Hi Everyone
Please find attached [*see note below] our paper on community mobilization leading to increase in CPR by 11% in an urban slum of 278,000. At the cost of under USD 10 per user. We worked with local women that wanted to work but couldnt give fixed hours. This also helped us establish a database of all 39K households that allowed us to revisit and adjust services as the couples adapted to using FP and wanted to graduate to better methods
with regards
Adnan Khan, MBBS, MS.
Chief Knowledge Officer
RADS
HIFA profile: Adnan Khan is a Chief Knowledge Officer with Research and Development Solutions in Pakistan, and has a professional interest in health systems research, with a particular focus on participatory and community driven approaches to family planning. adnan AT resdev.org
[*Note from HIFA moderator (NPW): HIFA does not carry attachments but the full text is available at the URL below.
Community-Driven Family Planning in Urban Slums: Results from Rawalpindi, Pakistan
https://www.hindawi.com/journals/bmri/2023/2587780/
ABSTRACT
Background. Pakistan’s contraceptive prevalence rate (CPR) has remained static (less than 1% annual increase since 2006) due to several demand and supply issues. The Akhter Hameed Khan Foundation implemented a community-driven, demand-generation intervention with complementary supply side family planning (FP) services in a large urban informal settlement in Rawalpindi, Pakistan.
Methods. The intervention recruited local women as outreach workers called Aapis (sisters), who conducted household outreach and provided counseling, contraceptives, and referrals. Program data were used to guide in-program corrections, identify the most willing to use married women of reproductive age (MWRA), and target specific geographic locations. The evaluation compared results from two surveys. The baseline survey included 1485 MWRA while the endline included 1560 MWRA that were sampled using the same methodology. A logit model was used with survey weights and clustered standard errors, to estimate the odds of using a contraceptive method.
Results. CPR in Dhok Hassu increased from 33% at the baseline to 44% at endline. Long-acting reversible contraceptives (LARCs) usage increased from 1% at baseline to 4% at endline. Increase in CPR is correlated with increasing number of children and education of MWRA and is the highest between the ages of 25 and 39 and for working women. Qualitative evaluation of the intervention provided lessons about in-program corrections using data and empowerment of the female outreach workers and MWRA. Conclusion. The Aapis Initiative is a unique community-based demand-supply side intervention that successfully increased modern contraceptive prevalence rate (mCPR) by economically engaging the women from within the community as outreach workers and enabling healthcare providers to establish a sustainable ecosystem for increasing knowledge and access to family planning services.]
