Trial reportReproductive health2025
"Now that they come to our doorsteps to teach us these things…" - Postpartum contraception outcomes from a pre-post effectiveness-implementation study of an integrated community health worker intervention in rural Nepal.
Trial report in Reproductive health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03371186 (Implementing an Integrated RMNCH Intervention by Community Health Workers in Achham and Dolakha), which is not on this map. Cited by 1 paper.
What it found
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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.
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.
Implementing an Integrated RMNCH Intervention by Community Health Workers in Achham and Dolakha: National Pilot
Who cites it
1 citing paper in PubMed.
- Transitions between contraceptive states among women aged 15-49 Years in Guinea.Public health in practice (Oxford, England) · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
31 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPostpartum contraceptive counseling and access are challenging in Nepal’s remote, hilly areas, driving a disproportionately high unmet need for contraception. Community health workers (CHWs) play an important role in delivering healthcare in difficult to reach places, but there is limited evidence from professionalized CHW models and their impact over time in Nepal. We implemented a pilot program in two rural districts in Nepal where full-time, salaried, and supervised CHWs delivered a bundled reproductive, maternal, newborn, and child health (RMNCH) intervention. This included contraceptive counseling adapted from the Balanced Counseling Strategy. Here we describe postpartum contraceptive outcomes associated with the integrated RMNCH intervention over a five-year period.
methodsApplying a type 2 hybrid effectiveness-implementation approach, we conducted a non-randomized pre-post study with repeated measurements and nested qualitative data collection to study the intervention’s reach, effectiveness, adoption, implementation, and maintenance.
resultsCompared to the pre-intervention period, we observed higher ward-level post-intervention postpartum contraceptive prevalence, stratified by early postpartum (RR: 2.20; 95% CI: 1.96, 2.48) and late postpartum (RR: 1.70; 95% CI: 1.50, 1.93), after adjusting for district and intervention site. Lactational amenorrhea method (LAM) was the most common method during early postpartum in most intervention sites. The proportion of women who switched to other effective methods after LAM was relatively low. Qualitative data indicated that CHWs’ longitudinal engagement with participants helped facilitate contraceptive counseling and uptake despite challenges such as participants’ fear of side effects, limited autonomy for women, and peer influence.
conclusionsOur findings suggest the integrated RMNCH intervention’s potential to increase modern contraceptive uptake in low-resource community settings and underscore CHWs’ ability to help drive longer-term change in their communities, especially around sensitive topics. This study contributes to the implementation research literature on community-based interventions to improve postpartum contraception use and may inform other CHW programs in similar contexts.
trial registrationClinicalTrials.gov Identifier: NCT03371186, registered 04 December 2017, retrospectively registered.
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