Fikree Fariyal F, Abshiro Worknesh K, Mai Murtala M, Hagos Kidest L, Asnake Mengistu
Evidence to Action, PATH; USA.
Pathfinder International/Ethiopia.
Afr J Reprod Health. 2017 Sep;21(3):37-48. doi: 10.29063/ajrh2017/v21i3.3.
Despite robust evidence regarding long-acting reversible contraceptive (LARC) low failure rates, immediate return to fertility and safety, LARC uptake among youth is low. We evaluated the effect on contraceptive uptake of training youth-friendly service providers to counsel and provide all contraceptive methods including LARCs in the same unit. A convenience purposive sampling technique was used to select 20 youth friendly health units; ten each in Amhara and Tigray regions, Ethiopia; randomly allocated to the intervention (five) and non-intervention (five) arms. Data were abstracted from the family planning registers over an eleven-month period: three months pre-intervention and eight months post-intervention. Analysis of contraceptive uptake and chi-square tests of association were conducted. The number of LARCs new acceptors in the intervention arm was 781 (pre-intervention=116; post intervention=665) as compared to 358 in the non-intervention arm (pre-intervention=95; post intervention=263). Odds of adopting LARCs at pre-intervention (0.70); rose to 1.30 for the post-intervention phase (p-value <0.0001); comparing intervention to non-intervention study arms. Training youth friendly service providers to counsel and provide all contraceptive methods including LARCs in one location resulted in higher LARCs uptake for all sexually active young women; including those planning on delaying their first pregnancy.
尽管有充分证据表明长效可逆避孕法（LARC）失败率低、生育能力可迅速恢复且安全，但青少年对LARC的接受程度较低。我们评估了培训对青少年友好的服务提供者在同一单位进行咨询并提供包括LARC在内的所有避孕方法对避孕方法接受情况的影响。采用便利目的抽样技术选择了20个对青少年友好的健康单位；埃塞俄比亚阿姆哈拉和提格雷地区各10个；随机分为干预组（5个）和非干预组（5个）。在11个月期间从计划生育登记册中提取数据：干预前3个月和干预后8个月。进行了避孕方法接受情况分析和关联性卡方检验。干预组新接受LARC的人数为781人（干预前=116人；干预后=665人），而非干预组为358人（干预前=95人；干预后=263人）。干预前采用LARC的几率为0.70；干预后阶段升至1.30（p值<0.0001）；干预组与非干预组研究臂相比。培训对青少年友好的服务提供者在一个地点进行咨询并提供包括LARC在内的所有避孕方法，使得所有性活跃年轻女性，包括那些计划推迟首次怀孕的女性，对LARC的接受程度更高。
