Integrating reproductive and child health services enables access to modern contraception in Sierra Leone.


Journal

The International journal of health planning and management
ISSN: 1099-1751
Titre abrégé: Int J Health Plann Manage
Pays: England
ID NLM: 8605825

Informations de publication

Date de publication:
Apr 2019
Historique:
received: 11 12 2018
revised: 16 12 2018
accepted: 18 12 2018
pubmed: 27 1 2019
medline: 10 1 2020
entrez: 26 1 2019
Statut: ppublish

Résumé

From mid-2015, reproductive and child health interventions were integrated into a routine 6-month contact point: vitamin A supplementation, nutrition counseling with the mother's participation in the preparation of a complementary food, and confidential family planning counseling with provision of modern forms of contraceptives. By mid-2017, these services had reached 28% of health facilities nationwide. To evaluate awareness and uptake of modern contraception and complementary feeding practices. All health facilities were visited, and the health worker "in-charge" were interviewed to ascertain their training status and supply chains. Within each catchment, community mothers of children 6 to 23 months of age were interviewed. Interviews were conducted with 321 "in-charges" and 670 mothers. Advantages and different types of contraception were understood by 99.0% of mothers, and 52.7% reported they were utilizing depot injections, hormonal implants, or oral contraceptive pills (45.1%, 34.6%, and 20.6% of users, respectively). Uptake was higher among Christians (62.1%) versus Muslims (48.6%) and among those with secondary/tertiary (61.5%) or primary education (60.5%) versus no education (43.3%) (P < 0.005 and P < 0.05, respectively). Complementary feeding practices included minimal meal diversity, 49.2% (fed three or more of six food groups), and recommended minimal meal frequency appropriate for age, 52.6%. Health workers reported frequent stockouts of vitamin A capsules (8%), male condoms (1%), oral contraceptives (10%), depot injections (20%), and hormonal implants (30%). In communities served by these integrated services, awareness and uptake of modern contraception exceeded national targets despite weak supply chains, and complementary feeding practices were favorable compared with the national survey.

Sections du résumé

BACKGROUND BACKGROUND
From mid-2015, reproductive and child health interventions were integrated into a routine 6-month contact point: vitamin A supplementation, nutrition counseling with the mother's participation in the preparation of a complementary food, and confidential family planning counseling with provision of modern forms of contraceptives. By mid-2017, these services had reached 28% of health facilities nationwide.
OBJECTIVE OBJECTIVE
To evaluate awareness and uptake of modern contraception and complementary feeding practices.
METHODS METHODS
All health facilities were visited, and the health worker "in-charge" were interviewed to ascertain their training status and supply chains. Within each catchment, community mothers of children 6 to 23 months of age were interviewed.
RESULTS RESULTS
Interviews were conducted with 321 "in-charges" and 670 mothers. Advantages and different types of contraception were understood by 99.0% of mothers, and 52.7% reported they were utilizing depot injections, hormonal implants, or oral contraceptive pills (45.1%, 34.6%, and 20.6% of users, respectively). Uptake was higher among Christians (62.1%) versus Muslims (48.6%) and among those with secondary/tertiary (61.5%) or primary education (60.5%) versus no education (43.3%) (P < 0.005 and P < 0.05, respectively). Complementary feeding practices included minimal meal diversity, 49.2% (fed three or more of six food groups), and recommended minimal meal frequency appropriate for age, 52.6%. Health workers reported frequent stockouts of vitamin A capsules (8%), male condoms (1%), oral contraceptives (10%), depot injections (20%), and hormonal implants (30%).
CONCLUSION CONCLUSIONS
In communities served by these integrated services, awareness and uptake of modern contraception exceeded national targets despite weak supply chains, and complementary feeding practices were favorable compared with the national survey.

Identifiants

pubmed: 30680789
doi: 10.1002/hpm.2728
doi:

Types de publication

Journal Article

Langues

eng

Pagination

701-713

Subventions

Organisme : Irish Aid
ID : HKI 1501

Informations de copyright

© 2019 John Wiley & Sons, Ltd.

Auteurs

Ami S Koroma (AS)

Directorate of Food and Nutrition, Ministry of Health and Sanitation, Freetown, Sierra Leone.

Sonya K Ghatahora (SK)

Helen Keller International, Freetown, Sierra Leone.

Mariama Ellie (M)

Directorate of Food and Nutrition, Ministry of Health and Sanitation, Freetown, Sierra Leone.

Anita Kargbo (A)

Helen Keller International, Freetown, Sierra Leone.

Umu H Jalloh (UH)

Helen Keller International, Freetown, Sierra Leone.

Abdulai Kandeh (A)

Helen Keller International, Freetown, Sierra Leone.

Henry Alieu (H)

Helen Keller International, Freetown, Sierra Leone.

Mariama Bah (M)

Helen Keller International, Freetown, Sierra Leone.

Hamid Turay (H)

Helen Keller International, Freetown, Sierra Leone.

Mustapha Sonnie (M)

Helen Keller International, Freetown, Sierra Leone.

Santigie Sesay (S)

Reproductive Health and Family Planning Program, Director of Reproductive and Child Health, Ministry of Health and Sanitation, Freetown, Sierra Leone.

Mary H Hodges (MH)

Helen Keller International, Freetown, Sierra Leone.

David Doledec (D)

Helen Keller International, Regional Office, Nairobi, Kenya.

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