EngenderHealth, Washington, District of Columbia, USA.
EngenderHealth, Dar es Salaam, Tanzania.
Int J Gynaecol Obstet. 2022 Dec;159(3):662-671. doi: 10.1002/ijgo.14203. Epub 2022 Apr 21.
To evaluate an intervention that aimed at strengthening voluntary access to long-acting reversible contraception (LARC) within postabortion care (PAC) in hospitals in mainland Tanzania and Zanzibar.
From 2016 to 2018, we conducted PAC quality improvement interventions, emphasizing family planning (FP) counseling and voluntary access to LARC. Researchers conducted an interrupted time-series analysis of service statistics compiled from 2014 to 2020 using segmented linear mixed effects regression models to assess the interventions' effect on postabortion contraceptive uptake.
The intervention in mainland Tanzania was associated with an immediate 38% increase in postabortion LARC uptake, a trend that declined from late 2016 to mid-2020 to 34%. In Zanzibar, the intervention was associated with a gradual increase in LARC uptake that peaked in late 2018 at 23% and stabilized at approximately 15% by mid-2020. Whereas the interventions in mainland facilities did not generate significant changes in postabortion FP uptake overall, the launch of interventions in Zanzibar in mid-2016 was associated with a precipitous rise in that outcome over time, which plateaued at approximately 54% by 2019.
Increased voluntary uptake of postabortion contraception was associated with the introduction of training in PAC, including FP, and quality improvement interventions and gains were sustained over time.
评估一项旨在加强坦桑尼亚大陆和桑给巴尔岛医院流产后护理（PAC）中长效可逆避孕（LARC）自愿获取的干预措施。
2016 年至 2018 年，我们开展了 PAC 质量改进干预措施，强调计划生育（FP）咨询和 LARC 的自愿获取。研究人员使用分段线性混合效应回归模型对 2014 年至 2020 年期间编制的服务统计数据进行了中断时间序列分析，以评估干预措施对流产后避孕措施采用的影响。
在坦桑尼亚大陆，干预措施与流产后 LARC 采用率立即增加了 38%，这一趋势从 2016 年末到 2020 年年中下降到 34%。在桑给巴尔，干预措施与 LARC 采用率逐渐增加有关，2018 年末达到峰值 23%，到 2020 年年中稳定在 15%左右。虽然在大陆设施的干预措施并没有总体上对流产后 FP 采用率产生显著变化，但 2016 年年中在桑给巴尔启动的干预措施与该结果随时间的急剧上升有关，到 2019 年达到约 54%的峰值。
流产后避孕措施的自愿采用率增加与 PAC 培训、包括 FP 以及质量改进干预措施的引入有关，并且在一段时间内得到了维持。
