A Mixed-methods Evaluation of a Person-centered Family Planning Intervention for Community Health Workers in India on Family Planning Outcomes

Abstract

Background: Person-centered quality for family planning has been gaining increased attention, yet few interventions have focused on this,or measured associations between PCFP and family planning outcomes (uptake, continuation, etc.). In India, the first point of contact for family planning is often the community health care worker, in this case, Accredited Social Health Activists (ASHAs). Methods: In this study, we evaluate a training on person-centered family planning as an add-on to a training on family planning provision for urban ASHAs in Varanasi, India in 2019 using mixed methods. We first validate a scale to measure person-centered family planningin a community health worker population, and find it to be valid. Higher person-centered family planningscores are associated with family planning uptake. Results: Comparing women who saw intervention compared to control ASHAs, we find that the intervention had no impact on overall person-centered family planningscores. Women in the intervention arm were more likely to report that their ASHA had a strong preference about what method they choose, suggesting that the training increased provider pressure. However, qualitative interviews with ASHAs suggest that they value person-centered care for their interactions and absorbed the messages from the intervention.Conclusions: More research is needed on how to intervene to change behaviors related to person-centered family planning.This study received IRB approval from the University of California, San Francisco (IRB # 15-25950) and was retrospectively registered at clinicaltrials.gov (NCT04206527) on 20 December 2019.https://clinicaltrials.gov/ct2/show/NCT04206527?term=NCT04206527&draw=2&rank=1