Community‐Driven Family Planning in Urban Slums: Results from Rawalpindi, Pakistan

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.

Impact of Integrating Family planning with Maternal and child health on uptake of contraception: A Quasi-Experimental Study in Rural Pakistan

“…Despite, the overall proportion of women using long-acting reversible contraceptive (LARC) methods including intra-uterine devices were still very low in the study. However, the point percentage increase provides substantial evidence consistent with other studies [33] that after addressing the misconceptions through counseling [34], [35] women would maximize their need of limiting or spacing the birth intervals.…”

Factors associated with family planning use among refugee and host populations in Adjumani district, West Nile, Uganda: a comparative study

“…The mCPR for the refugees in Adjumani [28.2%] is higher than the mCPR back home in South Sudan [2.7%] with high unmet need of family planning [30.8%] and maternal mortality ratio of 789/100,000 live births [ 25 ]. The high mCPR amongst the refugees in Uganda could be attributed to the high exposure to FP information and services in the settlements provided by several partners through community outreaches [ 26 ].…”

Artificial intelligence in prosthodontics

“…Similar to any other technology, AI has its own set of limitations and boundaries. AI technology has not been completely understood owing to its complexity, and it has the ability to autonomously change its behaviour [49]. Data are the backbone of AI algorithms and their models.…”