increasing postpartum check-ups and contraceptive use among young women in india: creating...
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![Page 1: Increasing Postpartum Check-ups and Contraceptive Use Among Young Women in India: Creating Conditions for Scale-up Mary Philip Sebastian & M.E.Khan India](https://reader035.vdocuments.us/reader035/viewer/2022072014/56649e8e5503460f94b9251c/html5/thumbnails/1.jpg)
Increasing Postpartum Check-ups and Contraceptive Use
Among Young Women in India: Creating Conditions for
Scale-up
Mary Philip Sebastian & M.E.KhanIndia
Partners: LLRM Medical college, Meerut; Department of health and family welfare; &
Integrated Child Development Scheme (ICDS) project
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Purpose• Background: 28% of all births are
spaced less than two years apart• Goal: To promote 24 months birth to
pregnancy interval for better pregnancy outcomes
• Best Practice: Promote Lactational Amenorrhea Method (LAM) and postpartum contraception
• Reason this BP chosen: Tested BP in phase 1 and now expanding
• Budget:US$169,894
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Progress• Orientation of district officials
– District officials, PHC medical officer, DPO, CDPO and supervisors from ICDS
– TOT completed; date for community worker training finalized
• Training of community workers from 52 villages– Completed in Batches with 25 workers– 471 community workers trained– Pre-post training test conducted
• Educational campaign and service delivery is ongoing
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Pre & Post Test results: Community workers training
Sub-district Name
Average % correct-
Pre-test Post-test
Sardana 66* 96
Daurala 68* 97
Mawana 26 83
Hastinapur 43 89* High since covered in Phase 1
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Baseline measures compared to post-intervention, Index
womenMentioned: Baseli
ne (n=820)
Monitoring check (n=220)
At least 2 health benefits of HTSP
67% 98.6%
3 conditions of LAM 2% 54.5%
Fertility returns in about 40 days after delivery
1.1% 54.5%
Out of 416 index women delivered so far; 364 (87.5%)were delivered in institution
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Voices from Field• ASHA said “We’re happy you chose our village for training. First time we are being taught all this. We did not know spacing could save lives”.
• Initial visits shows that project has created supportive environment for IUDs.– One pregnant women said “I will use IUD after delivery because I want next pregnancy after 3 years”.
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Capacity Building Activities Undertaken
• Orientation of district officials
• Training of community workers• Training supervisors in monitoring and supervision
• Sharing monitoring check results in monthly meetings and reorientation on needed topics
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Challenges• Identification of private doctors was Time consuming– Most village doctors are quacks– Identified MBBS doctors from adjacent areas– Difficult to persuade for full day training
• Pulse polio campaign left very few dates available for training of community workers
• Frequent transfer of officials; Vacancy and frequent transfers is expected to continue
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Lessons Learned• Simple to implement, and very effective in achieving outcome of HTSP, practice of LAM and postpartum contraception
• Acceptance of community workers in family increases if counseling focus is HTSP and its benefits to mother, child and family
• Monitoring improves community workers’ quality of counseling
• IEC materials, counseling aids and work registers developed are effective and useful tools
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Modifications• Long term technical assistance required
• Monthly meetings for ASHAs need to be organized regularly
• ASHA should be given topics for group meetings in monthly meetings
• Quality of monitoring and supervision in villages needs improvement
• Make registers and supervisor checklists part of MIS, effort ongoing