Intervention Approaches Used in the Evaluations Reviewed (N=40)

Comprehensive Services
Provision of multiple servicesMay include contraceptive services, contraceptive education, maternal/infant/child health services, child care, social work services, and/or home visitation
Contraceptive Information and Services
Provision of contraceptive servicesThrough clinical or home-based delivery, includes counseling on correct method use and side effects
Comprehensive sexuality educationIncludes contraceptive education, availability and correct use of contraceptives, sexual health and responsibility, dispelling myths about contraceptives
Pregnancy testingProvision of monthly pregnancy tests
Surveys of contraceptive useRegular assessments to monitor contraceptive use
Counseling on use of LAM with or without emergency contraceptionContraceptive services organized to provide LAM counseling and education; may include take-home supply of emergency contraception
Postpartum contraceptionProvision of contraceptive services and counseling in the immediate or extended(24 months) postpartum period
Planning for Contraceptive Use and Pregnancy Planning
Antenatal contraceptive planIn antenatal period, clients encouraged to articulate fertility intentions and prepare contraceptive plan to achieve fertility intentions
“Implementation Intention Formation” trainingTraining in “if-then” planning: “If I am brushing my teeth in the morning, then I will take my contraceptive pill.”21
Planning the next pregnancyClients encouraged to state the preferred timing of their next pregnancy
Community-Based Social and Behavioral Change Communication
Interpersonal counseling on fertility return after live birthClients advised that fertility can return before menses returns and, to avoid unintended pregnancy, not to wait for menses return before starting use of contraceptives
Interpersonal counseling on healthy pregnancy spacingClients advised of health/quality of life benefits of spacing next pregnancy 24 months after last birth, and potential adverse outcomes for mother and infant of closely spaced births
Social networks/group discussions in homes of village influentialsGroup discussions to convey accurate information about contraceptive methods, advance understanding of the positive benefits of contraceptive use, and encourage discussions about contraceptive use with husbands and friends
Peer counseling interactionsCounseling by and discussion with social groups who have similar age, background, and social status as subjects
Motivating, Mentoring, Goal Setting
Cell phone counselingUsing cell phones, project counselors use standardized curricula (based on teen's goals and needs) to hold weekly counseling calls for the first 6 months, followed by calls every 2 weeks for the next 12 months, for a total of 42 counseling sessions over 18 months. Cell phone service provided 450 minutes per month of use without surcharge.
Goal settingNurses/social workers assist teens in preparing short- and long-term plans to achieve life goals
Mentorship curriculumUse of planned mentorship curriculum by providers who have had similar life experiences and often serve as “big sisters”
Home visitationPeriodic visits by nurses/community health workers to the homes of postpartum women, usually once a month over a 1–2-year period, to provide education, counseling, and/or contraceptive services
Motivational interviewingUse of a counseling style that “emphasizes an individual's personal goals and self-efficacy in relation to complex behaviors”20
Skills training and job placementEducational support for adolescent mothers under age 16 to return them to school, and skills training and job placement for adolescent mothers over age 18
  • Abbreviation: LAM, Lactational Amenorrhea Method.