Effectiveness of community-based interpersonal communication for generating family planning demand in key groups.

OBJECTIVE: The study aimed to document the impact of interpersonal communication (IPC) activities on increasing volume of family planning clients, new users, long term contraceptive uptake, post-partum, and post abortion family planning uptake at the associated health facilities of the Sabz Sitara Network. METHODOLOGY: A comparative secondary analysis of retrospective programme service delivery data from two groups of providers was performed. The exposure variable is defined as receipt of IPC. The six outcome variables are volume of: family planning (FP) clients, FP clients less < 25 years, intra-uterine device (IUD) insertions, post-partum FP clients (PPFP), users, and post-abortion FP (PAFP) clients. RESULTS: The increase in client volume in IPC supported providers is significant for all the FP outcomes when adjusted for provider qualification and location. The adjusted model shows a significant increase of 10 more FP clients, 2 more youth clients and IUD insertions each, 3 more new users, and 1 more client for post abortion services. CONCLUSIONS: The IPC intervention has a positive and significant impact on increasing client volume for all related FP outcomes at the associated provider facilities. Location and qualification of providers seem to moderate the impact. Considering qualification, and geo-social demographics of the area to tweak intervention intensity and design will help amplify the associated beneficial outcomes and minimize underperformance. To maximize return on investment, subsequent evaluations should help determine the ideal time frame required to achieve and sustain the positive results.

Predictors of postpartum family planning uptake in Sindh and Punjab provinces of Pakistan.

OBJECTIVE: Combination of beneficiary and supply side factors for determining what influences Postpartum family planning use in Sindh and Punjab provinces of Pakistan. METHODS: A facility-based survey was conducted among 1690 married women of reproductive age (MWRA - i.e. married women between the ages of 15 and 49 years) visiting public facilities in six districts across Sindh and Punjab provinces of Pakistan. RESULTS: Half (53%) of the interviewed women used postpartum contraceptives. Participants who used PPFP were: 55% more likely to be from Punjab than Sindh, 39% more likely to be between 25 to 34 year of age than under 25 years. After adjusting for all variables in the model, women who delivered in the private sector remained to have lower odds of PPFP use compared to those who delivered in public facilities. Women who had four or more sons were nearly 20 time more likely to use PPFP compared to women with no sons, and the PPFP use increases with the number of sons. On the contrary, women who had four or more daughters were 16 times less likely to use PPFP compared with women with no daughters. CONCLUSIONS: Postpartum women are among those with the greatest unmet need as a result of a combination of beneficiary and supplier side factors. The health system's response to meet the contraceptive needs of postpartum women should work along the continuum of care from pregnancy to postpartum, with expanded method choice and alternative service delivery outlets.