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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Integrating family planning messages into immunization services: A cluster-randomized trial in Ghana and Zambia
Health Policy and Planning, Volume 29, No. 3, Year 2014
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Description
Objective To determine whether integrating family planning (FP) messages and referrals into facility-based, child immunization services increase contraceptive uptake in the 9-to 12-month post-partum period. Methods A cluster-randomized trial was used to test an intervention where vaccinators were trained to provide individualized FP messages and referrals to women presenting their child for immunization services. In each of 2 countries, Ghana and Zambia, 10 public sector health facilities were randomized to control or intervention groups. Shortly after the introduction of the intervention, exit interviews were conducted with women 9-12 months postpartum to assess contraceptive use and related factors before and after the introduction of the intervention. In total, there were 8892 participants (Control Group Ghana, 1634; Intervention Group Ghana, 1129; Control Group Zambia, 3751; Intervention Group Zambia, 2468). Intervention effects were evaluated using logistic mixed models that accounted for clustering in data. In addition, in-depth interviews were conducted with vaccinators, and a process assessment was completed mid-way through the implementation of the intervention. Results In both countries, there was no significant effect on non-condom FP method use (Zambia, P = 0.56 and Ghana, P = 0.86). Reported referrals to FP services did not improve nor did women's knowledge of factors related to return of fecundity. Some providers reported having made modifications to the intervention; they generally provided FP information in group talks and not individually as they had been trained to do. Conclusion Rigorous evidence of the success of integrated immunization services in resource poor settings remains weak. © 2013 The Author. All rights reserved.
Authors & Co-Authors
Vance, Gwyneth
United States, Durham
Fhi 360
Janowitz, Barbara K.
United States, Durham
Fhi 360
Chen, Mario
United States, Durham
Fhi 360
Boyer, Brooke
United States, Durham
Fhi 360
Kasonde, Prisca
United States, Durham
Fhi 360
Quansah-Asare, Gloria
Ghana, Accra
Ghana Health Service
Kafulubiti, Beatrice
Zambia, Kasama
Zambia Ministry of Health
Stanback, John
United States, Durham
Fhi 360
Statistics
Citations: 39
Authors: 8
Affiliations: 3
Identifiers
Doi:
10.1093/heapol/czt022
e-ISSN:
14602237
Research Areas
Health System And Policy
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Randomised Control Trial
Study Approach
Qualitative
Study Locations
Ghana
Zambia
Participants Gender
Female