Memon Zahid Ali, Reale Sophie, Ahmed Wardah, Spencer Rachael, Lashari Talib Hussain, Bhutta Zulfiqar, Soltani Hora
Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan.
Health Research Institute, Sheffield Hallam University, Sheffield, United Kingdom.
JMIR Res Protoc. 2022 Mar 8;11(3):e35291. doi: 10.2196/35291.
The uptake of modern contraceptive methods (MCMs) remains low, with 25% of women reporting their use in Pakistan. The overarching interventions covering service delivery platforms at facility and community levels necessitate the integration of family planning (FP) with maternal, newborn, and child health (MNCH) services.
The main aim of this study is to evaluate the impact of an integrated FP-MNCH service delivery model to increase coverage of MCMs in rural Pakistan. Moreover, we aim to measure the level of effectiveness of interventions regarding the uptake of MCMs.
A quasi-experimental, sequential, mixed methods study design with pre- and postevaluation will be adopted to evaluate the impact of integration of FP with MNCH services. The interventions include the following: (1) capacity strengthening of health care providers, including technical trainings; training in counseling of women who attend immunization centers, antenatal care (ANC) clinics, and postnatal care (PNC) clinics; and provision of job aids; (2) counseling of women and girls attending ANC, PNC, and pediatric clinics; (3) ensuring sustained provision of supplies and commodities; (4) community engagement, including establishing adolescent-friendly spaces; and (5) use of District Health Information System data in decision-making. Descriptive statistics will be used to estimate prevalence (ie, proportions) and frequencies of outcome indicators. A univariate difference-in-difference analytical approach will be used to estimate the effect of the interventions. In addition, a Blinder-Oaxaca decomposition analysis will be conducted to identify and quantify determinants of the modern contraceptive prevalence rate.
The intervention phase began in July 2021 and will run until June 2022. The impact assessment will be conducted from July to September 2022.
This project will evaluate the impact of integrating FP with MNCH services. Furthermore, this study will identify the drivers and barriers in uptake of MCMs and will simultaneously help in modifying the interventional strategies that can be scaled up through existing service delivery platforms within the public and private sectors, according to the local sociocultural and health system context.
ClinicalTrials.gov NCT05045599; https://clinicaltrials.gov/ct2/show/NCT05045599.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/35291.
现代避孕方法（MCMs）的使用率仍然很低，在巴基斯坦，只有25%的女性报告使用过这些方法。涵盖设施和社区层面服务提供平台的总体干预措施需要将计划生育（FP）与孕产妇、新生儿和儿童健康（MNCH）服务相结合。
本研究的主要目的是评估综合的FP-MNCH服务提供模式对提高巴基斯坦农村地区MCMs覆盖率的影响。此外，我们旨在衡量关于MCMs使用的干预措施的有效性水平。
将采用一项带有前后评估的准实验性、序列性、混合方法研究设计，以评估FP与MNCH服务整合的影响。干预措施包括以下内容：（1）加强医疗保健提供者的能力，包括技术培训；对前往免疫中心、产前保健（ANC）诊所和产后保健（PNC）诊所的女性进行咨询培训；以及提供工作辅助工具；（2）对前往ANC、PNC和儿科诊所的妇女和女孩进行咨询；（3）确保持续提供物资和商品；（4）社区参与，包括建立对青少年友好的空间；（5）在决策中使用地区卫生信息系统数据。描述性统计将用于估计结果指标的患病率（即比例）和频率。将使用单变量差异分析方法来估计干预措施的效果。此外，将进行布林德-奥克分解分析，以识别和量化现代避孕普及率的决定因素。
干预阶段于2021年7月开始，将持续到2022年6月。影响评估将于2022年7月至9月进行。
该项目将评估FP与MNCH服务整合的影响。此外，本研究将确定MCMs使用的驱动因素和障碍，并将同时有助于根据当地社会文化和卫生系统背景，修改可通过公共和私营部门现有服务提供平台扩大规模的干预策略。
ClinicalTrials.gov NCT05045599；https://clinicaltrials.gov/ct2/show/NCT05045599。
国际注册报告识别号（IRRID）：DERR1-10.2196/35291。
