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dc.contributor.authorPearson, Erinen_US
dc.contributor.authorSenderowicz, Leighen_US
dc.contributor.authorPradhan, Elinaen_US
dc.contributor.authorFrancis, Joelen_US
dc.contributor.authorMuganyizi, Projestineen_US
dc.contributor.authorShah, Iqbalen_US
dc.contributor.authorCanning, Daviden_US
dc.contributor.authorKarra, Maheshen_US
dc.contributor.authorUlenga, Nzovuen_US
dc.contributor.authorBärnighausen, Tillen_US
dc.coverage.spatialEnglanden_US
dc.date2020-04-16
dc.date.accessioned2021-02-08T19:59:09Z
dc.date.available2021-02-08T19:59:09Z
dc.date.issued2020-05-12
dc.identifierhttps://www.ncbi.nlm.nih.gov/pubmed/32398077
dc.identifier.citationErin Pearson, Leigh Senderowicz, Elina Pradhan, Joel Francis, Projestine Muganyizi, Iqbal Shah, David Canning, Mahesh Karra, Nzovu Ulenga, Till Bärnighausen. 2020. "Effect of a postpartum family planning intervention on postpartum intrauterine device counseling and choice: evidence from a cluster-randomized trial in Tanzania.." BMC Womens Health, Volume 20, Issue 1, pp. 102 - ?. https://doi.org/10.1186/s12905-020-00956-0
dc.identifier.issn1472-6874
dc.identifier.urihttps://hdl.handle.net/2144/42004
dc.description.abstractBACKGROUND: The World Health Organization recommends postpartum family planning (PPFP) for healthy birth spacing. This study is an evaluation of an intervention that sought to improve women's access to PPFP in Tanzania. The intervention included counseling on PPFP during antenatal and delivery care and introducing postpartum intrauterine device (PPIUD) insertion as an integrated part of delivery services for women electing PPIUD in the immediate postpartum period. METHODS: This cluster-randomized controlled trial recruited 15,264 postpartum Tanzanian women aged 18 or older who delivered in one of five study hospitals between January and September 2016. We present the effectiveness of the intervention using a difference-in-differences approach to compare outcomes, receipt of PPIUD counseling and choice of PPIUD after delivery, between the pre- and post-intervention period in the treatment and control group. We also present an intervention adherence-adjusted analysis using an instrumental variables estimation. RESULTS: We estimate linear probability models to obtain effect sizes in percentage points (pp). The intervention increased PPIUD counseling by 19.8 pp (95% CI: 9.1 - 22.6 pp) and choice of PPIUD by 6.3 pp (95% CI: 2.3 - 8.0 pp). The adherence-adjusted estimates demonstrate that if all women had been counseled, we would have observed a 31.6 pp increase in choice of PPIUD (95% CI: 24.3 - 35.8 pp). Among women counseled, determinants of choosing PPIUD included receiving an informational leaflet during counseling and being counseled after admission for delivery services. CONCLUSIONS: The intervention modestly increased the rate of PPIUD counseling and choice of PPIUD, primarily due to low coverage of PPIUD counseling among women delivering in study facilities. With universal PPIUD counseling, large increases in choice of PPIUD would have been observed. Giving women informational materials on PPIUD and counseling after admission for delivery are likely to increase the proportion of women choosing PPIUD. TRIAL REGISTRATION: Registered with clinicaltrials.gov (NCT02718222) on March 24, 2016, retrospectively registered.en_US
dc.description.sponsorship4041 - Susan Thompson Buffett Foundationen_US
dc.format.extentp. 102en_US
dc.languageeng
dc.language.isoen_US
dc.relation.ispartofBMC Womens Health
dc.rights© The Author(s) 2020. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.en_US
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectCounselingen_US
dc.subjectPPIUDen_US
dc.subjectTanzaniaen_US
dc.subjectAdolescenten_US
dc.subjectAdulten_US
dc.subjectChoice behavioren_US
dc.subjectContraceptionen_US
dc.subjectContraception behavioren_US
dc.subjectFamily planning servicesen_US
dc.subjectFemaleen_US
dc.subjectHumansen_US
dc.subjectIntrauterine devicesen_US
dc.subjectPostnatal careen_US
dc.subjectPostpartum perioden_US
dc.subjectPregnancyen_US
dc.subjectObstetrics & reproductive medicineen_US
dc.subjectNursingen_US
dc.subjectPaediatrics and reproductive medicineen_US
dc.subjectPublic health and health servicesen_US
dc.titleEffect of a postpartum family planning intervention on postpartum intrauterine device counseling and choice: evidence from a cluster-randomized trial in Tanzaniaen_US
dc.typeArticleen_US
dc.description.versionPublished versionen_US
dc.identifier.doi10.1186/s12905-020-00956-0
pubs.elements-sourcepubmeden_US
pubs.notesEmbargo: Not knownen_US
pubs.organisational-groupBoston Universityen_US
pubs.organisational-groupBoston University, Frederick S. Pardee School of Global Studiesen_US
pubs.publication-statusPublished onlineen_US
dc.identifier.orcid0000-0003-0962-092X (Karra, Mahesh)
dc.identifier.mycv561975


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© The Author(s) 2020. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Except where otherwise noted, this item's license is described as © The Author(s) 2020. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.