Unité de Formation et de Recherche en Sciences Médicales d'Abidjan (DSPIM-UFR/SMA), Université Félix Houphouet Boigny, 01 BPV 34, Abidjan 01, Côte d'Ivoire.
Institut Africain Santé Publique (IASP), 12 BP 199, Ouagadougou, Burkina Faso.
Reprod Health. 2022 Aug 20;19(1):181. doi: 10.1186/s12978-022-01467-x.
Although several interventions integrating maternal, neonatal, child health and nutrition with family planning have been implemented and tested, there is still limited evidence on their effectiveness to guide program efforts and policy action on health services integration. This study aims to assess the effectiveness of a service delivery model integrating maternal and child health services, nutrition and family planning services, compared with the general standard of care in Burkina Faso, Cote d'Ivoire, and Niger.
This is a quasi experimental study with one intervention group and one control group of 3 to 4 health facilities in each country. Each facility was matched to a control facility of the same level of care that had similar coverage on selected reproductive health indicators such as family planning and post-partum family planning. The study participants are pregnant women (up to 28 weeks of gestational age) coming for their first antenatal care visit. They will be followed up to 6 months after childbirth, and will be interviewed at each antenatal visit and also during visits for infant vaccines. The analyzes will be carried out by intention to treat, using generalized linear models (binomial log or log Poisson) to assess the effect of the intervention on the ratio of contraceptive use prevalence between the two groups of the study at a significance level of 5%, while taking into account the cluster effect and adjusting for potential confounding factors (socio-demographic characteristics of women unevenly distributed at inclusion).
This longitudinal study, with the provision of family planning services integrated into the whole maternal care continuum, a sufficiently long observation time and repeated measurements, will make it possible to better understand the timeline and the factors influencing women's decision-making on the use of post-partum family planning services. The results will help to increase the body of knowledge regarding the impact of maternal and child health services integration on the utilization of post-partum family planning taking into account the specific context of sub-Saharan Africa French speaking countries where such information is very needed.
尽管已经实施和测试了几种将母婴健康、儿童健康和营养与计划生育相结合的干预措施，但仍缺乏关于其有效性的有限证据，无法为卫生服务整合的项目工作和政策行动提供指导。本研究旨在评估在布基纳法索、科特迪瓦和尼日尔，将母婴健康服务、营养和计划生育服务相结合的服务提供模式与一般标准护理相比的有效性。
这是一项在每个国家有一个干预组和一个对照组的准实验研究，每组有 3 到 4 个卫生机构。每个机构都与同一级别的对照机构相匹配，这些机构在选定的生殖健康指标（如计划生育和产后计划生育）方面具有相似的覆盖率。研究参与者为前来首次产前检查的孕妇（妊娠 28 周以下）。将对她们进行随访至产后 6 个月，并在每次产前检查时以及在婴儿疫苗接种期间进行访谈。分析将采用意向治疗进行，使用广义线性模型（二项逻辑或对数泊松）评估干预措施对两组研究中避孕使用流行率之比的影响，置信水平为 5%，同时考虑到聚类效应并调整潜在混杂因素（在纳入时分布不均的妇女的社会人口特征）。
这项纵向研究将计划生育服务纳入整个母婴护理连续体，观察时间足够长且进行重复测量，这将有助于更好地理解影响妇女产后计划生育服务使用决策的时间线和因素。研究结果将有助于增加有关母婴健康服务整合对考虑到撒哈拉以南非洲法语国家特定背景下产后计划生育利用的影响的知识体系，在这些国家非常需要此类信息。
