The Effectiveness of Joint Provision of Community Group-based Family Planning Counseling with Routine Individual Counseling Provided to Perinatal Women on Postpartum Contraception Acceptance

Introduction

World Health Organizations recommend postpartum family planning as a critical component of health care that has the potential to meet women's desire for contraception and save millions of maternal and infant lives in low- and middle-income countries. It recommends that after "a woman gave birth," she should avoid pregnancy for at least two years prior to the next pregnancy to ease the maternal, prenatal, and infant risks. It is also an important determinant of women's ability to exercise their reproductive autonomy and a key facilitator of gender equality and women's empowerment. Additionally, it is a key to achieving global public health goals, such as the Sustainable Development Goals on sexual and reproductive health.

Therefore, it is crucial to start using contraception as soon as possible after giving birth because it lowers the risk of an unwanted pregnancy and prolongs the time between pregnancies, which benefits both mothers and newborns' health. Contraceptive plans should optimally be initiated as part of prenatal care and counseling, especially as many methods can be provided at the time of delivery or during the hospital stay. When contraceptive counseling is offered during both the prenatal and postpartum periods, the prevalence of postpartum contraceptive use, including the use of more effective methods, is highest, especially when it is offered in group-based compared to individual counseling. Maternal and infant mortality can be prevented by combining prenatal care, family planning, postpartum care, vaccination, and nutrition programs as an integrated service.

Methods

This study is designed as a two-arm, unblinded, cluster randomized controlled trial with baseline and follow-up measurements. Perinatal women among the study participants will be randomly assigned to each arm. One arm includes routine individual family planning counseling only, and the other group includes joint provision of community group-based counseling with routine individual counseling. The trial protocol will be developed, delivered, and reported in accordance with the Consolidated Standards of Reporting Trials (CONSORT) guidelines. The study participants will be women with near-term, term, and post-term pregnancies and postnatal women who live in the West Shoa Zone.