PMID- 36963067
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230327
IS  - 2767-3375 (Electronic)
IS  - 2767-3375 (Linking)
VI  - 3
IP  - 3
DP  - 2023
TI  - Integrating postpartum IUD counselling and insertion into routine maternity care 
      in Nepal: Assessing trends over time.
PG  - e0001665
LID - 10.1371/journal.pgph.0001665 [doi]
LID - e0001665
AB  - To meet the postpartum family planning (PPFP) needs of women in Nepal, an 
      intervention was launched to integrate PPFP counselling and postpartum IUD 
      (PPIUD) insertion into maternity care. Women delivering in study hospitals over a 
      period of 18 months were interviewed at the time of delivery and at 15 months 
      following the end of the study enrollment period to assess if the impact of the 
      intervention observed at the end of the study was maintained. Data were collected 
      prior to the intervention, at the middle month of the intervention roll out, at 
      the end of the enrollment period and 15 months after the end of the enrollment 
      period. We compared PPFP counselling and insertion rates before, during, at the 
      end of and after the intervention study period, using cross-tabulation and 
      chi-square tests. Overall, PPFP counselling rates increased from 11% at the 
      baseline month to 45% at the end of the enrollment in February 2017 and remained 
      the same 15 months later in July 2018. PPIUD uptake, however, rose from a 
      negligible 0.1% at the baseline to 4.3% in February 2017, but declined to 3.4% in 
      July 2018. PPIUD uptake among women who were counselled showed a similar trend, 
      increasing from 1.9% at the baseline to 9.6% in February 2017 and declining to 
      6.0% in July 2018. The intervention had an appreciable continued impact on PPIUD 
      counselling rates and although PPIUD uptake rose during the intervention, this 
      trend was not observed in the 15 months post-study follow up. The impact of the 
      intervention was greater and persistent in hospitals that had a longer period of 
      exposure to intervention. The results suggest that counselling was well 
      integrated with the maternity care, though uptake of PPIUD dropped after 
      intervention activities such as active monitoring, technical supervision, 
      provision of IUDs and training were withdrawn. Trial registration: This study has 
      been registered with Clinical Trial.gov. The registration number is NCT02718222. 
      Details about the study design have been published by Canning et al, 2016.
CI  - Copyright: (c) 2023 Puri et al. This is an open access article distributed under 
      the terms of the Creative Commons Attribution License, which permits unrestricted 
      use, distribution, and reproduction in any medium, provided the original author 
      and source are credited.
FAU - Puri, Mahesh Chandra
AU  - Puri MC
AUID- ORCID: 0000-0002-2913-1480
AD  - Center for Research on Environment, Health and Population Activities (CREHPA), 
      Kusunti, Lalitpur, Kathmandu, Nepal.
FAU - Guo, Muqi
AU  - Guo M
AD  - Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States 
      of America.
FAU - Stone, Lucy
AU  - Stone L
AUID- ORCID: 0000-0001-6627-984X
AD  - Faculty of Medicine, Health and Life Science, Swansea University Medical School, 
      Swansea University, Wales, United Kingdom.
FAU - Shah, Iqbal H
AU  - Shah IH
AUID- ORCID: 0000-0001-8850-4374
AD  - Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States 
      of America.
LA  - eng
PT  - Journal Article
DEP - 20230322
PL  - United States
TA  - PLOS Glob Public Health
JT  - PLOS global public health
JID - 9918283779606676
PMC - PMC10032507
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/03/25 06:00
MHDA- 2023/03/25 06:01
PMCR- 2023/03/22
CRDT- 2023/03/24 18:30
PHST- 2022/05/24 00:00 [received]
PHST- 2023/02/08 00:00 [accepted]
PHST- 2023/03/24 18:30 [entrez]
PHST- 2023/03/25 06:00 [pubmed]
PHST- 2023/03/25 06:01 [medline]
PHST- 2023/03/22 00:00 [pmc-release]
AID - PGPH-D-22-00849 [pii]
AID - 10.1371/journal.pgph.0001665 [doi]
PST - epublish
SO  - PLOS Glob Public Health. 2023 Mar 22;3(3):e0001665. doi: 
      10.1371/journal.pgph.0001665. eCollection 2023.