Evaluation of integrating family planning with maternal and child health services
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Notice bibliographique
Résumé
Family planning (FP) reduces the burden of unintended pregnancies and maternal and child mortality. Pakistan has the lowest modern Contraceptive Prevalence Rate (mCPR) in the South Asian region. Despite national efforts, poor access to FP services combined with community level barriers has left 17% of currently married women with an unmet need for FP and 46% of pregnancies are unintended, leading to high abortion rates. Recognizing the essential need for FP, this study’s aim was to design evidence informed intervention and evaluate the impact of integrating FP with Maternal, Newborn and Child Health (MNCH) service delivery model to increase Modern Contraceptive Methods (MCMs) coverage in rural Pakistan. A sequential exploratory mixed methods design was adopted comprising of qualitative and quantitative components. The qualitative component was to inform the intervention design based on healthcare workforce and community members’ perspectives. The quantitative quasiexperimental component of the study was undertaken to assess the effectiveness of FP with MNCH integration on MCMs uptake in two districts of rural Pakistan (Matiari and Badin). Interventions strategies were identified through a systemic review and meta-analysis. The intervention comprised healthcare workforce training, sustaining FP supplies, and community engagement; implemented through existing service delivery platforms at the healthcare facility and community levels. The interventions were delivered at six health care facilities in the intervention and similar level health facilities were selected in the control district. A comparative analysis of health facility data (using t-test) of Badin (control) and Matiari (intervention) showed a statistically significant difference across the MNCH continuum of care; whereby Badin had an average of 93.5 new FP clients and 18.8 follow-up visits compared to a mean of 281.7 new FP clients and 123.7 follow-up visits in Matiari. Baseline and follow-up surveys additionally conducted to measure population level impact also revealed a statistically significant increase of 11.3% in current use of MCMs in the intervention group (p-value <0.001) in the follow-up survey as compared to the baseline. This study shows that designing evidence-informed interventions to integrate FP with MNCH significantly improves MCM uptake and may have effective scale-up potential within similar settings.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle