The impact of collaboration and family planning counseling in the community setting

Abstract

Background: Since uptake of family planning methods is influenced by poor knowledge of modern contraceptive methods and by cultural beliefs and community opinions, there may be benefit in having the counseling on offer from someone who lives within the community he/she serves, and who is cognizant of the nature of local concerns. Objective: To assess the impact of collaboration between a private health care facility, a  non-governmental organization, and community health care workers on the uptake of modern methods of contraception by women in the rural  community of Ekeakpara in Osisioma Ngwa LGA of Abia State, Nigeria.

Design: A cross-sectional study.

Setting: A health care facility.

Subjects: All acceptors of modern methods of contraception at the facility from January 2004 to December 2006, and from June 2010 to May 2012.

Materials and Methods: Contraceptive uptake between two periods (January 2004 - December 2006 and June 2010 – May 2012) was  compared. Qualitative data on acceptors of contraception between June 2010 and May 2012 were collected using in-depth interviews.

Results: Mean age of the women was 33.4 years. Majority (38%) of the women had only primary education. Their parities ranged from 1 to 10 with a mean parity of 5.1. With community mobilization, the women acceptance and attitude to modern methods of contraception was better than  previously. Prior to community mobilization, 13 out of 30 women in need of permanent limitation of their family size chose injectable contraceptives. With community mobilization, majority of the women (120 out of 122) in need of permanent limitation of their family size opted for either the long-acting reversible contraceptive methods or bilateral tubal ligation.

Conclusion: The positive impact of community mobilization in collaboration with an NGO as exemplified in this study suggests the need to encourage donors, governments, and the private sector to increase resources to fund family planning in rural communities in Nigeria.

Key words: Collaboration, Community health worker, Family planning uptake, Rural Nigeria