OBJECTIVE: To determine whether integrating family planning (FP) messages and referrals into facility-based, child immunization services increase contraceptive uptake in the 9- to 12-month post-partum period. METHODS: A cluster-randomized trial was used to test an intervention where vaccinators were trained to provide individualized FP messages and referrals to women presenting their child for immunization services. In each of 2 countries, Ghana and Zambia, 10 public sector health facilities were randomized to control or intervention groups. Shortly after the introduction of the intervention, exit interviews were conducted with women 9-12 months postpartum to assess contraceptive use and related factors before and after the introduction of the intervention. In total, there were 8892 participants (Control Group Ghana, 1634; Intervention Group Ghana, 1129; Control Group Zambia, 3751; Intervention Group Zambia, 2468). Intervention effects were evaluated using logistic mixed models that accounted for clustering in data. In addition, in-depth interviews were conducted with vaccinators, and a process assessment was completed mid-way through the implementation of the intervention. RESULTS: In both countries, there was no significant effect on non-condom FP method use (Zambia, P = 0.56 and Ghana, P = 0.86). Reported referrals to FP services did not improve nor did women's knowledge of factors related to return of fecundity. Some providers reported having made modifications to the intervention; they generally provided FP information in group talks and not individually as they had been trained to do. CONCLUSION: Rigorous evidence of the success of integrated immunization services in resource poor settings remains weak.
RCT Entities:
OBJECTIVE: To determine whether integrating family planning (FP) messages and referrals into facility-based, child immunization services increase contraceptive uptake in the 9- to 12-month post-partum period. METHODS: A cluster-randomized trial was used to test an intervention where vaccinators were trained to provide individualized FP messages and referrals to women presenting their child for immunization services. In each of 2 countries, Ghana and Zambia, 10 public sector health facilities were randomized to control or intervention groups. Shortly after the introduction of the intervention, exit interviews were conducted with women 9-12 months postpartum to assess contraceptive use and related factors before and after the introduction of the intervention. In total, there were 8892 participants (Control Group Ghana, 1634; Intervention Group Ghana, 1129; Control Group Zambia, 3751; Intervention Group Zambia, 2468). Intervention effects were evaluated using logistic mixed models that accounted for clustering in data. In addition, in-depth interviews were conducted with vaccinators, and a process assessment was completed mid-way through the implementation of the intervention. RESULTS: In both countries, there was no significant effect on non-condom FP method use (Zambia, P = 0.56 and Ghana, P = 0.86). Reported referrals to FP services did not improve nor did women's knowledge of factors related to return of fecundity. Some providers reported having made modifications to the intervention; they generally provided FP information in group talks and not individually as they had been trained to do. CONCLUSION: Rigorous evidence of the success of integrated immunization services in resource poor settings remains weak.
Entities:
Keywords:
Family planning; immunization; integration; referrals; vaccinators
Authors: Chelsea M Cooper; Rebecca Fields; Corinne I Mazzeo; Nyapu Taylor; Anne Pfitzer; Mary Momolu; Cuallau Jabbeh-Howe Journal: Glob Health Sci Pract Date: 2015-03-05
Authors: Julie Espey; Rosine Ingabire; Julien Nyombayire; Alexandra Hoagland; Vanessa Da Costa; Amelia Mazzei; Lisa B Haddad; Rachel Parker; Jeannine Mukamuyango; Victoria Umutoni; Susan Allen; Etienne Karita; Amanda Tichacek; Kristin M Wall Journal: BMJ Sex Reprod Health Date: 2020-09-16
Authors: Kate L Sheahan; Ilene S Speizer; Jennifer Orgill-Meyer; Siân Curtis; Morris Weinberger; John Paul; Antonia V Bennett Journal: BMC Public Health Date: 2021-07-12 Impact factor: 3.295