Community health worker promotions increase uptake of long-acting reversible contraception in Rwanda

Mazzei, Amelia; Ingabire, Rosine; Mukamuyango, Jeannine; Nyombayire, Julien; Sinabamenye, Robertine; Bayingana, Roger; Parker, Rachel; Tichacek, Amanda; Easter, Sarah Rae; Karita, Etienne; Allen, Susan; Wall, Kristin M.

doi:10.1186/s12978-019-0739-0

Cited by 27 publications

(28 citation statements)

References 46 publications

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“…[38][39][40] We hypothesized that provider training would be associated with LARC uptake, since other studies in SSA have found providers to be a barrier based on biases based on sociodemographics, misconceptions about safety or lack of training in provision. 41 However, we did not find a significant association between provider training and LARC uptake, which could be due to several reasons. The indicator measured whether a provider received inservice training in the last two years, but did not account for how recently the training took place or the quality of that training.…”

Section: Discussioncontrasting

confidence: 58%

<p>Quality of Long-acting Reversible Contraception Provision in Lomé, Togo</p>

Weidert¹,

Tekou²,

Prata³

2020

OAJC

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Context: Provision of high-quality contraceptive counseling and services is essential to ensure family planning (FP) programs are rights-based and voluntary. Togo's modern contraceptive use has steadily increased with almost a quarter of the method mix attributed to longacting reversible contraceptives (LARC). The purpose of this study is to assess the quality of LARC provision in Togo. Methods: Data for this study were collected in 2016 as part of a larger research study conducted in Lomé, Togo to assess the effectiveness of the ongoing FP service delivery model. Quality of FP service was assessed in terms of program capacity and program performance. Program capacity was measured with five individual variables and program performance was measured with the Method Information Index (MII). Descriptive statistics and mixed effects models were used to assess likelihood of LARC uptake. Results: Of the 669 clients included in the study, 19.4% received a LARC method. Multivariable results show that LARC uptake is significantly associated with supervisory visit at the facility in the last three months (program capacity indicator) (OR 1.44; 95%CI 1.48-2.39) and is twice as likely for those with a positive MII score, even after controlling for provider and client characteristics (OR 2.1; 95%CI 1.61-2.51). Conclusion: This study identified supervisory visits and comprehensive contraceptive counseling as the key quality factors positively associated with uptake of LARC. Continued focus on quality of care and provider-client information exchange is necessary to ensure women's FP needs are met.

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Section: Discussioncontrasting

confidence: 58%

<p>Quality of Long-acting Reversible Contraception Provision in Lomé, Togo</p>

Weidert¹,

Tekou²,

Prata³

2020

OAJC

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“…We hypothesize that even only less than one in ten of women discussed family planning with CHWs their odds was higher, if there was an opportunity for all women to discuss family planning with CHWs, the coverage would have been much higher. This implies that more efforts should also be invested in community based interventions to reach communities with appropriate information to increase family planning uptake (55)(56)(57).…”

Section: Discussionmentioning

confidence: 99%

Family planning uptake in Kagera and Mara regions in Tanzania: a cross-sectional community survey

Massenga¹,

Norohna²,

Awadhi³

et al. 2020

Preprint

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BackgroundIn Tanzania, 27.1% of all women of reproductive age are currently using modern contraception, and 16.8% have an unmet need for family planning. We therefore examined factors associated with family planning uptake after giving birth in two regions of Tanzania.MethodsSub-analysis of a cross-sectional household survey conducted in April 2016 in Mara and Kagera regions in Tanzania. A total of 1184 women aged 15-49 years, who had given birth less than two years prior to the survey were included. Logistic regression mixed effect modelling was used to examine factors associated with family planning uptake. Univariate analysis was used to present crude effects of covariates, followed by stepwise forward selection to build a multiple logistic regression model. A p-value ≥ 0.20 was applied as the criterion to retain a variable into the model.ResultsAmong 1184 women within two years after giving birth, 393 (33.2%) used family planning methods. After adjusting for (1) age, (2) level of education, (3) living in union, (4) being accompanied to ANC by a partner and (5) being able to mention at least one method, factors independently associated with family planning uptake included: (1) having discussed family planning with the partner (aOR 2.90; 95% CI 1.88-4.49), (2) having been counselled on family planning during ANC (aOR 2.15; 95% CI 1.48-3.13), (3) having discussed family planning with a community health worker (aOR 3.32; 95% CI 1.91-5.77), (4) having discussed family planning with a facility health care worker (aOR 1.79; 95% CI 1.22-2.62), (5) having primary or higher educational level (aOR 1.66; 95% CI 1.01-2.273) and (6) being in union (aOR 1.86; 95% CI 1.02-3.42).ConclusionSupportive constitutes including educational interaction with facility and community health workers, as well as having a supportive partner are facilitators to increased uptake of family planning among women in Tanzania

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“…In 2017, IUDs and implants were used by only less than 10% of women in reproductive age. Gallo, 2019;Austad, Shah, & Rohloff, 2018;Bhandari, Pokhrel, Gabrielle, & Amatya, 2019;Dempsey, Billingsley, Savage, & Korte, 2012;Finer, Jerman, & Kavanaugh, 2012;Harzif, Mariana, Malik, Silvia, & Lovita, 2019;Weber, Briggs, & Hanson, 2017), parity (Asad et al, 2019;Bhandari et al, 2019;Finer et al, 2012;Mazzei et al, 2019), family welfare (Adedini et al, 2019;Bhandari et al, 2019;Fekadu, Omigbodun, Roberts, & Yalew, 2019), women's knowledge (Dempsey et al, 2012;Harzif et al, 2019;Mazzei et al, 2019), women's education (Adedini et al, 2019;Asad et al, 2019;Mazzei et al, 2019;Ontiri et al, 2019;Secura & McNicholas, 2013), husband education (Bhandari et al, 2019), women's occupation (Adedini et al, 2019;Fekadu et al, 2019), husband's occupation (Bhandari et al, 2019), religion (Mazzei et al, 2019;Ontiri et al, 2019), desire for children in the future (Bhandari et al, 2019;Ontiri et al, 2019), accessibility (Secura & McNicholas, 2013) were documented as significant predictors of LARC used. Health related factors for LARC adoption were health workers skills (Harzif et al, 2019;Ontiri et al, 2019), counselling (Mazzei et al, 2019;Secura & McNicholas, 2013) and history of abortion (Fekadu et al, 2019)…”

Section: Introductionmentioning

confidence: 95%

“…Health related factors for LARC adoption were health workers skills (Harzif et al, 2019;Ontiri et al, 2019), counselling (Mazzei et al, 2019;Secura & McNicholas, 2013) and history of abortion (Fekadu et al, 2019). Other factors such as cost of contraception (Adedini et al, 2019;Finer et al, 2012;Harzif et al, 2019;Secura & McNicholas, 2013), health worker training on LARC (Mazzei et al, 2019;Secura & McNicholas, 2013), logistical support (Mazzei et al, 2019;Secura & McNicholas, 2013), partner's support (Mazzei et al, 2019), myths (Secura & McNicholas, 2013) and exposure to mass media (Adedini et al, 2019) were also related to the used of LARC.…”

Section: Introductionmentioning

confidence: 99%

The Utilization of Long-Acting Reversible Contraception and Associated Factors Among Women in Indonesia

Gayatri¹

2020

GJHS

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Long-acting reversible contraceptives (LARCs), consist of IUD and implats, were effective and efficient methods in preventing the pregnancy. However, the used of these methods in Indonesia was still low. This study sought to explore LARC utilization trends and the factors influencing LARC used among reproductive women in Indonesia. This research analyzed data from the Indonesia Demographic and Health Survey 2017. Respondents in this study were women who currently used modern contraceptive methods. A total of 20,409 women who used modern methods were included in the analysis. Descriptive analysis was performed using chi-square and percentages. Logistic regression with complex sample design was used to determine the associated factors in LARC utilization. Among women in reproductive age who currently used modern contraception, IUDs and implants were viewed particularly unfavorably which only 16.5% of women used LARC. Findings highlighted that higher LARC use among reproductive age women in Indonesia correlated with higher parity, older women, higher education, working women, desire to limit the pregnancy in the future and more visited by fieldworkers in the last 12 months. This study underscored that even though only 4% of respondents were visited by fieldworkers, the utilize of LARC was higher among women who visited by fieldworkers. This study suggests that communication skills among fieldworker need to be enhanced to do counselling and work closely with the community member.

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Community health worker promotions increase uptake of long-acting reversible contraception in Rwanda

Cited by 27 publications

References 46 publications

<p>Quality of Long-acting Reversible Contraception Provision in Lomé, Togo</p>

<p>Quality of Long-acting Reversible Contraception Provision in Lomé, Togo</p>

Family planning uptake in Kagera and Mara regions in Tanzania: a cross-sectional community survey

The Utilization of Long-Acting Reversible Contraception and Associated Factors Among Women in Indonesia

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