Sothornwit Jen, Lumbiganon Pisake, Saranrittichai Kesinee, Sangkomkamhang Ussanee, Singhdaeng Thanyarat, Jampathong Nampet
Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Department of Health Behavior and Health Promotion, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.
Int J Womens Health. 2022 Jul 26;14:945-956. doi: 10.2147/IJWH.S370012. eCollection 2022.
This study sought to identify the factors that act as barriers and facilitators to developing and implementing Immediate postpartum (IPP) insertion of contraceptive implants service according to the Consolidated Framework for Implementation Research (CFIR).
We conducted in-depth interviews and focus group discussions to explore IPP contraceptive implantation programs implemented in community, regional, and university hospitals in Thailand. The CFIR was used to guide the data collection and analyses.
All CFIR domains were found to have an impact on planning and implementation. Out of 38 constructs, nine were identified as either barriers or facilitators, and four were determined to be both. Barriers included an insufficient training budget, lack of policy to support non-teenagers, disconnect among organizations, and lack of knowledge on the part of the clients. Facilitators included the relative advantage of implants over other contraceptive methods, reimbursement policy, laws that promote teenage autonomy, setting IPP implants as a key performance indicator (KPI), identifying project champions, and educating clients through antenatal counseling or multimedia intervention.
Barriers and facilitators to the successful implementation of an IPP contraceptive implant program were identified. In order to successfully implement this service, modifiable barriers should be overcome and facilitators should be strengthened. Strategies tailored to the local context should be developed to ensure the sustainability of the program. Educating clients is crucial and need both hospital- and community interventions.
本研究旨在根据实施研究综合框架（CFIR）确定阻碍和促进产后即时（IPP）植入避孕植入物服务开展和实施的因素。
我们进行了深入访谈和焦点小组讨论，以探讨泰国社区、地区和大学医院实施的IPP避孕植入项目。CFIR用于指导数据收集和分析。
发现CFIR的所有领域都对规划和实施有影响。在38个要素中，9个被确定为阻碍因素或促进因素，4个被确定既是阻碍因素又是促进因素。阻碍因素包括培训预算不足、缺乏支持非青少年的政策、组织间脱节以及服务对象知识匮乏。促进因素包括植入物相对于其他避孕方法的相对优势、报销政策、促进青少年自主的法律、将IPP植入物设定为关键绩效指标（KPI）、确定项目倡导者以及通过产前咨询或多媒体干预对服务对象进行教育。
确定了成功实施IPP避孕植入项目的阻碍因素和促进因素。为了成功实施这项服务，应克服可改变的阻碍因素并加强促进因素。应制定适合当地情况的策略以确保项目的可持续性。对服务对象进行教育至关重要，需要医院和社区的干预。
