Feasibility testing of a community dialogue approach for promoting the uptake of family planning and contraceptive services in Zambia

Abstract

Background: Community dialogues have been used in participatory approaches in various health prevention and awareness programs, including family planning interventions, to increase understanding and alignment of particular issues from different peoples’ perspectives. The main objective of this paper is to document the feasibility of a community dialogue approach, which aimed to promote dialogue between healthcare providers and community members. The feasibility testing was part of formative-phase research needed to design an intervention, with the ultimate goal of increasing the uptake of family planning and contraception. The community dialogue intervention generated discussions on key approaches to improve family planning and contraception provision and uptake. Methods: Key stages of the community dialogue were undertaken, with representation from healthcare providers and community members. Participants included frontline and managerial health care providers, community health workers, family planning and contraception users, the youth, other stakeholders from the education sector, and civil society. How the dialogue was implemented (operational feasibility) as well as the cultural feasibility of the community dialogue content was evaluated through participant observations during the dialogue, using a standardised feasibility testing tick-list, and through focus group discussions with the stakeholders who participated in the community dialogue. Results: Overall, 21 of the 30 invited participants attended the meeting- 70 per cent attendance. The approach facilitated discussions on how quality care could be achieved in family planning and contraception provision, guided by the ground rules that were agreed upon by the different stakeholders. A need for more time for the discussion was noted. Participants also noted the need for more balanced representation from adolescents as well as other family planning stakeholders, such as community members, especially in comparison to healthcare providers. Some participants were not comfortable with the language used. Young people felt older participants used complicated terminologies while community members felt the health care providers outnumbered them, in terms of representation. Conclusion: Generally, the community dialogue was well received by the community members and the healthcare providers, as was observed from the sentiments expressed by both categories. Some key considerations for refining the approach included soliciting maximum participation from otherwise marginalized groups like the youth would provide stronger representation.

Facilitating community participation in family planning and contraceptive services provision and uptake: community and health provider perspectives

“…The present study focuses on the exploratory qualitative research conducted during the UPTAKE project formative phase in Zambia. The UPTAKE project was a complex-designed intervention, aiming to increase contraceptive met needs, through community and healthcare provider participation in the provision and use of FP/C methods and services, within a human-rights framework [ 15 ]. The exploratory qualitative research not only contributed to the development of the intervention, but also to the identification of key human-rights framework domains, within which to contextualize activities to increase met needs [ 9 ].…”

Facilitating community participation in family planning and contraceptives service provision and uptake: community and health provider perspectives

“…The present study was carved out of the UPTAKE project and focuses on the exploratory qualitative research conducted during the intervention development in Zambia. The UPTAKE project was a complexdesigned intervention, aiming to increase contraceptive met needs, through community and healthcare provider participation in the provision and use of FP/C methods and services, within a human-rights framework [15]. The exploratory qualitative research not only contributed to the development of the intervention, but also identifying of key human-rights framework domains, within which to contextualize activities to increase met needs [9].…”

“…In this manuscript, we speci cally explored community participation practices and activities according community and healthcare provider perspectives. Other exploratory qualitative research activities are published elsewhere [15][16][17][18].…”

Facilitating community participation in family planning and contraceptives service provision and uptake: community and health provider perspectives

“…The UPTAKE project was a complex-designed intervention, aiming to increase contraceptive met needs, through community and healthcare provider participation in the provision and use of FP/C methods and services, within a human-rights framework, coordinated by the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction. The intervention consisted of a facilitated community and HCP dialogue using a Theory of Change framework to identify, discuss, implement and evaluate activities (within the human-rights framework domains), to increase contraceptive met needs [15]. The project was designed to be executed in two phases, formative (intervention development) and intervention (implementation and evaluation), respectively.…”

“…The formative exploratory qualitative research had four focus areas; (i) knowledge, attitudes, and practices in FP/C services and utilization; (ii) barriers and enablers to FP/C services; (iii) understanding of quality in FP/C services and; (iv) community participation practices and activities. Speci cally, this manuscript focuses on the fourth focus area (community participation practices and activities) while other UPTAKE formative phase activities are published elsewhere [15][16][17][18].…”