Postpartum Initiation of Long-acting Reversible Contraceptives: Knowledge Attitude and Practice Study (KAP) (KAP)

Regular Six Weeks Versus Earlier Postpartum Initiation of Long-acting Reversible Contraceptives: Knowledge Attitude and Practice Study (KAP)

Comparing Knowledge, attitude and Practice of clients and service providers about the regular (6 weeks) versus earlier initiation of LARC, through a structured questionnaire prepared in English and translated to local language i.e. Arabic.

Study Overview

• Status: Recruiting
• Conditions: Contraception
• Intervention / Treatment: Other: screening and data collection

Detailed Description

Family planning is a behavior that allows individuals and couples to anticipate and attain their desired number of children, at the spacing and timing of their births. It is achieved through the use of contraceptive methods and treatment of involuntary infertility.

Postpartum family planning is the prevention of unintended and closely spaced pregnancies during the first 12 months following childbirth. Short interval pregnancies are associated with increased maternal morbidities such as anemia, bleeding disorders, premature rupture of membranes, puerperal endometritis and mortality .

Postpartum family planning (PPFP) has long been recognized as an important component of maternal health care. Through birth spacing and prevention of high-risk and unwanted pregnancies, PPFP helps women who have recently delivered to avoid exposure to the risks of maternal death. Likewise, the importance of the interplay between maternal health services and use of contraception in the postpartum period has been recognized for decades.

Globally, more than 90 percent of women during the first year postpartum want to either delay or avoid future pregnancies . An increase in contraceptive use during the postpartum period should substantially reduce rates of maternal and infant mortality by preventing unplanned and unwanted pregnancies and by spacing new pregnancies at least two years after the previous birth .

• Study Type: Observational
• Enrollment (Estimated): 600

Contacts and Locations

• Study Contact: Name: Nada M. Khalil, Diploma; Phone Number: +201146640044; Email: Topspot55@gmail.com
• Study Contact Backup: Name: Omar Mamdouh Shaaban, Doctorate; Phone Number: +201061000250, +208824144661; Email: omshaaban2000@yahoo.com

Study Locations

• Egypt
  • Assiut, Egypt, 71515
    • Recruiting
    • Assiut University
    • Contact: mahmoud abdelaleem, Doctorate; Phone Number: +201018880201; Email: mahmaleem2000@yahoo.co.uk

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Client's group:

All females visiting family planning centers in public health facilities who delivered within a year and receiving a LARC method or willing are asked to volunteer.

Service provider group:

All service providers who are working in primary health care units & hospitals, including general practitioners, ob/gyn. specialists, nurses, and social workers are asked to volunteer.

Description

Inclusion Criteria:

Client's group All clients who were attending family planning centers in public health facilities at the study period if they have had a postpartum LARC method (Copper IUD, Progestin-releasing IUS, Subdermal implant) or willing to use it in the first year after delivery.

Service provider group:

All service providers who are working in primary health care units & hospitals, including general practitioners, ob/gyn. specialists, nurses, and social workers.

Exclusion Criteria:

• Clients and service providers who refused to participate in the study
• Clients who are currently using or willing to use a method other than LARC

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Service providers; General practitioners, specialists, nurses, and social workers.	Other: screening and data collection; Structured questionnaire prepared in English and translated to local language (Arabic). The questionnaire is then linguistically validated by two forwards translations and one backward translation. Data was collected by the investigators who were not participating in the study. Personal or telephone interview will be conducted with clients and service providers conducted to collect the data.
Clients; All clients who were attending family planning centers in public health facilities at the study period will be included if they have had a postpartum LARC method (Copper IUD, Progestin-releasing IUS or Subdermal implant) or willing to use it in the first year after delivery.	Other: screening and data collection; Structured questionnaire prepared in English and translated to local language (Arabic). The questionnaire is then linguistically validated by two forwards translations and one backward translation. Data was collected by the investigators who were not participating in the study. Personal or telephone interview will be conducted with clients and service providers conducted to collect the data.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Clients' knowledge	The percentage of clients who have good knowledge that LARC can be initiated early after delivery	Immediately. The outcome is provided in the questionnaire which is completed once by the client

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Clients' attitude	The percentage of clients who have positive attitude towards early initiation of LARC after delivery	Immediately. The outcome is provided in the questionnaire which is completed once by the client
Clients' practice	The percentage of clients who had previously or lately initiated any LARC early after delivery	Immediately. The outcome is provided in the questionnaire which is completed once by the client
Providers' knowledge	The percentage of providers who have good knowledge that LARC can be initiated early after delivery	Immediately. The outcome is provided in the questionnaire which is completed once by the client
Providers' attitude	The percentage of providers who have positive attitude towards early initiation of LARC after delivery	Immediately. The outcome is provided in the questionnaire which is completed once by the client
Providers' practice	The percentage of providers who had previously or lately initiated any LARC for women early after delivery	Immediately. The outcome is provided in the questionnaire which is completed once by the client

Collaborators and Investigators

• Sponsor: Assiut University
• Investigators: Study Chair: Ahmed Ali Abdelaleem, Doctorate, Obstetrics and gynecology department, Assiut University; Study Chair: Karim abdelhameed, Doctorate, Obstetrics and gynecology department, Assiut University

Publications and helpful links

General Publications

• Committee Opinion No. 642: Increasing Access to Contraceptive Implants and Intrauterine Devices to Reduce Unintended Pregnancy. Obstet Gynecol. 2015 Oct;126(4):e44-e48. doi: 10.1097/AOG.0000000000001106.
• Washington CI, Jamshidi R, Thung SF, Nayeri UA, Caughey AB, Werner EF. Timing of postpartum intrauterine device placement: a cost-effectiveness analysis. Fertil Steril. 2015 Jan;103(1):131-7. doi: 10.1016/j.fertnstert.2014.09.032. Epub 2014 Oct 25.
• Conde-Agudelo A, Belizan JM. Maternal morbidity and mortality associated with interpregnancy interval: cross sectional study. BMJ. 2000 Nov 18;321(7271):1255-9. doi: 10.1136/bmj.321.7271.1255.

Study record dates

Study Major Dates

• Study Start (Actual): June 15, 2023
• Primary Completion (Estimated): December 1, 2024
• Study Completion (Estimated): October 1, 2025

Study Registration Dates

• First Submitted: July 15, 2023
• First Submitted That Met QC Criteria: February 14, 2024
• First Posted (Actual): February 22, 2024

Study Record Updates

• Last Update Posted (Actual): February 22, 2024
• Last Update Submitted That Met QC Criteria: February 14, 2024
• Last Verified: February 1, 2024

More Information

Terms related to this study

• Keywords: LARC; Postpartum contraception; KAP
• Other Study ID Numbers: 04-2023-200279

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No