Participatory approaches involving community and healthcare providers in family planning/contraceptive information and service provision: a scoping review

Abstract

As efforts to address unmet need for family planning and contraception (FP/C) accelerate, voluntary use, informed choice and quality must remain at the fore. Active involvement of affected populations has been recognized as one of the key principles in ensuring human rights in the provision of FP/C and in improving quality of care. However, community participation continues to be inadequately addressed in large-scale FP/C programmes. Community and healthcare providers’ unequal relationship can be a barrier to successful participation. This scoping review identifies participatory approaches involving both community and healthcare providers for FP/C services and analyzes relevant evidence. The detailed analysis of 25 articles provided information on 28 specific programmes and identified three types of approaches for community and healthcare provider participation in FP/C programmes. The three approaches were: (i) establishment of new groups either health committees to link the health service providers and users or implementation teams to conduct specific activities to improve or extend available health services, (ii) identification of and collaboration with existing community structures to optimise use of health services and (iii) operationalization of tools to facilitate community and healthcare provider collaboration for quality improvement. Integration of community and healthcare provider participation in FP/C provision were conducted through FP/C-only programmes, FP/C-focused programmes and/or as part of a health service package. The rationales behind the interventions varied and may be multiple. Examples include researcher-, NGO- or health service-initiated programmes with clear objectives of improving FP/C service provision or increasing demand for services; facilitating the involvement of community members or service users and, in some cases, may combine socio-economic development and increasing self-reliance or control over sexual and reproductive health. Although a number of studies reported increase in FP/C knowledge and uptake, the lack of robust monitoring and evaluation mechanisms and quantitative and comparable data resulted in difficulties in generating clear recommendations. It is imperative that programmes are systematically designed, evaluated and reported.

The Decision-making in Couples and Moderncontraception use among Women in Côte d'Ivoire

“…Concerning other type of decision, the rate is 100%. The latter result means that when the provider participate in the decision-making process in a way that emphasized the women's values and preferences; the rate of contraceptive increases (Steyn, 2016). When women receive comprehensive information about side effects clearly from an intimate, friend-like relationship with their providers,they are motivated to use contraception (Dehlendorf et al, 2013).…”

Impacts on Global Health from Nursing Research

“…For many women in Kenya and other sub-Saharan countries, coinfection of HIV and malaria contributes to a variety of poor reproductive outcomes including preterm birth, hemorrhage, and maternal mortality. The need for family planning is immense in Kenya given the rate of contraception use in reproductive-aged individuals ranges from 28% to 34% 7,8. Family planning services also provide childbearing families the opportunity to space their pregnancy to support optimal health outcomes for pregnant women.…”

Rationale and design of a complex intervention measuring the impact and processes of social accountability applied to contraceptive programming: CaPSAI Project

“…Limited knowledge and information about FP/C, poor access to quality services, poor quality of care and client-provider interaction, structural inefficiencies in service provision and untrained health professionals remain barriers for those seeking services 2 . Interventions that change the attitude, norms, and behavior of both service users and providers, such as health communication, community group engagement, addressing provider bias and improving client-provider interactions, have proven effective in addressing these barriers 3,4 .…”

“…Participation is central to a rights-based approach and to the provision of contraceptive services [7][8][9][10] . In recent years, a number of social accountability programs have shown promising results in the field of sexual and reproductive health 3,11,12 . Social accountability interventions have been effective in: increasing service utilization; better service delivery; improved health provider responsiveness; increasing knowledge and information; governance; and in health outcomes in broader reproductive, maternal, newborn, child and adolescent health (RMNCAH) ( Table 1).…”