impact of interpersonal communication on uptake of birth spacing in somaliland november 25 th, 2014
DESCRIPTION
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 areasTRANSCRIPT
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Impact of Interpersonal Communication on uptake of Birth Spacing in SomalilandNovember 25th, 2014
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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
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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
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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
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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
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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
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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
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Main findings
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Knows 3 or more methods of birth spacing
Non-IPC Pregnant Lactating
13.7
33.435.3
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Knows LAM is effective for 6 months
Non-IPC Pregnant Lactating
24.3 24
30.4
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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
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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
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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
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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
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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
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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
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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
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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
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Thank You!
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