RT Journal Article
SR Electronic
T1 Antenatal Care Interventions to Increase Contraceptive Use Following Birth in Low- and Middle-Income Countries: Systematic Review and Narrative Synthesis
JF Global Health: Science and Practice
JO GLOB HEALTH SCI PRACT
FD Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs
SP e2400059
DO 10.9745/GHSP-D-24-00059
VO 12
IS 5
A1 McCarthy, Ona L.
A1 Fardousi, Nasser
A1 Tripathi, Vandana
A1 Stafford, Renae
A1 Levin, Karen
A1 Khan, Farhad
A1 Pepper, Maxine
A1 Campbell, Oona M.R.
YR 2024
UL http://www.ghspjournal.org/content/12/5/e2400059.abstract
AB Key MessagesThis systematic review adds to the limited evidence on the effectiveness of interventions delivered during the antenatal period on postpartum contraceptive use in low- and middle-income countries.The 31 unique interventions in 34 reports included in this review were heterogeneous, with 18 studies reporting a positive effect on contraceptive use in the first year postpartum.Interventions that included a multifaceted package of initiatives appeared to be more likely to have a positive effect on postpartum contraceptive use.Funders, policymakers, and providers may consider strengthening their support for multifaceted antenatal care interventions to promote voluntary postpartum contraceptive use to address the health risks associated with short interpregnancy intervals.Introduction:Health risks associated with short interpregnancy intervals, coupled with women’s desires to avoid pregnancy following childbirth, underscore the need for effective postpartum family planning programs. The antenatal period provides an opportunity to intervene; however, evidence is limited on the effectiveness of interventions aimed at reaching women in the antenatal period to increase voluntary postpartum family planning in low- and middle-income countries (LMICs). This systematic review aimed to identify and describe interventions in LMICs that attempted to increase postpartum contraceptive use via contacts with pregnant women in the antenatal period.Methods:Studies published from January 2012 to July 2022 were considered if they were conducted in LMICs, evaluated an intervention delivered during the antenatal period, were designed to affect postpartum contraceptive use, were experimental or quasi-experimental, and were published in French or English. The main outcome of interest was postpartum contraceptive use within 1 year after birth, defined as the use of any method of contraception at the time of data collection. We searched EMBASE, Global Health, and Medline and manually searched the reference lists from studies included in the full-text screening.Results:We double-screened 771 records and included 34 reports on 31 unique interventions in the review. Twenty-three studies were published from 2018 on, with 21 studies conducted in sub-Saharan Africa. Approximately half of the study designs (n=16) were randomized controlled trials, and half (n=15) were quasi-experimental. Interventions were heterogeneous. Among the 24 studies that reported on the main outcome of interest, 18 reported a positive intervention effect, with intervention recipients having greater contraceptive use in the first year postpartum.Conclusion:While the studies in this systematic review were heterogeneous, the findings suggest that interventions that included a multifaceted package of initiatives appeared to be most likely to have a positive effect.