Community health worker promotions increase uptake of long-acting reversible contraception in Rwanda

We coordinated community health worker (CHW) promotions with training and support of government clinic nurses to increase uptake of long-acting reversible contraception (LARC), specifically the copper intrauterine device (IUD) and the hormonal implant, in Kigali, Rwanda. From August 2015 to Septembe...

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Bibliographic Details
Published in:Reproductive health 2019-06, Vol.16 (1), p.75-75, Article 75
Main Authors: Mazzei, Amelia, Ingabire, Rosine, Mukamuyango, Jeannine, Nyombayire, Julien, Sinabamenye, Robertine, Bayingana, Roger, Parker, Rachel, Tichacek, Amanda, Easter, Sarah Rae, Karita, Etienne, Allen, Susan, Wall, Kristin M
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
Adult
AIDS
Analysis
Birth control
Christian-Muslim relations
Clinics
Community health aides
Community Health Workers - psychology
Contraception
Contraception - methods
Contraceptive Agents, Female - administration & dosage
Counseling
Couples
Disease transmission
Education
Family planning
Female
Fertility
Health Promotion
HIV
Human immunodeficiency virus
Humans
Husband-wife relations
Intrauterine Devices, Copper - standards
Long-acting reversible contraception
Long-Acting Reversible Contraception - standards
Nurses
Nursing
Practice
Pregnancy
Reproductive health
Rwanda
Staff Development
Womens health
Workers
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Summary:We coordinated community health worker (CHW) promotions with training and support of government clinic nurses to increase uptake of long-acting reversible contraception (LARC), specifically the copper intrauterine device (IUD) and the hormonal implant, in Kigali, Rwanda. From August 2015 to September 2016, CHW provided fertility goal-based family planning counseling focused on LARC methods, engaged couples in family planning counseling, and provided written referrals to clients expressing interest in LARC methods. Simultaneously, we provided didactic and practical training to clinic nurses on LARC insertion and removal. We evaluated: 1) aggregate pre- versus post-implementation LARC uptake as a function of CHW promotions, and 2) demographic factors associated with LARC uptake among women responding to CHW referrals. 7712 referrals were delivered by 184 CHW affiliated with eight government clinics resulting in 6072 family planning clinic visits (79% referral uptake). 95% of clinic visits resulted in LARC uptake (16% copper IUD, 79% hormonal implant). The monthly average for IUD insertions doubled from 29 prior to service implementation to 61 after (p 
ISSN:1742-4755
1742-4755
DOI:10.1186/s12978-019-0739-0