Tesfaye Tatek, Mamo Ephrem, Teshome Ayele, Kebede Birhanu, Abrham Tizita, Solomon Ananya, Seid Selahadin
Obstetrics and Gynaecology Department, Y12HMC, Addis Ababa, Ethiopia.
Public Health Department, Y12HMC, Addis Ababa, Ethiopia.
Health Serv Insights. 2023 Mar 10;16:11786329231160017. doi: 10.1177/11786329231160017. eCollection 2023.
Postpartum Family Planning (PPFP), which aims to prevent high risk unintended and closely spaced pregnancies during the first year following childbirth, is one of the highest impact interventions to avoid increased risk of premature birth, low birth weight, fetal and neonatal death, and adverse maternal health outcomes. This study aimed to assess the combined effect of a package of interventions on the use and quality of PPFP services at Y12HMC, Addis Ababa Ethiopia.
Cross-sectional study design was conducted to evaluate the effect of the package of chosen interventions: creating a private counseling space near the postpartum ward and providing training for health care providers on the WHO decision tool kit and Long Acting Contraceptive Methods (LACM). Interviews were conducted with 470 women (235 before and 235 after the intervention). Frequency tables and graphs were used to describe the study variables and statistical significance between pre and post intervention indicators was declared at value <.05.
From 470 participants, 421 respondents participated which makes response rate of 90%. The majority of the participants were in the age category 20 to 29 years, married/lived together, completed at least primary education and had more than one child both at baseline and post intervention. The proportion of women who chose PPFP increased from 55.8% at baseline to 69% after the intervention. The most preferred contraceptive method was implant. The overall service satisfaction level of the study participants was 95.4% post intervention, significantly higher than at baseline (78%, < .05). Providers indicated that clients are satisfied with the service and that the institutional structure is appropriate for delivering integrated services following the intervention.
This study demonstrated that quality improvement interventions like creating a private counseling space and providing training using WHO decision tool kit can achieve significant improvement on satisfaction of clients and PPFP uptake.
产后计划生育（PPFP）旨在防止分娩后第一年出现高风险意外怀孕和间隔过短的怀孕，是避免早产、低出生体重、胎儿和新生儿死亡以及孕产妇不良健康结局风险增加的最具影响力的干预措施之一。本研究旨在评估一套干预措施对埃塞俄比亚亚的斯亚贝巴Y12HMC产后计划生育服务的使用和质量的综合影响。
采用横断面研究设计来评估所选一套干预措施的效果：在产后病房附近设立一个私密咨询空间，并为医疗保健提供者提供关于世界卫生组织决策工具包和长效避孕方法（LACM）的培训。对470名女性（干预前235名，干预后235名）进行了访谈。使用频率表和图表来描述研究变量，干预前后指标之间的统计学显著性在P值<0.05时判定。
470名参与者中，421名受访者参与，回复率为90%。大多数参与者年龄在20至29岁之间，已婚/同居，至少完成了小学教育，并且在基线和干预后都有不止一个孩子。选择产后计划生育的女性比例从基线时的55.8%增加到干预后的69%。最受欢迎的避孕方法是植入剂。干预后研究参与者的总体服务满意度为95.4%，显著高于基线时（78%，P<0.05）。提供者表示，客户对服务满意，并且干预后机构结构适合提供综合服务。
本研究表明，诸如设立私密咨询空间和使用世界卫生组织决策工具包进行培训等质量改进干预措施可以显著提高客户满意度和产后计划生育的采用率。
