Community-based integrated approach to changing women's family planning behaviour in Pakistan, 2014–2016

Abstract

<b>Setting:</b> Karachi, Pakistan. <b>Objective:</b> To assess the effectiveness of a community-based integrated approach in changing women's behaviour regarding contraceptive use. <b>Design:</b> The Sukh Initiative is a multipronged approach with door-to-door services using community health workers to provide quality family planning/reproductive health services at both public and private facilities and a 24/7 family planning helpline service that provides youth skill-based education. <b>Methods:</b> Retrospective pre- and post-intervention data using samples of 5140 and 3810 women, respectively. <b>Results:</b> The contraceptive prevalence rate increased by 10.7%, from 42.3% at baseline to 53.0% mid-intervention, with an increase in use of modern contraceptive methods of 9.2%. A significant association was found between door-to-door counselling and the use of contraceptive methods (OR 3.4, 95%CL 2.9-4.1) and access to public and private facilities for modern contraceptives (OR 2.4, 95%CL 2.0-3.0). However, support group meetings and 24/7 helpline use did not show any association with use of contraceptive method. <b>Conclusion:</b> The study helped to increase access to and choice of family planning services through a community-based approach that successfully reduced unmet needs and improved continuity in contraceptive use.