Clinical trial NCT06273670: Postpartum Initiation of Long-acting Reversible Contraceptives: Knowledge Attitude and Practice Study (KAP)
Official title: Regular Six Weeks Versus Earlier Postpartum Initiation of Long-acting Reversible Contraceptives: Knowledge Attitude and Practice Study (KAP)
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Contraception
Keywords: Postpartum contraception
LARC
KAP
Lead sponsor: Assiut University
Sponsor class: OTHER
First posted: 2024-02-22
Enrollment: 600
Sex: ALL
Minimum age (years): 18
Maximum age (years): 60
Standard ages: ADULT
Accepts healthy volunteers: yes
Observational model: OTHER
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Client's group:

All females visiting family planning centers in public health facilities who delivered within a year and receiving a LARC method or willing are asked to volunteer.

Service provider group:

All service providers who are working in primary health care units \& hospitals, including general practitioners, ob/gyn. specialists, nurses, and social workers are asked to volunteer.

Brief summary: Comparing Knowledge, attitude and Practice of clients and service providers about the regular (6 weeks) versus earlier initiation of LARC, through a structured questionnaire prepared in English and translated to local language i.e. Arabic.

Detailed description: Family planning is a behavior that allows individuals and couples to anticipate and attain their desired number of children, at the spacing and timing of their births. It is achieved through the use of contraceptive methods and treatment of involuntary infertility.

Postpartum family planning is the prevention of unintended and closely spaced pregnancies during the first 12 months following childbirth. Short interval pregnancies are associated with increased maternal morbidities such as anemia, bleeding disorders, premature rupture of membranes, puerperal endometritis and mortality .

Postpartum family planning (PPFP) has long been recognized as an important component of maternal health care. Through birth spacing and prevention of high-risk and unwanted pregnancies, PPFP helps women who have recently delivered to avoid exposure to the risks of maternal death. Likewise, the importance of the interplay between maternal health services and use of contraception in the postpartum period has been recognized for decades.

Globally, more than 90 percent of women during the first year postpartum want to either delay or avoid future pregnancies . An increase in contraceptive use during the postpartum period should substantially reduce rates of maternal and infant mortality by preventing unplanned and unwanted pregnancies and by spacing new pregnancies at least two years after the previous birth .

Eligibility criteria: Inclusion Criteria:

Client's group All clients who were attending family planning centers in public health facilities at the study period if they have had a postpartum LARC method (Copper IUD, Progestin-releasing IUS, Subdermal implant) or willing to use it in the first year after delivery.

Service provider group:

All service providers who are working in primary health care units \& hospitals, including general practitioners, ob/gyn. specialists, nurses, and social workers.

Exclusion Criteria:

* Clients and service providers who refused to participate in the study
* Clients who are currently using or willing to use a method other than LARC

Primary outcomes:
measure: Clients' knowledge
timeFrame: Immediately. The outcome is provided in the questionnaire which is completed once by the client
Secondary outcomes:
measure: Clients' attitude
timeFrame: Immediately. The outcome is provided in the questionnaire which is completed once by the client
measure: Clients' practice
timeFrame: Immediately. The outcome is provided in the questionnaire which is completed once by the client
measure: Providers' knowledge
timeFrame: Immediately. The outcome is provided in the questionnaire which is completed once by the client
measure: Providers' attitude
timeFrame: Immediately. The outcome is provided in the questionnaire which is completed once by the client
measure: Providers' practice
timeFrame: Immediately. The outcome is provided in the questionnaire which is completed once by the client
Other outcomes:
Locations:
city: Assiut
country: Egypt
facility: Assiut University
Study officials:
affiliation: Obstetrics and gynecology department, Assiut University
name: Ahmed Ali Abdelaleem, Doctorate
role: STUDY_CHAIR
affiliation: Obstetrics and gynecology department, Assiut University
name: Karim abdelhameed, Doctorate
role: STUDY_CHAIR
References:
citation: Committee Opinion No. 642: Increasing Access to Contraceptive Implants and Intrauterine Devices to Reduce Unintended Pregnancy. Obstet Gynecol. 2015 Oct;126(4):e44-e48. doi: 10.1097/AOG.0000000000001106.
citation: Washington CI, Jamshidi R, Thung SF, Nayeri UA, Caughey AB, Werner EF. Timing of postpartum intrauterine device placement: a cost-effectiveness analysis. Fertil Steril. 2015 Jan;103(1):131-7. doi: 10.1016/j.fertnstert.2014.09.032. Epub 2014 Oct 25.
citation: Conde-Agudelo A, Belizan JM. Maternal morbidity and mortality associated with interpregnancy interval: cross sectional study. BMJ. 2000 Nov 18;321(7271):1255-9. doi: 10.1136/bmj.321.7271.1255.