Post-partum family planning in Burkina Faso (Yam Daabo): a two group, multi-intervention, single-blinded, cluster-randomised controlled trial

Abstract

Background Post-partum family planning services can prevent maternal and child morbidity and mortality in lowresource settings. We assessed the effect of a family planning intervention package on modern contraceptive use at 12 months post partum in predominantly rural Burkina Faso. Methods Yam Daabo was a two group, multi-intervention, single-blinded, cluster randomised controlled trial. Primary health-care centres were randomly allocated to intervention or control clusters in a 1:1 ratio with only data analysts masked to the allocation assignment. Interventions comprised refresher training for the provider, a counselling tool, supportive supervision, availability of contraceptive services 7 days a week, client appointment cards, and invitation letters for partners. The primary outcome was modern contraceptive prevalence at 12 months, and secondary outcomes were modern contraceptive prevalence at 6 weeks and 6 months post partum. Analysis was by modified intention to treat. Prevalence ratios were adjusted for cluster effects and baseline characteristics. This study was registered with the Pan-African Clinical Trials Registry (PACTR201609001784334). Findings From July 27-Oct 17, 2016, eight clinics were randomised and 571 women were enrolled and allocated: 286 to four intervention clusters and 285 to four control clusters. Of these, 523 completed the 12-month study exit interview (260 in the intervention group, 263 in the control group) and 523 were included in the intention-to-treat analysis. At 12 months, modern contraceptive prevalence was 55% among women who received the package and 29% among those who received routine care in control clusters (adjusted prevalence ratio 1•79, 95% CI 1•30−2•47). Significant differences in modern contraceptive prevalence were also seen between intervention and control groups at 6 weeks (42% and 10%, respectively; adjusted prevalence ratio 3•88, 95% CI 1•46−10•35) and 6 months (59% and 24%, respectively; 2•31, 1•44−3•71). Interpretation A package of six low-technology interventions, aimed at strengthening existing primary health-care services and enhancing demand for these services, can effectively increase modern contraceptive use for up to a year post partum in rural settings in Burkina Faso and has the potential to be suitable in similar settings in this country and others.

Effectiveness of post-partum family planning interventions on contraceptive use and method mix at 1 year after childbirth in Kinshasa, DR Congo (Yam Daabo): a single-blind, cluster-randomised controlled trial

“…2 In response, the Yam Daabo trial (meaning "your choice" in Mooré, one of the local languages in Burkina Faso) was designed to test the effectiveness of a low-technology, postpartum family planning intervention package, established using participatory action research, on contraceptive uptake. 9 In predominantly rural settings in Burkina Faso, results showed that the use of modern contraceptives almost doubled at 12 months post partum, reaching 55% of women in the intervention group versus 29% of women who received routine care in the control group (adjusted prevalence ratio 1•79, 95% CI 1•30-2•47). 9 Significant differences were also found in the proportion of women in the two groups using long-acting contra ceptives, mostly implants (29% vs 17%), and short-acting methods (26% vs 12%), with injectables prevailing.…”

Population Growth Control Policy and Its Effect to Law Enforcement

“…One effort that can be done is to maximize the role of competent agencies or agencies in dealing with population growth (Kelsen, 2010). In the process of minimizing population growth, it must be done in several stages that have been formatted so well that it can be carried out and run well because at any time population growth can change (Tran et al, 2019). To minimize population growth in Indonesia, one can be done with family planning (KB) programs that have been carried out by the government (Woo, Alamgir, & Potter, 2016).…”

Discontinuation and switching of postpartum contraceptive methods over twelve months in Burkina Faso and the Democratic Republic of the Congo: a secondary analysis of the Yam Daabo trial

“…To improve the use of postpartum contraceptive methods, in 2015, we implemented a set of interventions in two African countries, Burkina Faso (BF) and the Democratic Republic of the Congo (DRC), and tested them in a cluster-randomized trial called Yam Daabo described previously [ 2 , 3 ]. The main results showed a significant increase in the use of contraceptive methods among women receiving interventions compared to women in the control group in both countries [ 4 , 5 ].…”