impact of interpersonal communication on uptake of birth spacing in somaliland november 25 th, 2014

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Impact of Interpersonal Communication on uptake of Birth Spacing in Somaliland November 25 th , 2014

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Background I n 2010, PSI/Somaliland as part of the UKAID funded Essential Package of Health Services pilot, launched a maternal and child health interpersonal communication program covering antenatal care, facility delivery, postnatal care, infant and young child feeding, and modern birth spacing I n 2014, PSI/Somaliland conducted a study to evaluate the effect of the program on behaviors and knowledge; this presentation focuses on birth spacing. R esearch objectives, among others: - To assess the impact of the PSI IPC intervention on antenatal care (ANC), postnatal care (PNC), safe delivery and infant and young child feeding (IYCF) practices among WRA - To assess the impact of the PSI IPC intervention on birth spacing and uptake of modern contraception methods among WRA - To assess correlates of ANC, PNC, safe delivery, IYCF, and birth spacing/family planning practices in the PSI IPC intervention areas compared to non-intervention areas

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Page 1: Impact of Interpersonal Communication on uptake of Birth Spacing in Somaliland November 25 th, 2014

Impact of Interpersonal Communication on uptake of Birth Spacing in SomalilandNovember 25th, 2014

Page 2: Impact of Interpersonal Communication on uptake of Birth Spacing in Somaliland November 25 th, 2014

Health Consortium for the Somali People (HCS)

The Health Consortium for the Somali People (HCS) provides innovative and collaborative health solutions, bringing health experts together to deliver a holistic approach to better serve the Somali people.

• HCS was designed with both the public and private health sector in mind, ensuring equitable and efficient access to quality products and services.

• HCS is the most responsive implementing health partner operating in all 3 zones of Somalia.

• HCS has a proven track record of implementing EPHS service delivery in collaboration with the ministries of health

Page 3: Impact of Interpersonal Communication on uptake of Birth Spacing in Somaliland November 25 th, 2014

Background In 2010, PSI/Somaliland as part of the UKAID funded Essential Package of Health Services pilot, launched a maternal and child health interpersonal communication program covering antenatal care, facility delivery, postnatal care, infant and young child feeding, and modern birth spacing

In 2014, PSI/Somaliland conducted a study to evaluate the effect of the program on behaviors and knowledge; this presentation focuses on birth spacing.

Research objectives, among others: - To assess the impact of the PSI IPC intervention on antenatal care (ANC), postnatal care (PNC), safe delivery and infant and young child feeding (IYCF) practices among WRA

- To assess the impact of the PSI IPC intervention on birth spacing and uptake of modern contraception methods among WRA

- To assess correlates of ANC, PNC, safe delivery, IYCF, and birth spacing/family planning practices in the PSI IPC intervention areas compared to non-intervention areas

Page 4: Impact of Interpersonal Communication on uptake of Birth Spacing in Somaliland November 25 th, 2014

Research methodology A post-test intervention-comparison design was used. Married Somali women with a child 6-11 months living in the four regions where the program is active were included in the study:

- women who participated in the program when pregnant (N=327) - women who participated in the program while lactating with a child under six months (N=328)

- Comparison women (N=307) recruited from households in non-intervention areas A questionnaire was administered covering birth spacing behaviors, knowledge, and attitudes

The data were analyzed using logistic regression to measure differences between groups

Page 5: Impact of Interpersonal Communication on uptake of Birth Spacing in Somaliland November 25 th, 2014

Study participants

Awdal Sahil Togdheer Marodijeex Total0

200

400

600

800

1000

1200

29 3192

155

307

64 6171

131

327

67 6769

125

328

IPC LactatingIPC PregnantNon-IPC

Page 6: Impact of Interpersonal Communication on uptake of Birth Spacing in Somaliland November 25 th, 2014

Participant Sociodemographics

Low SES High SES0

20

40

60

80

100

120

140

160

58.641.4

4456

47.9 52.1

Socio-Economic Status

IPC Lactating N=328IPC Pregnant N=327Non-IPC N=307

Page 7: Impact of Interpersonal Communication on uptake of Birth Spacing in Somaliland November 25 th, 2014

Participant Sociodemographics

Ever attended school0

20

40

60

80

100

120

30

33.7

36.6

Literacy

IPC Lactating N=328IPC Pregnant N=327Non-IPC N=307

Page 8: Impact of Interpersonal Communication on uptake of Birth Spacing in Somaliland November 25 th, 2014

Main findings

Page 9: Impact of Interpersonal Communication on uptake of Birth Spacing in Somaliland November 25 th, 2014

Knows 3 or more methods of birth spacing

Non-IPC Pregnant Lactating

13.7

33.435.3

Page 10: Impact of Interpersonal Communication on uptake of Birth Spacing in Somaliland November 25 th, 2014

Knows LAM is effective for 6 months

Non-IPC Pregnant Lactating

24.3 24

30.4

Page 11: Impact of Interpersonal Communication on uptake of Birth Spacing in Somaliland November 25 th, 2014

Attitudes about pills

Non-IPC Pregnant Lactating0

10

20

30

40

50

60

70

80

90

100

47.7

81.1 81.9

47.2

85.9 85.9

38

64.760

SafeEffectiveInfertility

Page 12: Impact of Interpersonal Communication on uptake of Birth Spacing in Somaliland November 25 th, 2014

Attitudes about injectibles

Non-IPC Pregnant Lactating0

10

20

30

40

50

60

70

80

90

43.4

82.9 81.8

45.7

83.9 85.2

35.6

62.4 61.8

SafeEffectiveInfertility

Page 13: Impact of Interpersonal Communication on uptake of Birth Spacing in Somaliland November 25 th, 2014

Ever used birth spacing

Non-IPC Pregnant Lactating0

10

20

30

40

50

60

70

50

66

60.3

6.4

16.3 16.9

AnyModern

Page 14: Impact of Interpersonal Communication on uptake of Birth Spacing in Somaliland November 25 th, 2014

Currently using birth spacing

Non-IPC Pregnant Lactating0

10

20

30

40

50

60

37.8

53.450.4

6.4

12.216.3

AnyModern

Page 15: Impact of Interpersonal Communication on uptake of Birth Spacing in Somaliland November 25 th, 2014

Participants’ exposure to other MCH communications

0

40

80

120

160

200

7.2 36 3212.5

7542.5

14.2

76.1

39.1

Radio

IPC Lactating N=328IPC Pregnant N=327Non-IPC N=307

Page 16: Impact of Interpersonal Communication on uptake of Birth Spacing in Somaliland November 25 th, 2014

Participants’ exposure to other MCH communications

Has received education on ANC

Has received education on facility delivery

Has received education on PNC

Has received education on IYCF

Has received education on birth spacing

0

5

10

15

20

25

30

5.5 3.9 4.6 4.67.2

6.7

5.2 5.5 5.8

11.34.3

2.42.4

5.2

8.8

Non Radio/Non PSI IPC

IPC Lactating N=328IPC Pregnant N=327Non-IPC N=307

Page 17: Impact of Interpersonal Communication on uptake of Birth Spacing in Somaliland November 25 th, 2014

Summary results Women who had been exposed to IPC were significantly more likely than the comparison group to currently be using any form of birth spacing

Among those currently using birth spacing, the lactating group was significantly more likely than the other two to be using a modern method

Intervention women had significantly better knowledge and attitudes about modern birth spacing than comparison women on all measures

Page 18: Impact of Interpersonal Communication on uptake of Birth Spacing in Somaliland November 25 th, 2014

Conclusions The program appears to be effective in changing knowledge, attitudes, and behaviors around modern birth spacing, though the design does not account for self-selection bias

These types of program should be taken to scale in similar contexts The increased adoption of MBS among the lactating group (who more recently received the intervention) suggests that recency of messaging may be key to motivating uptake of MBS

Page 19: Impact of Interpersonal Communication on uptake of Birth Spacing in Somaliland November 25 th, 2014

Thank You!

To learn more visit www.hcsshare.org