Delivery of home-based postpartum contraception in rural Guatemalan women: a cluster-randomized trial protocol.
Adolescent
Adult
Community Health Services
Contraception
Delivery of Health Care
Family Planning Services
Female
Guatemala
Home Health Nursing
House Calls
Humans
Postnatal Care
Pregnancy
Randomized Controlled Trials as Topic
Reproductive Health
Rural Health Services
Time Factors
Treatment Outcome
Women's Health
Young Adult
Cluster-randomized trial
Community programming
Implant
Long-acting reversible contraceptives
Nursing
Postpartum contraception
Journal
Trials
ISSN: 1745-6215
Titre abrégé: Trials
Pays: England
ID NLM: 101263253
Informations de publication
Date de publication:
21 Nov 2019
21 Nov 2019
Historique:
received:
31
07
2019
accepted:
17
09
2019
entrez:
23
11
2019
pubmed:
23
11
2019
medline:
18
6
2020
Statut:
epublish
Résumé
Postpartum contraception is important to prevent unintended and closely spaced pregnancies following childbirth. This study is a cluster-randomized trial of communities in rural Guatemala where women receive ante- and postnatal care through a community-based nursing program. When nurses visit women for their postpartum visit in the intervention clusters, instead of providing only routine care that includes postpartum contraceptive education and counseling, the nurses will also bring a range of barrier, short-acting, and long-acting contraceptives that will be offered and administered in the home setting, after routine clinical care is provided. A barrier to postpartum contraception is access to medications and devices. Our study removes some access barriers (distance, time, cost) by providing contraception in the home. We also trained community nurses to place implants, which are a type of long-acting reversible contraceptive method that was previously only available in the closest town which is about an hour away by vehicular travel. Therefore, our study examines how home-based delivery of routinely available contraceptives and the less routinely available implant may be associated with increased uptake of postpartum contraception within 3 months of childbirth. The potential implications of this study include that nurses may be able to be trained to safely provide contraceptives, including placing implants, in the home setting, and provision of home-based contraception may be an effective way of delivering an evidence-based intervention for preventing unintended and closely spaced pregnancies in the postpartum period. Clinicaltrials.gov, NCT04005391. Retrospectively registered on 1 July 2019.
Sections du résumé
BACKGROUND
BACKGROUND
Postpartum contraception is important to prevent unintended and closely spaced pregnancies following childbirth.
METHODS
METHODS
This study is a cluster-randomized trial of communities in rural Guatemala where women receive ante- and postnatal care through a community-based nursing program. When nurses visit women for their postpartum visit in the intervention clusters, instead of providing only routine care that includes postpartum contraceptive education and counseling, the nurses will also bring a range of barrier, short-acting, and long-acting contraceptives that will be offered and administered in the home setting, after routine clinical care is provided.
DISCUSSION
CONCLUSIONS
A barrier to postpartum contraception is access to medications and devices. Our study removes some access barriers (distance, time, cost) by providing contraception in the home. We also trained community nurses to place implants, which are a type of long-acting reversible contraceptive method that was previously only available in the closest town which is about an hour away by vehicular travel. Therefore, our study examines how home-based delivery of routinely available contraceptives and the less routinely available implant may be associated with increased uptake of postpartum contraception within 3 months of childbirth. The potential implications of this study include that nurses may be able to be trained to safely provide contraceptives, including placing implants, in the home setting, and provision of home-based contraception may be an effective way of delivering an evidence-based intervention for preventing unintended and closely spaced pregnancies in the postpartum period.
TRIAL REGISTRATION
BACKGROUND
Clinicaltrials.gov, NCT04005391. Retrospectively registered on 1 July 2019.
Identifiants
pubmed: 31752969
doi: 10.1186/s13063-019-3735-3
pii: 10.1186/s13063-019-3735-3
pmc: PMC6869182
doi:
Banques de données
ClinicalTrials.gov
['NCT04005391']
Types de publication
Clinical Trial Protocol
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
639Subventions
Organisme : National Institute of Child Health and Human Development
ID : 5K12HD001271-18
Références
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