Objective: To evaluate whether a community engagement and service-strengthening intervention raised awareness of family planning (FP) and early pregnancy bleeding (EPB), and increased FP and postabortion care (PAC) use.
Methods: The intervention was carried out in 3 communities in Kenya over 18months; 3 additional communities served as the comparison group. A pre-post, contemporaneously controlled, quasi-experimental evaluation was conducted independently from the intervention.
Results: Baseline characteristics were similar. Awareness of FP methods increased (P≤0.001) in the intervention group. The incidence of reported EPB (before 5months of pregnancy) in the comparison group was 13.3% at baseline and 6.0% at endline (P=0.02); 79% at baseline and 100% at endline sought care (P>0.05). In the intervention group, recognition and reporting of EPB increased from 9.8% to 13.1% (P>0.05); 65% sought PAC at baseline and 80% at endline (P=0.11). The relative increase in EPB reports after the intervention was over 3 times greater in the intervention group (P≤0.01).
Conclusion: The intervention raised FP and EPB awareness but not FP and PAC services use. As fewer comparison group respondents reported experiencing EPB, the PAC impact of the intervention is unclear. Mechanisms to improve EPB reporting are needed to avoid this reporting bias.
Keywords: Community action cycle; Community health workers; Community mobilization; Family planning; Kenya; Postabortion care; Safe motherhood; Unsafe abortion.
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