Banerjee Sushanta K, Andersen Kathryn, Pearson Erin, Warvadekar Janardan, Khan Danish U, Batra Sangeeta
IDF, New Delhi, India.
Ipas, Chapel Hill, North Carolina, USA.
BMJ Open. 2017 Feb 24;7(2):e012198. doi: 10.1136/bmjopen-2016-012198.
This study aimed to compare the effectiveness of a high-intensity model (HIM) and a low-intensity model (LIM) of behaviour change communication interventions in Bihar and Jharkhand states of India designed to improve women's knowledge and usage of safe abortion services, as well as the dose effect of intervention exposure.
We conducted two cross-sectional household surveys among married women aged 15-49 years in intervention and comparison districts. Difference-in-difference models were used to assess the efficacy of the intervention, adjusting for sociodemographic characteristics.
Although both intervention types improved abortion knowledge, the HIM intervention was more effective in improving comprehensive knowledge about abortion. In particular, there were improvements in knowledge on legality of abortion (AOR=2.2; 95% CI 1.6 to 2.9) and nearby sources of safe abortion care (AOR=1.7; 95% CI 1.2 to 1.3).
Higher level of exposure to abortion-related messages was related to more accurate knowledge about abortion within both intervention groups. Evidence was mixed on changes in abortion care-seeking behaviour. More work is needed to ensure that women seek safe abortion services in lieu of informal services that may be more likely to lead to postabortion complications.
本研究旨在比较高强度模式（HIM）和低强度模式（LIM）的行为改变沟通干预措施在印度比哈尔邦和贾坎德邦的效果，这些干预措施旨在提高妇女对安全堕胎服务的知识和使用率，以及干预暴露的剂量效应。
我们在干预区和对照区对15 - 49岁的已婚妇女进行了两次横断面家庭调查。采用差分模型评估干预效果，并对社会人口学特征进行调整。
尽管两种干预类型都提高了堕胎知识，但高强度模式干预在提高堕胎综合知识方面更有效。特别是，在堕胎合法性知识（调整后比值比[AOR]=2.2；95%置信区间[CI] 1.6至2.9）和附近安全堕胎护理来源知识（AOR=1.7；95% CI 1.2至1.3）方面有改善。
在两个干预组中，更高程度地接触堕胎相关信息与对堕胎更准确的知识相关。关于堕胎寻求护理行为的变化，证据不一。需要开展更多工作，以确保妇女寻求安全堕胎服务，而不是选择那些可能更容易导致堕胎后并发症的非正式服务。
