RT Journal Article
SR Electronic
T1 Engaging Community Health Workers to Enhance Modern Contraceptive Uptake Among Young First-Time Parents in Five Cities of Uttar Pradesh
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 e2200170
DO 10.9745/GHSP-D-22-00170
VO 12
IS Supplement 2
A1 Sharma, Mukesh Kumar
A1 Das, Emily
A1 Sahni, Hitesh
A1 Mirano, Jessica
A1 Graham, Kate
A1 Kumar, Abhishek
A1 Finkle, Clea
YR 2024
UL http://www.ghspjournal.org/content/12/Supplement_2/e2200170.abstract
AB Key FindingsIn Uttar Pradesh, India, young married first-time parents (FTPs) have a higher unmet need for family planning (FP) compared to married women in general, and their modern contraceptive prevalence rate is low.After accredited social health activists were coached and mentored in providing information and counseling on FP and healthy birth spacing with a particular focus on FTPs, the exposure to FP information was documented in 5 cities where the intervention was piloted.There was a positive association between any FTP intervention exposure and modern contraceptive method use, and this association is relatively stronger in cities where an intentional focus on FTPs was added to a functional family planning program than in cities without FTP interventions.Key ImplicationsProgram managers should consider tailoring specific FP programs by engaging community health workers and improving outreach services to ensure young FTPs have access to a range of contraceptive methods.Interventions that support FP counseling and methods, specifically for young FTPs, are critical for achieving goals outlined in Family Planning 2030 and the related Sustainable Development Goals.Introduction:Young newly married women and first-time parents (FTPs), particularly those living in slum settlements, have a high unmet need for modern contraceptive methods to limit and space births. We describe an intervention in which adolescents and youth sexual and reproductive health (AYSRH) services tailored to FTPs were incorporated into the government’s existing family planning (FP) program in 5 cities of Uttar Pradesh. We examined the effect of this intervention on modern contraceptive use among FTPs aged 15–24 years.Methods:To assess the effect of this pilot, in 2019, 1 year after the implementation of the program, we analyzed community-based output tracking survey data on 549 married women who are FTPs in the pilot cities. These FTPs were compared with 253 women who were FTPs from other cities where the program was implemented without a specific focus on FTPs. Descriptive statistics and multivariate logistic regression analysis were applied to understand the association between exposure to FP information, either through accredited social health activists or through service delivery points, and use of modern contraceptives.Results:Use of modern contraceptives was higher among FTPs in the 5 pilot cities than non-pilot cities (39% vs. 32%; P<.05). The interaction effect of city type and exposure to the information showed a positive association between modern contraceptive use and program exposure, greater in pilot cities than non-pilot cities.Conclusions:Higher uptake of modern contraceptives among young women may be achieved when an FTP-focused intervention is layered on the government’s existing FP programs. Future studies with a longer duration of implementation, in a wider geography, and with longitudinal design are recommended to provide more robust measures of high impact intervention/practices in urban areas.