAMANECH) project is being implemented in two Nairobi slums, Viwandani and Korogocho, to assess the impact of strengthening public–private partnerships for the delivery of healthcare on the health of mothers, newborns and young children in two informal settlements in Kenya.Methods and analysisThis is a quasi-experimental study; our approach is to support private as well as public health providers and the community to enhance access to and demand for quality healthcare services. Key activities include: infrastructural upgrade of selected Private Not-For-Profit health facilities operating in the two slums, building capacity for healthcare providers as well as the Health Management Teams in Nairobi, facilitating provision of supportive supervision by the local health authorities and forming networks of Community Health Volunteers (CHVs) to create demand for health services. To assess the impact of the intervention, the study is utilising multiple data sources using a combination of qualitative and quantitative methods. A baseline survey was conducted in 2013 and an end-line survey will be conducted at least 1 year after full implementation of the intervention. Systematic monitoring and documentation of the intervention is on-going to strengthen the case for causal inference.Ethics and disseminationEthical approval for the study was obtained from the Kenya Medical Research Institute. Key messages from the results will be packaged and widely disseminated through workshops, conference presentations, reports, factsheets and academic publications to facilitate uptake by policymakers.Protocol registration numberKEMRI- NON-SSC-PROTOCOL No. 393.

scholarly journals What mechanisms drive uptake of family planning when integrated with childhood immunisation in Ethiopia? A realist evaluation

2020 ◽  
Author(s):  
Shari Krishnaratne ◽  
Jessie K. Hamon ◽  
Jenna Hoyt ◽  
Tracey Chantler ◽  
Justine Landegger ◽  
...  
Keyword(s):  
Family Planning ◽  
Child Health ◽  
Maternal And Child Health ◽  
Realist Evaluation ◽  
Successful Implementation ◽  
Modern Contraceptive ◽  
Religious Leaders ◽  
Programme Theory ◽  
Integrated Delivery ◽  
And Child Health

Abstract Background: Maternal and child health are key priorities among the Sustainable Development Goals , which include a particular focus on reducing morbidity and mortality among women of reproductive age, newborns, and children under the age of five. Two key components of maternal and child health are family planning (FP) and immunisation. Providing these services through an integrated delivery system could increase the uptake of vaccines and modern contraceptive methods (MCMs) particularly during the post-partum period. Methods: A realist evaluation was conducted in two woredas in Ethiopia to determine the key mechanisms and their triggers that drive successful implementation and service uptake of an intervention of integrated delivery of immunisations and FP. This evaluation included the: 1) development of an initial programme theory; 2) review of relevant published theories; 3) analysis of project monitoring data; 4) analysis of qualitative data from 23 semi-structured interviews to determine key mechanisms and drivers; and 5) development of a revised programme theory comprised of context-mechanism-actor-outcome and context-mechanism-intervention-actor-outcome configurations based on empirical findings. Results: The proportion of women who brought their children for immunisation and received MCMs was 63.0% (4,260/6,764) overall [74.3% (2,944/3,961) in Assosa woreda and 46.9% (1,316/2,803) in Bambasi woreda]. Key contextual factors identified were: a strong belief in values among religious leaders and community members that challenged FP; a lack of support for FP from male partners based on religious values; and the use of trained Health Extension Workers (HEWs) to deliver FP services. Within these contexts, intervention components that focused on the alignment of religious texts with FP, the promotion of FP by religious leaders, and the training of HEWs and health care workers on FP counselling and service delivery, influenced the implementation of the intervention and triggered several mechanisms of acceptability, access, and adoption of innovations. Conclusions: Linking context and intervention components to the mechanisms they triggered helped explain the intervention outcomes, and more broadly how and for who the intervention worked. This enabled the development of a programme theory that could be used to inform the integrated delivery of FP services in similar contexts.

scholarly journals What mechanisms drive uptake of family planning when integrated with childhood immunisation in Ethiopia? A realist evaluation

2020 ◽  
Author(s):  
Shari Krishnaratne ◽  
Jessie K. Hamon ◽  
Jenna Hoyt ◽  
Tracey Chantler ◽  
Justine Landegger ◽  
...  
Keyword(s):  
Family Planning ◽  
Child Health ◽  
Maternal And Child Health ◽  
Realist Evaluation ◽  
Successful Implementation ◽  
Modern Contraceptive ◽  
Religious Leaders ◽  
Programme Theory ◽  
Integrated Delivery ◽  
And Child Health

Abstract Background:Maternal and child health are key priorities among the Sustainable Development Goals , which include a particular focus on reducing morbidity and mortality among women of reproductive age, newborns, and children under the age of five. Two key components of maternal and child health are family planning (FP) and immunisation. Providing these services through an integrated delivery system could increase the uptake of vaccines and modern contraceptive methods (MCMs) particularly during the post-partum period. Methods:A realist evaluation was conducted in two woredas in Ethiopia to determine the key mechanisms and their triggers that drive successful implementation and service uptake of an intervention of integrated delivery of immunisations and FP. This evaluation included the: 1) development of an initial programme theory; 2) review of relevant published theories; 3) analysis of project monitoring data; 4) analysis of qualitative data from 23 semi-structured interviews to determine key mechanisms and drivers; and 5) development of a revised programme theory comprised of context-mechanism-actor-outcome (CAMO) and context-mechanism-intervention-actor-outcome (CIAMO) configurations based on empirical findings. Results:The proportion of women who brought their children for immunisation and received MCMs was 63.0% (4,260/6,764) overall [74.3% (2,944/3,961) in Assosa woreda and 46.9% (1,316/2,803) in Bambasi woreda]. Key contextual factors identified were: a strong belief in values among religious leaders and community members that challenged FP; a lack of support for FP from male partners based on religious values; and the use of trained Health Extension Workers (HEWs) to deliver FP services. Within these contexts, intervention components that focused on the alignment of religious texts with FP, the promotion of FP by religious leaders, and the training of HEWs and health care workers on FP counselling and service delivery, influenced the implementation of the intervention and triggered several mechanisms of acceptability, access, and adoption of innovations. Conclusions:Linking context and intervention components to the mechanisms they triggered helped explain the intervention outcomes, and more broadly how and for who the intervention worked. This enabled the development of a programme theory that could be used to inform the integrated delivery of FP services in similar contexts.

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