PMID- 29890982 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240318 IS - 1472-6963 (Electronic) IS - 1472-6963 (Linking) VI - 18 IP - 1 DP - 2018 Jun 11 TI - Effectiveness of a package of postpartum family planning interventions on the uptake of contraceptive methods until twelve months postpartum in Burkina Faso and the Democratic Republic of Congo: the YAM DAABO study protocol. PG - 439 LID - 10.1186/s12913-018-3199-2 [doi] LID - 439 AB - BACKGROUND: Postpartum family planning (PPFP) information and services can prevent maternal and child morbidity and mortality in low-resource countries, where high unmet need for PPFP remains despite opportunities offered by routine postnatal care visits. This study aims to identify a package of PPFP interventions and determine its effectiveness on the uptake of contraceptive methods during the first year postpartum. We hypothesize that implementing a PPFP intervention package that is designed to strengthen existing antenatal and postnatal care services will result in an increase in contraceptive use. METHODS: This is an operational research project using a complex intervention design with three interacting phases. The pre-formative phase aims to map study sites to establish a sampling frame. The formative phase employs a participatory approach using qualitative methodology to identify barriers and catalysts to PPFP uptake to inform the design of a PPFP intervention package. The intervention phase applies a cluster randomized-controlled trial design based at the primary healthcare level, with the experimental group implementing the PPFP package, and the control group implementing usual care. The primary outcome is modern contraceptive method uptake at twelve months postpartum. Qualitative research is embedded in the intervention phase to understand the operational reasons for success or failure of PPFP services. DISCUSSION: Designing, testing, and scaling-up effective, affordable, and sustainable health interventions in low-resource countries is critical to address the high unmet need for PPFP. Due to socio-cultural complexities surrounding contraceptive use, this research assumes that this is more effectively accomplished by engaging key stakeholders, including adolescents, women, men, key community members, service providers, and policy-makers. At the individual level, knowledge, attitudes, and behaviors of women and couples toward PPFP will likely be influenced by a set of low-cost interventions. At the health service delivery level, the implementation of this trial will probably require a shift in behavior and accountability of providers regarding the systematic integration of PPFP into their clinical practice, as well as the optimization of health service organization to ensure the availability of competent staff and contraceptive supplies. TRIAL REGISTRATION: Retrospectively registered in the Pan African Clinical Trials Registry ( PACTR201609001784334 , 27 September 2016). FAU - Tran, Nguyen Toan AU - Tran NT AUID- ORCID: 0000-0001-7134-7878 AD - Department of Reproductive Health Research, World Health Organization, Avenue Appia 20, 1211, Geneve 27, Switzerland. AD - Institute of Demography and Socioeconomics (IDESO), Geneva University, Boulevard du Pont d'Arve 40, 1211, Geneva, Switzerland. AD - Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology, PO Box 123, Sydney, NSW, 2007, Australia. FAU - Gaffield, Mary Eluned AU - Gaffield ME AD - Department of Reproductive Health Research, World Health Organization, Avenue Appia 20, 1211, Geneve 27, Switzerland. gaffieldm@who.int. FAU - Seuc, Armando AU - Seuc A AD - Department of Reproductive Health Research, World Health Organization, Avenue Appia 20, 1211, Geneve 27, Switzerland. FAU - Landoulsi, Sihem AU - Landoulsi S AD - Department of Reproductive Health Research, World Health Organization, Avenue Appia 20, 1211, Geneve 27, Switzerland. FAU - Yamaego, Wambi Maurice E AU - Yamaego WME AD - Institut de Recherche en Sciences de la Sante, 03 B.P. 7192, Ouagadougou 03, Burkina Faso. AD - Institut Africain de la Sante Publique, 12 B.P. 199, Ouagadougou, Burkina Faso. FAU - Cuzin-Kihl, Asa AU - Cuzin-Kihl A AD - Department of Reproductive Health Research, World Health Organization, Avenue Appia 20, 1211, Geneve 27, Switzerland. FAU - Kouanda, Seni AU - Kouanda S AD - Institut de Recherche en Sciences de la Sante, 03 B.P. 7192, Ouagadougou 03, Burkina Faso. AD - Institut Africain de la Sante Publique, 12 B.P. 199, Ouagadougou, Burkina Faso. FAU - Thieba, Blandine AU - Thieba B AD - Institut de Recherche en Sciences de la Sante, 03 B.P. 7192, Ouagadougou 03, Burkina Faso. AD - Institut Africain de la Sante Publique, 12 B.P. 199, Ouagadougou, Burkina Faso. FAU - Mashinda, Desire AU - Mashinda D AD - School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo. FAU - Yodi, Rachel AU - Yodi R AD - School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo. FAU - Kiarie, James AU - Kiarie J AD - Department of Reproductive Health Research, World Health Organization, Avenue Appia 20, 1211, Geneve 27, Switzerland. FAU - Reier, Suzanne AU - Reier S AD - Department of Reproductive Health Research, World Health Organization, Avenue Appia 20, 1211, Geneve 27, Switzerland. LA - eng GR - 001/WHO_/World Health Organization/International PT - Journal Article DEP - 20180611 PL - England TA - BMC Health Serv Res JT - BMC health services research JID - 101088677 PMC - PMC5996535 OTO - NOTNLM OT - Antenatal care OT - Cluster randomized controlled trial OT - Complex intervention OT - Contraceptive uptake OT - Health services operational research OT - Postnatal care OT - Postpartum family planning OT - Pregnancy OT - Public health intervention package OT - Qualitative research COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: The research protocol was approved by the Research Project Review Panel (RP2) of the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP) at WHO in Geneva, and the WHO Research Ethics Review Committee, Geneva, Switzerland. The study was approved by the respective ethical committees of Burkina Faso (Comite d'ethique pour la recherche en sante - Ministere de la sante & Ministere de l'enseignement superieur, de la recherche scientifique et de l'innovation; reference number: 2016-02-019) and of the DRC (Comite d'ethique - Ministere de l'enseignement superieur et universitaire, Universite de Kinshasa, Ecole de sante publique; reference number: ESP/CE/039b/2016). All adult participants will provide written consent. Non-adult participants will give their informed assent and their respective parents or guardians their informed consent. COMPETING INTERESTS: The authors declare that they have no competing interests. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. EDAT- 2018/06/13 06:00 MHDA- 2018/06/13 06:01 PMCR- 2018/06/11 CRDT- 2018/06/13 06:00 PHST- 2016/11/11 00:00 [received] PHST- 2018/05/10 00:00 [accepted] PHST- 2018/06/13 06:00 [entrez] PHST- 2018/06/13 06:00 [pubmed] PHST- 2018/06/13 06:01 [medline] PHST- 2018/06/11 00:00 [pmc-release] AID - 10.1186/s12913-018-3199-2 [pii] AID - 3199 [pii] AID - 10.1186/s12913-018-3199-2 [doi] PST - epublish SO - BMC Health Serv Res. 2018 Jun 11;18(1):439. doi: 10.1186/s12913-018-3199-2.