ArticleReproductive health2019
Community health worker promotions increase uptake of long-acting reversible contraception in Rwanda.
Article in Reproductive health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- Health extension service utilization in Ethiopia: systematic review and meta-analysis.BMC health services research · 2024Pooled it
- Policy in practice: assessing Senegal's family planning progress using a mixed-methods approach.BMJ global health · 2026Article
- Effects of the Challenge Initiative's Community Health Volunteers (CHVs) on Public Sector Service Provision of Family Planning Services in Urban Sindh, Pakistan.International journal of environmental research and public health · 2025Article
- Evaluation of immediate and sustained effects of transitioning quality long-acting reversible contraceptives (LARCs) services to public sector health facilities in Ghana: a pre-post intervention study.Reproductive health · 2025Article
- Contraception use and pregnancy in women receiving a 2-dose Ebola vaccine in Rwanda: A retrospective analysis of UMURINZI vaccination campaign data.PLoS medicine · 2025Article
- Article
- Knowledge, beliefs and practices of nurses with long-acting reversible contraception, Cape Town.African journal of primary health care & family medicine · 2023Article
- Barriers and Enablers Influencing Women's Adoption and Continuation of Vaginally Inserted Contraceptive Methods: A Literature Review.Studies in family planning · 2022Review
- Article
- Antibiotic-resistantInternational journal of STD & AIDS · 2022Article
- Cross-sectional assessment of government health center needs to implement long-acting reversible contraception services in rural Rwanda.BMC women's health · 2021Article
- Postpartum long-acting contraception uptake and service delivery outcomes after a multilevel intervention in Kigali, Rwanda.BMJ sexual & reproductive health · 2021Article
- An examination of the barriers to and benefits from collaborative couple contraceptive use in Rwanda.Reproductive health · 2021Article
- Youths' perceptions of community health workers' delivery of family planning services: a cross-sectional, mixed-methods study in Nakaseke District, Uganda.BMC public health · 2021Article
- Family Planning Uptake in Kagera and Mara Regions in Tanzania: A Cross-Sectional Community Survey.International journal of environmental research and public health · 2021Article
- Towards achieving the family planning targets in the African region: a rapid review of task sharing policies.Reproductive health · 2021Review
- Article
- Article
- Uptake of long acting reversible contraception following integrated couples HIV and fertility goal-based family planning counselling in Catholic and non-Catholic, urban and rural government health centers in Kigali, Rwanda.Reproductive health · 2020Observational
- "I cannot say no when a pregnant woman needs my support to get to the health centre": involvement of community health workers in Rwanda's maternal health.BMC health services research · 2020Article
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundWe coordinated community health worker (CHW) promotions with training and support of government clinic nurses to increase uptake of long-acting reversible contraception (LARC), specifically the copper intrauterine device (IUD) and the hormonal implant, in Kigali, Rwanda.
methodsFrom August 2015 to September 2016, CHW provided fertility goal-based family planning counseling focused on LARC methods, engaged couples in family planning counseling, and provided written referrals to clients expressing interest in LARC methods. Simultaneously, we provided didactic and practical training to clinic nurses on LARC insertion and removal. We evaluated: 1) aggregate pre- versus post-implementation LARC uptake as a function of CHW promotions, and 2) demographic factors associated with LARC uptake among women responding to CHW referrals.
results7712 referrals were delivered by 184 CHW affiliated with eight government clinics resulting in 6072 family planning clinic visits (79% referral uptake). 95% of clinic visits resulted in LARC uptake (16% copper IUD, 79% hormonal implant). The monthly average for IUD insertions doubled from 29 prior to service implementation to 61 after (p < 0.0001), and the monthly average for implant insertions increased from 109 to 309 (p < 0.0001). In adjusted analyses, LARC uptake was associated (p < 0.05) with the CHW referral being issued to the couple (versus the woman alone, adjusted odds ratio, aOR = 2.6), having more children (aOR = 1.3), desiring more children (aOR = 0.8), and having a religious affiliation (aOR = 2.9 Protestant, aOR = 3.1 Catholic, aOR = 2.5 Muslim each versus none/other). Implant versus non-LARC uptake was associated with having little or no education; meanwhile, having higher education was associated with IUD versus implant uptake.
conclusionsFertility goal-based and couple-focused family planning counseling delivered by CHW, coupled with LARC training and support of nursing staff, substantially increased uptake of LARC methods.
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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.