Modern Contraceptive Use, Postpartum Family Planning
Conditions
Keywords
Modern contraceptive use, Postpartum family planning, Service integration, Maternal & child health services
Brief summary
This study aims to explore the effectiveness of integrated package interventions within maternal and child health services in improving modern postpartum contraceptive use in northeast Ethiopia. Its primary objective is to enhance the utilization of postpartum contraceptive methods to reduce unmet needs for these methods in the Amhara region of Ethiopia.
Detailed description
One of the advantages of this intervention study is that the provision of postpartum family planning (PPFP) services will not be limited to a few points of contact but will instead be integrated into the entire maternal care continuum. However, many studies in other countries have not used quasi-experimental or intervention study designs. This pre/post-test interventional study with a control group employs extended observation and intervention periods, along with repeated measurements at the aggregate/population level. This approach will better capture changes in postpartum family planning (PPFP) integration and the factors influencing the use of integrated PPFP services. This dissertation research project will contribute to various stakeholders. For health professionals and managers, it will enhance their knowledge and skills regarding the impact of integrating PPFP with maternal health services and its role in improving maternal and child health. It will also identify facilitators and barriers to PPFP integration with maternal and child health services. Healthcare providers will gain leadership and communication skills in client-centered counseling and its effect on postpartum contraceptive use. The study highlights the importance of provider-led PPFP counseling and interventions for postpartum mothers visiting health facilities for maternal and child care services. Reproductive-age mothers will benefit from this study by gaining access to modern contraceptives immediately after childbirth and up to 12 months postpartum. This will improve their health and their children's well-being by enabling them to space or limit births as desired. PPFP use, as shown in prior studies, significantly reduces maternal and neonatal morbidity and mortality by preventing unintended pregnancies. Donors and non-governmental organizations (NGOs) can use these findings to strengthen healthcare systems through targeted support, including regular mentoring, logistics, and capacity-building training for providers and management teams. Researchers will benefit from this study's findings as a baseline for future research, leveraging its recommendations and addressing its limitations. The project aims to assess the effect of integrating PPFP with maternal and child health services (e.g., postnatal care, delivery, PMTCT, immunization, and under-five childcare) and to identify the level of integration, facilitators, and barriers. Policymakers, the Ethiopian Ministry of Health, and regional health bureaus can use these findings to design strategies aligned with the Sustainable Development Goals (SDGs), particularly reducing unmet PPFP needs. One SDG targets improved maternal health through integrated maternal and child health services, which this study supports by promoting PPFP use and advancing maternal and neonatal health outcomes.
Interventions
BEHAVIORALProviding training and Mentoring
The intervention packages are providing postpartum family planning training at each MCH units, Using WHO PPFP counseling toolkit, mentoring health care provider to fill knowledge and skill gap, contraceptive logistic availability, and regular supportive supervision
Sponsors
Wollo University
Jimma University
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
DOUBLE (Investigator, Outcomes Assessor)
Intervention model description
All postpartum mothers who come to the hospital for labor/delivery, infant immunization, PMTCT (Prevention of Mother-to-Child Transmission), postnatal care (PNC), or under-five childcare services will be screened and counseled for postpartum family planning (PPFP). Those who decide to use a modern contraceptive method will either be referred to family planning units or provided with their chosen method directly. Postpartum mothers who do not initially decide to use a modern contraceptive method will receive additional counseling during their next visit. The intervention will be implemented by nurses and midwives working in selected maternal and child health units. These healthcare providers will receive a three-day PPFP training session delivered by a senior obstetrician-gynecologist, public health expert, and maternal/reproductive health specialist, all of whom are certified Training of Trainers. Coaching and mentoring will also be provided to ensure they acquire adequate knowledge.
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 49 Years
Healthy volunteers
Yes
Inclusion criteria
* Postpartum mothers who gave birth one year preceding the survey * All postpartum mothers who come for maternal and child health services(PMTCT, PNC, labor, delivery, under 5 OPD care and immunization services and post-partum women units) * Those mothers whose age are between 18- 49 years old
Exclusion criteria
* Those participants who were seriously ill * Mentally unable to communicate
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Modern postpartum contraceptive use | Up to six months | The primary outcome measure is modern postpartum contraceptive use, assessed via interviewer-administered questionnaires. Data were collected using standardized, pre-tested tools by trained midwives with prior data collection experience. Quantitative data will be analyzed using STATA 17 software with a Generalized Estimating Equation (GEE) model. The outcome variable was evaluated by measuring the effectiveness of the intervention package, which was delivered by trained healthcare providers across selected maternal and child health (MCH) units. These units included labor/delivery, immunization, postnatal care (PNC), PMTCT (Prevention of Mother-to-Child Transmission), and under-five child outpatient services. The study followed a pre/post-intervention design: a baseline assessment was conducted first, followed by a six-month intervention period, and a post-intervention assessment. The intervention's effect will be evaluated using difference-in-differences analysis. |
Countries
Ethiopia
Outcome results
None listed