Lemani Clara, Kamtuwanje Nenani, Phiri Billy, Speizer Ilene S, Singh Kavita, Mtema Olive, Chisanu Ndidza, Tang Jennifer H
University of North Carolina Project-Malawi, Lilongwe, Malawi.
Department of Maternal and Child Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Int J Gynaecol Obstet. 2018 Apr;141(1):37-44. doi: 10.1002/ijgo.12439. Epub 2018 Feb 2.
The primary objective was to assess the effect of family planning interventions at two health facilities in Malawi on couple years of protection (CYP).
A prospective quasi-experimental design was used to compare CYP and uptake of long-acting reversible contraception (LARC) between two intervention facilities (Area 25 Health Center and Kasungu District Hospital) and two nonintervention facilities (Mkanda Health Center and Dowa District Hospital). The interventions included community mobilization and demand generation for family planning, and training and mentoring of providers in LARC insertion. Monthly data were collected from 1 year prior to intervention implementation until 2 years thereafter.
From the pre-intervention year to the second post-intervention year, CYP increased by 175.1% at Area 25, whereas it decreased by 33.8% at Mkanda. At Kasungu and Dowa, CYP increased by 90.7% and 64.4%, respectively. Uptake of LARC increased by 12.2% at Area 25 r, 6.2% at Kasungu, and 2.9% at Dowa, but decreased by 3.8% at Mkanda.
The interventions led to an increase in CYP and LARC uptake. Future family planning programs should sensitize communities about family planning and train providers to provide all contraceptives so that women can make informed decisions and use the contraceptive of their choice.
主要目的是评估马拉维两家医疗机构的计划生育干预措施对夫妇保护年限(CYP)的影响。
采用前瞻性准实验设计,比较两家干预机构(25区健康中心和卡松古区医院)与两家非干预机构(姆坎达健康中心和多瓦区医院)的CYP及长效可逆避孕法(LARC)的采用情况。干预措施包括社区动员和计划生育需求生成,以及为LARC植入的提供者提供培训和指导。从干预实施前1年直至此后2年每月收集数据。
从干预前一年到干预后第二年,25区的CYP增加了175.1%,而姆坎达的CYP下降了33.8%。在卡松古和多瓦,CYP分别增加了90.7%和64.4%。25区LARC的采用率增加了12.2%,卡松古增加了6.2%,多瓦增加了2.9%,但姆坎达下降了3.8%。
这些干预措施导致了CYP和LARC采用率的增加。未来的计划生育项目应提高社区对计划生育的认识,并培训提供者提供所有避孕方法,以便女性能够做出明智的决定并使用她们选择的避孕方法。