Introduction The Reproductive Life Plan (RLP) is a clinical tool to help clients find strategies to achieve their reproductive goals. Despite much research on the RLP from high-income countries, it has never been studied in low-or middle income countries. Together with health workers called Mentor Mothers (MMs), we used a context-adapted RLP in disadvantaged areas in Eswatini. Our aim was to evaluate the implementation of the RLP in this setting. Methodology MMs participated in focus group discussions (FGDs, n = 3 MMs n = 29) in January 2018 and at follow-up in May 2018 (n = 4, MMs n = 24). FGDs covered challenges in using the RLP, how to adapt it, and later experiences from using it. We used a deductive qualitative thematic analysis with the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework, creating themes guided by its four constructs: facilitation, innovation, recipients and context. The MMs also answered a questionnaire to assess the implementation process inspired by normalization process theory. Results The RLP intervention was feasible and acceptable among MMs and fit well with existing practices. The RLP questions were perceived as advantageous since they opened up discussions with clients and enabled reflection. All except one MM (n = 23) agreed or strongly agreed that they valued the effect the RLP has had on their work. Using the RLP, the MMs observed progress in pregnancy planning among their clients and thought it improved the quality of contraceptive counselling. The clients' ability to form and achieve their

No abstract

No abstract

Background Family planning in Eswatini is limited and unplanned pregnancies are common. The Reproductive Life Plan (RLP) is a clinical tool formerly evaluated in high-income settings aiming to increase pregnancy planning. Mentor Mothers (MM), i.e. Community Health Workers, were trained in using an adapted RLP and introduced it into family planning (FP) discussions with their clients. This study aimed to evaluate these women’s impression of the RLP and to investigate their FP practices.Method Women were recruited during home visits, purposively selected to cover all areas where the MMs are working. Data were collected in September and October 2018 using anonymous questionnaires filled out by women aged 15-44 years that were either mothers or pregnant mothers-to-be. The questionnaire consisted of 20 questions on background, fertility desires, pregnancy planning as well as quality and perceived need for FP support. Chi-square tests or Fisher’s exact test were used for group comparisons and the need for more FP support.Results A total of 203 women participated. Most women (74% n=148) expressed that FP discussions with their MM using the RLP had helped them ‘very much’. A majority had a perceived need for these discussions; 70% wanted to have more support from their MM and 92% wanted more information about FP. Significantly more women with lower educational level (secondary or lower) and younger women (age 15-24 years) wanted more support compared to women with higher educational level and older women (p<0.001 and p=0.028). The unmet need for contraception was 22%.Conclusion The introduction of the RLP was well received among women but most of them requested more support in FP. Using the RLP may help women in this context achieve their reproductive goals.