Awareness and availability of modern contraceptives at Anganwadi Centers
- Conditions
- Lactating women who has childbirth recently (6-8 weeks)
- Registration Number
- CTRI/2021/11/037746
- Lead Sponsor
- NIH USAapplied for
- Brief Summary
Family planning (FP), including provision of contraception, is care that supports individuals to achieve their desired number and spacing of children. Expanding access to postpartum FP can prevent maternal and infant morbidity and mortality by decreasing unintended pregnancy and short inter-pregnancy intervals. India is the country with the largest number of women with an unmet need for contraception, and rural postpartum women are among those with the highest unmet need. Uptake of postpartum contraception among women in rural India is low, and short inter-pregnancy intervals are common. Key barriers to accessing postpartum FP in India include restrictive gender-based norms – i.e., social expectations of people’s behavior based on their gender – such as limited mobility of young women to reach public health centers and women’s lack of autonomy over contraceptive decision-making. Community-based infant vaccination programs in rural India are well attended and provide an opportunity to offer FP care to postpartum women. The *hypothesis* is that integrating community-based FP care with the existing infant vaccination program will reach more rural postpartum women and improve uptake of postpartum contraception. Through our prior work, we have shown that programs that address contextual gender-based norms are associated with increased contraceptive use. The *objective* of this study is to assess the effect of utilizing gender-transformative strategies - i.e., those targeting restrictive gender-based norms – to deliver FP in the context of a public health infant vaccination program. This proposal aims to assess the feasibility, acceptability, appropriateness, and preliminary effectiveness of linking this program with infant vaccination care. The intervention will utilize gender-transformative strategies demonstrating effectiveness in prior FP research, which have not been studied among postpartum women. We will adapt the intervention with input from multi-level stakeholders to help ensure its appropriateness for the infant vaccination program setting. This study involves a pilot cluster randomized controlled trial evaluating the implementation and potential impact of this gender-transformative FP intervention linked to infant vaccination care in rural India (N=320). Subcenters will be randomized to the intervention and control area. The intervention including on-site FP care (FP counselling and provision of contraception) during the infant vaccination visit or the standard of care (referral to public health centers for FP counselling and provision of contraception). Outcomes related to contraceptive use will be assessed via surveys at baseline, a 6-month follow-up visit, and in-depth interviews conducted with women and other key stakeholders (including husbands, mothers-in-law, frontline healthcare providers and community leaders). Implementation science frameworks will be used to guide both the adaptation and implementation processes. This intervention has the potential to increase access to postpartum contraception for women with unmet need across rural India.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Not Yet Recruiting
- Sex
- Female
- Target Recruitment
- 320
Women aged 18 and older residing in rural Maharashtra, who speak Marathi, delivered a baby within the past 8 weeks but did not undergo sterilization, hysterectomy or immediate PPIUCD placement and do not have a new pregnancy will be invited to participate.
If a woman is interested, meets inclusion criteria and consents, she will be enrolled and asked to complete a baseline questionnaire.
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method the feasibility, acceptability, and appropriateness of linking provision of postpartum family planning and infant vaccination care in rural India using a mixed-methods approach 2 years
- Secondary Outcome Measures
Name Time Method The preliminary effectiveness of linking provision of postpartum family planning and infant vaccination care on contraceptive method use in rural India 2 years
Trial Locations
- Locations (1)
Anganwadi Centres at Junnar Block
🇮🇳Pune, MAHARASHTRA, India
Anganwadi Centres at Junnar Block🇮🇳Pune, MAHARASHTRA, IndiaShahina BegumPrincipal investigator9503956734begums@nirrh.res.in