Engaging Community Health Workers to Enhance Modern Contraceptive Uptake Among Young First-Time Parents in Five Cities of Uttar Pradesh

Figures & Tables

TABLE 1.

Package of Interventions Implemented in the AYSRH Program in Pilot and Non-Pilot Cities

Interventions	Pilot Cities	Non-Pilot Cities
Dedicated and focused day for FP services for all married women aged 15–49 years	Yes	Yes
Dedicated and focused for FP services for FTPs aged 15–24 years	Yes	No
Coached ASHAs to update UHIRs to make FP data visible for all aged women 15–49 years	Yes	Yes
Coached ASHAs to update UHIRs to make FP data visible for FTPs aged 15–24 years and recorded for prioritization	Yes	No
Supported the ASHAs to understand the ensuring spacing at birth scheme and to help FTPs choose a method of their choice	Yes	No
Established adolescent-friendly health services	Yes	No
Trained at least 1 auxiliary nurse midwife/staff nurse at each urban primary health center in adolescent- and youth-friendly services	Yes
Trained staff on adolescent- and youth-friendly counseling skills related to FP and contraception	Yes	No¹
Whole-site orientation for urban primary health center staff on AYSRH and FTPs	Yes	No²

Abbreviations: ASHA, accredited social health activist; AYSRH, adolescent and youth sexual and reproductive health; FP, family planning; FTP, first-time parent; UHIR, urban health index register.
¹ No specific focus on adolescents and young people, but general training on FP.
² No specific focus on adolescents and young people, but general whole-site orientation.

TABLE 2.

Sociodemographic Characteristics Among First-Time Parents Living in Slum Areas Between Pilot and Non-Pilot Cities

	Pilot Cities, %	Non-Pilot Cities, %	Both, %
Age of women, years
15–21	29.4	33.6	30.8
22–24	70.7	66.4	69.2
Marital duration, years
Less than 5	80.3	81.0	79.7
5 or more	19.7	19.0	20.3
Education in completed years
None	13.3	13.4	13.8
Less than 6	14.4	10.3	13.1
6–9	23.0	30.0	25.4
12 or more	49.4	46.3	47.7
Wealth tertiles
Poor	27.3	46.6	33.3
Middle	33.3	33.2	33.3
Rich	39.3	20.2	33.3
Total unweighted number	549	253	802

TABLE 3.

Modern Contraceptive Use Among FTPs in Pilot and Non-Pilot Cities by Exposure to Family Planning Information and Sociodemographic Characteristics

	Pilot Cities, %	Non-Pilot Cities, %	Difference, %
Overall	38.5	31.9	6.6^a
Exposure to FP information through ASHA
No	36.4	30.2	6.2
Yes	40.7	35.2	5.5
Exposure to FP information at an SDP
No	35.6	29.7	5.9
Yes	43.8	33.7	10.1^a
Any exposure (either through ASHA or SDP)
No	35.1	30.0	5.1
Yes	40.6	32.8	7.8^a
Age of women, years
15–21	33.9	35.8	−1.9
22–24	40.4	29.8	10.6
Marital duration, years
Less than	41.4	33.5	7.8
5 or more	27.9	24.8	3.1
Education, years
None	32.6	19.0	13.6
Less than 6	42.8	18.5	24.3
6–9	32.3	30.1	2.2
12 or more	41.9	39.1	2.8
Wealth tertiles
Poor	26.3	29.1	−2.7
Middle	38.6	35.6	3.0
Rich	48.0	31.4	16.6
Total unweighted number	549	253

Abbreviations: ASHA, accredited social health activist; FP, family planning; FTP, first-time parent; SDP, service delivery point.
^a Significant at 5% using z-test.
Source: Output Tracking Survey, 2019.

TABLE 4.

Logistic Regression Analysis^a Showing the Interaction Effect of City Type and Program Exposure on Modern Contraceptive Method Use Among FTPs

	% mCPR	Odds Ratio (95% Confidence Interval)
		Model I	Model II	Model III
Non-pilot city
No exposure through ASHA	30.2	Reference
Exposure through ASHA	35.2	1.40 (0.78, 2.50)
Pilot city
No exposure through ASHA	36.4	1.36 (0.88, 2.11)
Exposure through ASHA	40.7	1.61^b (1.04, 2.48)
Non-pilot city
No exposure through SDP	29.7		Reference
Exposure through SDP	33.7		1.33 (0.76, 2.32)
Pilot City
No exposure through SDP	35.6		1.40 (0.87, 2.26)
Exposure through SDP	43.8		1.84^b (1.09, 3.11)
No exposure to ASHA or SDP
Non-pilot city	30.0			Reference
Pilot city	35.1			1.31 (0.75, 2.31)
Exposure to ASHA only
Non-pilot city	28.8			0.86 (0.32, 2.34)
Pilot city	36.4			1.40 (0.77, 2.53)
Exposure to SDP only
Non-pilot city	30.3			1.01 (0.51, 2.03)
Pilot city	40.2			1.53 (0.75, 3.13)
Exposure to ASHA and SDP
Non-pilot city	38.4			1.74 (0.84, 3.63)
Pilot city	45.8			1.90^b (1.03, 3.51)

Abbreviations: ASHA, accredited social health activist; FTP, first-time parent; mCPR, modern contraceptive prevalence rate; SDP, service delivery point.
^a Each model was adjusted for age of women, marital duration, education, caste, religion, household wealth, and working status.
^b P<.05.
Source: Output Tracking Survey, 2019.