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宗教领袖改善健康的怀孕时机和间隔:肯尼亚和加纳“希望渠道”方法的运筹学研究结果。

Faith Leaders Improve Healthy Timing and Spacing of Pregnancy: Results of Operations Research on the Channels of Hope Methodology in Kenya and Ghana.

机构信息

World Vision, 300 "I" Street NE, Washington, DC, US.

Formerly of World Vision, 300 "I" Street NE, Washington, DC 20002, US.

出版信息

Ann Glob Health. 2023 Mar 16;89(1):19. doi: 10.5334/aogh.3944. eCollection 2023.

Abstract

BACKGROUND

Family planning averts unintended pregnancies, unsafe abortions, and maternal deaths, while improving child health and socio-economic progress, but an estimated 218 million women and girls in low- and middle-income countries, especially in sub-Saharan Africa, have an unmet need for modern family planning. Faith leaders can impact the demand and uptake of family planning. However, there is limited understanding of the mechanisms for effective family planning advocacy by faith leaders. Channels of Hope (CoH) is World Vision's process that engages faith leaders and faith communities to address health issues.

OBJECTIVES

To determine the impact of CoH on promoting healthy timing and spacing of pregnancies and family planning (HTSP/FP) by mothers of children under two years old in select parts of Kenya and Ghana. To also determine faith leaders' attitudes, perceptions, and potential roles in influencing HTSP/FP after exposure to CoH.

METHODS

A mixed methods operations research comprising quantitative (quasi-experimental design with surveys of 4,372 mothers of children under two years old) and qualitative arms (in-depth interviews of 17 faith leaders and their seven spouses) was implemented.

FINDINGS

Taking both countries together, male sterilization, female condom, and LAM were the only FP methods that did not show increases from baseline to endline. Methods with the highest knowledge increases between intervention areas and control areas were implants, injectables and pills, with 18.4, 12.1 and 11.2 percentage point increases, respectively. The faith leaders in both countries reported that their views on healthy timing and spacing of pregnancies changed due to the Channels of Hope workshops.

CONCLUSION

The HTSP/FP model has potential for positive health and social transformation that is built on the trust of faith leaders. Ghana and Kenya provide great examples of possible scenarios in order to help prepare implementers to scale the learnings of this operations research across sub-Saharan Africa.

摘要

背景

计划生育可避免意外怀孕、不安全堕胎和孕产妇死亡,同时改善儿童健康和社会经济进步,但据估计,低收入和中等收入国家,特别是撒哈拉以南非洲地区,有 2.18 亿育龄妇女和女童对现代计划生育的需求未得到满足。宗教领袖可以影响计划生育的需求和采用。然而,对于宗教领袖有效倡导计划生育的机制,了解有限。“希望渠道”(CoH)是世界宣明会的一个程序,它使宗教领袖和宗教社区参与解决健康问题。

目的

在肯尼亚和加纳的部分地区,确定“希望渠道”对促进 2 岁以下儿童的母亲实现健康的生育间隔和计划生育(HTSP/FP)的影响。还确定宗教领袖在接触“希望渠道”后,在影响 HTSP/FP 方面的态度、看法和潜在作用。

方法

采用混合方法操作研究,包括定量(准实验设计,对 4372 名 2 岁以下儿童的母亲进行调查)和定性部分(对 17 名宗教领袖及其 7 名配偶进行深入访谈)。

发现

将两个国家放在一起,男性绝育、女用避孕套和 LAM 是唯一没有从基线到终线增加的计划生育方法。干预地区和对照地区之间知识增加最多的方法是植入物、注射剂和药丸,分别增加了 18.4%、12.1%和 11.2%。两国的宗教领袖都报告说,由于“希望渠道”研讨会,他们对健康生育间隔的看法发生了变化。

结论

HTSP/FP 模式具有积极的健康和社会变革的潜力,这是建立在宗教领袖信任的基础上的。加纳和肯尼亚提供了很好的范例,以便为实施者在整个撒哈拉以南非洲推广这项行动研究的经验做好准备。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4248/10022531/d84fd85950b0/agh-89-1-3944-g1.jpg

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