Effects of a community‐based, multi‐level family planning intervention on theoretically grounded intermediate outcomes for couples in rural Uganda: Results from a mixed methods pilot evaluation

Author:

Sileo Katelyn M.1ORCID,Muhumuza Christine2,Wanyenze Rhoda K.3,Kershaw Trace S.4,Ellerbe Brooke1,Muñoz Suyapa1,Sekamatte Samuel5,Lule Haruna6,Kiene Susan M.37

Affiliation:

1. Department of Public Health The University of Texas at San Antonio San Antonio Texas USA

2. Department of Disease Control and Environmental Health Makerere University School of Public Health Kampala Uganda

3. Department of Epidemiology and Biostatistics Makerere University School of Public Health Kampala Uganda

4. Department of Social and Behavior Science Yale School of Public Health New Haven Connecticut USA

5. Gombe Hospital Gombe Uganda

6. Global Centre of Excellence in Health (GLoCEH) Kampala Uganda

7. Division of Epidemiology and Biostatistics San Diego State University (SDSU) School of Public Health San Diego California USA

Abstract

AbstractObjectivesThis study tested the theoretically grounded conceptual model of a multi‐level intervention, Family Health = Family Wealth (FH = FW), by examining FH = FW's effect on intermediate outcomes among couples in rural Uganda. FH = FW is grounded in the social‐ecological model and the social psychological theory of transformative communication.DesignA pilot quasi‐experimental controlled trial.MethodsTwo matched clusters (communities) were randomly allocated to receive the FH = FW intervention or an attention/time‐matched water, sanitation and hygiene intervention (N = 140, 35 couples per arm). Quantitative outcomes were collected through interviewer‐administered questionnaires at baseline, 7‐months and 10‐months follow‐up. Focus group discussions (n = 39) and semi‐structured interviews (n = 27) were conducted with subsets of FH = FW participants after data collection. Generalized estimated equations tested intervention effects on quantitative outcomes, and qualitative data were analysed through thematic analysis—these data were mixed and are presented by level of the social‐ecological model.ResultsThe findings demonstrated an intervention effect on family planning determinants across social‐ecological levels. Improved individual‐level family planning knowledge, attitudes and intentions, and reduced inequitable gender attitudes, were observed in intervention versus comparator, corroborated by the qualitative findings. Interpersonal‐level changes included improved communication, shared decision‐making and equitable relationship dynamics. At the community level, FH = FW increased perceived acceptance of family planning among others (norms), and the qualitative findings highlighted how FH = FW's transformative communication approach reshaped definitions of a successful family to better align with family planning.ConclusionsThis mixed methods pilot evaluation supports FH = FW's theoretically grounded conceptual model and ability to affect multi‐level drivers of a high unmet need for family planning.

Funder

National Institute of Mental Health

Publisher

Wiley

Reference71 articles.

1. Amhara National Regional Sate Health Bureau. (2013).Training Manual on Hygiene and Sanitation Promotion and Community Mobilization for Volunteer Communtity Health Promotors (VCHP). Amhara Regional Health Bureau Bahir‐Dar Ethiopia: USAID Water and Sanitation Program (WSP).

2. MEN’S SOCIAL NETWORKS AND CONTRACEPTION IN GHANA

3. Toward an experimental ecology of human development.

4. How Can Community Health Programmes Build Enabling Environments for Transformative Communication? Experiences from India and South Africa

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3