Operations Research to Address Unmet Need for Contraception in the Postpartum Period in Sylhet District, Bangladesh
Condition: Health Knowledge, Attitudes, Practice
Study type: Interventional

Summary: 
      The proposed operations research study is designed to evaluate a package of family planning
      services and related behavior change interventions aimed at addressing the unmet need for
      family planning in postpartum women, integrated with an ongoing maternal and newborn health
      program, and to assess the program's impact (1) on knowledge of healthy fertility practices,
      (2) on contraceptive use prevalence in women during the postpartum period, (3) on postpartum
      birth spacing, and (4) to examine the feasibility and sustainability of the proposed
      integrated service delivery approach. The study will have a quasi-experimental design, with
      evaluation primarily through household surveys in four intervention unions and four
      comparison unions (unions are lowest local government entities with an average population of
      about 20,000) in rural Sylhet District, Bangladesh.
    

Detailed description: 
      The specific objectives of this operations research are:

        1. Integrated Family Planning/Maternal Neonatal Health Intervention: To develop and test an
           integrated Family Planning and Maternal and Neonatal Health (FP/MNH) service delivery
           approach in the Bangladesh setting, building on the ongoing Projahnmo study.
           Intervention activities will include behaviour change communications on healthy timing
           and spacing of pregnancy, couples counseling, social networking and expansion of
           contraceptive options for postpartum women, including provision of oral contraceptive
           pills and condoms in the home.

        2. Integrated Service Delivery Approach: To assess the strengths and limitations of
           integrating family planning into an ongoing community-based maternal and newborn care
           program.

             1. To compare the quality of counseling provided by CHWs in the integrated (MNH+FP)
                intervention arm versus regular (MNH) control arm in Sylhet district, Bangladesh

             2. To assess the knowledge of CHWs providing integrated (MNH+FP) counseling in the
                intervention arm versus CHWs providing regular MNH counseling in the control arm in
                Sylhet district, Bangladesh

             3. To determine factors that affect the quality of care provided by CHWs in both the
                intervention and control arms in Sylhet district, Bangladesh
    

Intervention name(s): Educational and Behavior Change intervention; Comparison Group
Intervention type(s): Behavioral; Other
Intervention description(s): Integrate post-partum family planning education and counselling into 2nd Antenatal Home visit by CHW (at approximately 32 weeks of pregnancy) Integrate post-partum family planning education and counselling into post-partum visits by CHWs during first month Continue providing family planning education and counselling to women through CHW home visits after first month.
Promote discussion and acceptance of post-partum family planning methods among key household members.
Facility level Ensure availability of postpartum contraceptive methods such as progestin-only pill.
Ensure availability of post-partum family planning and post-natal services. Community level Increase community awareness of the importance of birth spacing and benefits of LAM Educate influential community members on the importance of birth spacing and benefits of LAM.; A comparison area received standard government health services.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Keywords: intervention