Evidence map›Paper›PMID 29039263›Full record

ArticleGlobal health action2017

Integrating family planning services into HIV care: use of a point-of-care electronic medical record system in Lilongwe, Malawi.

Hannock Tweya, Caryl Feldacker, Lisa B Haddad, Chimango Munthali, Mwatha Bwanali, Colin Speight, Layout G Kachere, Petros Tembo, Sam Phiri

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Article in Global health action, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
  6. Article
  7. HIV Status and Contraceptive Utilization among Women in Cameroon.Journal of the International Association of Providers of AIDS Care
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Hannock Tweyaa Center for Operational Research, The International Union Against Tuberculosis and Lung Disease , Paris , France.
Caryl Feldackerc International Training and Education Center for Health , University of Washington , Seattle , WA , USA.ORCID http://orcid.org/0000-0002-8152-6754
Lisa B Haddadd Department of and Obstetrics , Emory University School of Medicine , Atlanta , GA , USA.
Chimango Munthalie Department of Informatics, Baobab Health Trust , Lilongwe , Malawi.
Mwatha Bwanalie Department of Informatics, Baobab Health Trust , Lilongwe , Malawi.
Colin Speightb Monitoring and Evaluation Department, Lighthouse Trust , Lilongwe , Malawi.
Layout G Kachereb Monitoring and Evaluation Department, Lighthouse Trust , Lilongwe , Malawi.
Petros Tembob Monitoring and Evaluation Department, Lighthouse Trust , Lilongwe , Malawi.
Sam Phirib Monitoring and Evaluation Department, Lighthouse Trust , Lilongwe , Malawi.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIntegrating family planning (FP) services into human immunodeficiency virus (HIV) clinical care helps improve access to contraceptives for women living with HIV. However, high patient volumes may limit providers' ability to counsel women about pregnancy risks and contraceptive options.

objectivesTo assess trends in the use of contraceptive methods after implementing an  electronic medical record (EMR) system with FP questions and determine the reasons for non-use of contraceptives among women of reproductive age (15-49 years) receiving antiretroviral therapy (ART) at the Martin Preuss Center clinic in Malawi.

methodsIn February 2012, two FP questions were incorporated into the ART EMR system (initial FP EMR module) to prompt providers to offer contraceptives to women. In July 2013, additional questions were added to the FP EMR module (enhanced FP EMR) to prompt providers to assess risks of unintended pregnancies, solicit reasons for non-use of contraceptives and offer contraceptives to non-pregnant women . We conducted a retrospective, longitudinal cohort study using the EMR routinely collected data. The primary outcome was the use of any modern contraceptive method. Descriptive statistics were used to describe the study population and report trends in contraceptive use during the initial and enhanced study periods.

resultsBetween February 2012 and December 2016, in HIV clinics, 20,253 women of reproductive age received ART, resulting in 163,325 clinic visits observations. The proportion of women using contraceptives increased significantly from 18% to 39% between February 2012 and June 2013, and from 39% to 67% between July 2013 and December 2016 (chi-square for trend p < 0.001). Common reasons reported for the non-use of contraceptives among those at risk of unintended pregnancy were: pregnancy ambivalence (n = 234, 51%) and never thought about it (n = 133, 29%).

conclusionIncorporating the FP EMR module into HIV clinical care prompted healthcare workers to encourage the use of contraceptives.

Indexed as

AdultAnti-Retroviral AgentsDelivery of Health Care, IntegratedElectronic Health RecordsFamily Planning ServicesFemaleHIV InfectionsHumansLongitudinal StudiesMalawiOutpatient Clinics, HospitalPoint-of-Care SystemsPregnancyRetrospective StudiesYoung AdultAnti-Retroviral Agentsantiretroviral therapycontraceptiveselectronic medical record systemFamily planning servicesintegrationMalawisub-Saharan Africa

Identifiers

PMID29039263
PMCPMC5678434

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.