ArticleBMC health services research2020
Improving post-partum family planning services provided by female community health volunteers in Nepal: a mixed methods study.
Article in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- FIGO position statement on postpartum intrauterine devices (PPIUD).International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Guideline
- Integrating family planning with nutrition and other sexual and reproductive health services in low-income and middle-income countries: findings from a scoping review.BMJ global health · 2025Article
- Scope of work and contributions of female community health volunteers in Nepal's healthcare sector: a qualitative study.BMJ open · 2024Article
- Strengthening primary health care through community health workers in South Asia.The Lancet regional health. Southeast Asia · 2024Review
- Stakeholders' perceptions of family planning programs during the COVID-19 period: A descriptive qualitative study.Enfermeria clinica · 2023Article
- Integrating postpartum IUD counselling and insertion into routine maternity care in Nepal: Assessing trends over time.PLOS global public health · 2023Article
- Community health workers at the dawn of a new era: 10. Programme performance and its assessment.Health research policy and systems · 2021Review
- Economic Evaluation of Provision of Postpartum Intrauterine Device Services in Bangladesh and Tanzania.Global health, science and practice · 2021Article
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11 authors.
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Abstract
backgroundFamily planning services in the post-partum period, termed post-partum family planning (PPFP) is critical to cover the unmet need for contraception, especially when institutional delivery rates have increased. However, the intention to choose PPFP methods such as post-partum intrauterine devices (PPIUD) remains low in countries such as Nepal. Community health workers such as Female Community Health Volunteers (FCHVs) could play an important role in improving the service coverage of PPFP in Nepal. However, their knowledge of PPFP and community-based services related to PPFP remain unclear. This study aims to assess the effect on community-based PPFP services by improving FCHV's knowledge through orientation on PPFP.
methodsWe conducted this mixed-methods study in Morang District in Nepal. The intervention involved orientation of FCHVs on PPFP methods. We collected quantitative data from three sources; via a survey of FCHVs that assessed their knowledge before and after the intervention, from their monthly reporting forms on counseling coverage of women at different stages of pregnancy from the communities, and by interviewing mothers in their immediate post-partum period in two selected hospitals. We also conducted six focus group discussions with the FCHVs to understand their perception of PPFP and the intervention. We performed descriptive and multivariable analyses for quantitative results and thematic analysis for qualitative data.
resultsIn total, 230 FCHVs participated in the intervention and their knowledge of PPFP improved significantly after it. The intervention was the only factor significantly associated with their improved knowledge (adjusted odds ratio = 24, P < 0.001) in the multivariable analysis. FCHVs were able to counsel 83.3% of 1872 mothers at different stages of pregnancy in the communities. In the two hospitals, the proportion of mothers in their immediate post-partum period whom reported they were counseled by FCHVs during their pregnancy increased. It improved from 7% before the intervention to 18.1% (P < 0.001) after the intervention. The qualitative findings suggested that the intervention improved their knowledge in providing PPFP counseling.
conclusionThe orientation improved the FCHV's knowledge of PPFP and their community-based counseling. Follow-up studies are needed to assess the longer term effect of the FCHV's role in improving community-based PPFP services.
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