What is it about?

We conducted an experimental approach study with three groups, called arms, at the community level. The purpose of the study was to test whether repositioning of nurses from their normal (standard) working place (arm-1) – a health center, to a more remote rural village working-level – a health post (arm 2) or door to door level (arm 3), affects the utilization of such long-acting methods. In Ethiopia, a health center serves 25,000 population while a health post is the lowest health structured staffed by two high school graduate nurses and serves only 5,000 population in a Kebele (smallest administrative unit). A total of 282 villages were randomly selected and assigned to a comparator group (n = 94) or 1 of 2 experimental groups (n = 94 each). After nine months of implementation, study findings showed that the use of LARC methods increased significantly by 72.3%. The proportion of women using LAFP methods increased by 45.9% and 45.7% in the health post and health center-based intervention groups, respectively. Compared to the comparator group, the net increase by percept was 11.3 and 12.3 percentage points in the health post and health center-based intervention groups.

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Why is it important?

Long-acting family planning (LAFP) methods, such as subdermal implants, intrauterine devices (IUD), prevent pregnancy more than three years per application. In low-income settings, increasing the uptake of long-acting methods is more effective and economical than short-acting methods such as pills, injectables, use of condoms, or other natural methods. However, accessibility of the service has long been a major challenge to utilization.

Perspectives

Given the low use of LAFP methods in similar settings, the deployment of contextually trained nurses, repositioned to the grassroots level could substantially increase the utilization of these methods.

Taddese Zerfu
African Population and Health Research Center

Read the Original

This page is a summary of: Effect of Deploying Trained Community Based Reproductive Health Nurses (CORN) on Long-Acting Reversible Contraception (LARC) Use in Rural Ethiopia: A Cluster Randomized Community Trial, Studies in Family Planning, May 2018, Wiley, DOI: 10.1111/sifp.12054.
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