Chi-Chi Undie1, Lynn M Van Lith2, Mercy Wahome3, Francis Obare4, Esther Oloo3, Carolyn Curtis5. 1. Reproductive Health Program, Population Council, Nairobi, Kenya. Electronic address: cundie@popcouncil.org. 2. Center for Communication Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA. 3. Programs Division, EngenderHealth, Nairobi, Kenya. 4. Reproductive Health Program, Population Council, Nairobi, Kenya. 5. Bureau for Global Health, United States Agency for International Development, Washington, USA.
Abstract
OBJECTIVE: To evaluate whether a community engagement and service-strengthening intervention raised awareness of family planning (FP) and early pregnancy bleeding (EPB), and increased FP and postabortion care (PAC) use. METHODS: The intervention was carried out in 3 communities in Kenya over 18months; 3 additional communities served as the comparison group. A pre-post, contemporaneously controlled, quasi-experimental evaluation was conducted independently from the intervention. RESULTS: Baseline characteristics were similar. Awareness of FP methods increased (P≤0.001) in the intervention group. The incidence of reported EPB (before 5months of pregnancy) in the comparison group was 13.3% at baseline and 6.0% at endline (P=0.02); 79% at baseline and 100% at endline sought care (P>0.05). In the intervention group, recognition and reporting of EPB increased from 9.8% to 13.1% (P>0.05); 65% sought PAC at baseline and 80% at endline (P=0.11). The relative increase in EPB reports after the intervention was over 3 times greater in the intervention group (P≤0.01). CONCLUSION: The intervention raised FP and EPB awareness but not FP and PAC services use. As fewer comparison group respondents reported experiencing EPB, the PAC impact of the intervention is unclear. Mechanisms to improve EPB reporting are needed to avoid this reporting bias.
OBJECTIVE: To evaluate whether a community engagement and service-strengthening intervention raised awareness of family planning (FP) and early pregnancy bleeding (EPB), and increased FP and postabortion care (PAC) use. METHODS: The intervention was carried out in 3 communities in Kenya over 18months; 3 additional communities served as the comparison group. A pre-post, contemporaneously controlled, quasi-experimental evaluation was conducted independently from the intervention. RESULTS: Baseline characteristics were similar. Awareness of FP methods increased (P≤0.001) in the intervention group. The incidence of reported EPB (before 5months of pregnancy) in the comparison group was 13.3% at baseline and 6.0% at endline (P=0.02); 79% at baseline and 100% at endline sought care (P>0.05). In the intervention group, recognition and reporting of EPB increased from 9.8% to 13.1% (P>0.05); 65% sought PAC at baseline and 80% at endline (P=0.11). The relative increase in EPB reports after the intervention was over 3 times greater in the intervention group (P≤0.01). CONCLUSION: The intervention raised FP and EPB awareness but not FP and PAC services use. As fewer comparison group respondents reported experiencing EPB, the PAC impact of the intervention is unclear. Mechanisms to improve EPB reporting are needed to avoid this reporting bias.
Keywords:
Community action cycle; Community health workers; Community mobilization; Family planning; Kenya; Postabortion care; Safe motherhood; Unsafe abortion
Authors: Gathari Ndirangu; Anthony Gichangi; Lynn Kanyuuru; Jane Otai; Rose Mulindi; Pamela Lynam; Nancy Koskei; Hannah Tappis; Linda Archer Journal: J Community Health Date: 2015-08