Abstract

IntroductionAfter testing the interventions for improving the prevalence of contraceptive use, very few studies have measured the long-term effects thereafter the end of the implementation. This study aimed to measure Yam Daabo interventions’ effects on contraceptive use in Burkina Faso at twelve months after completion of the intervention.MethodsYam Daabo was a two-group, multi-intervention, single-blind, cluster randomized controlled trial. Interventions comprised refresher training for the provider, a counseling tool, supportive supervision, availability of contraceptive services 7 days a week, client appointment cards, and invitation letters for partners. We used generalized linear mixed-effects models (log Poisson) to compare the modern contraceptive prevalence at 12 months post-intervention in the two groups. We collected data between September and November 2018. We conducted an intention-to-treat analysis and adjusted the prevalence ratios on cluster effects and unbalanced baseline characteristics.ResultsTwelve months after the completion of the Yam Daabo trial, we interviewed 87.4% (485 out of 555 women with available data at 12 months, that is, 247/276 in the intervention group (89.5%) and 238/279 in the control group (85.3%). No difference was observed in the use of hormonal contraceptive methods between the intervention and control groups (adjusted prevalence ratio = 1.21; 95% confidence interval [CI] = [0.91–1.61], p = 0.191). By contrast, women in the intervention group were more likely to use long-acting reversible contraceptives (LARC) than those in the control group (adjusted prevalence ratio = 1.35; 95% CI = [1.08–1.69], p = 0.008).ConclusionTwelve months after completion of the intervention, we found no significant difference in hormonal contraceptive use between women in the intervention and their control group counterparts. However, women in the intervention group were significantly more likely to use long-acting reversible contraceptives than those in the control group.Trial registrationThe trial registration number at the Pan African Clinical Trials Registry is PACTR201609001784334. The date of the first registration is 27/09/2016.

Highlights

  • After testing the interventions for improving the prevalence of contraceptive use, very few studies have measured the long-term effects thereafter the end of the implementation

  • The lost to follow-up rates were 10.5% in the intervention group (247 of 276 women included) and 14.7% in the control group (238 of 279 women included)

  • The use of long-acting reversible contraceptives was higher among women in the intervention group than in those in the control group with a statistically significant difference (37.4% vs. 27.5%; Adjusted prevalence ratio = 1.35; 95% CI = 1.08–1.69, p = 0.007)

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Summary

Introduction

After testing the interventions for improving the prevalence of contraceptive use, very few studies have measured the long-term effects thereafter the end of the implementation. This study aimed to measure Yam Daabo interventions’ effects on contraceptive use in Burkina Faso at twelve months after completion of the intervention. In 2015, we tested a package of interventions in two African countries, Burkina Faso and the Democratic Republic of the Congo, in a randomized cluster trial design called Yam Daabo [3, 4]. In the Democratic Republic of the Congo, at 12 months, 46% of the women in the intervention group and 35% of the women in the control group were using modern contraceptives (adjusted prevalence ratio: 1.58, 95% CI = 0.74–3.38), with significant differences in the use of contraceptive implants (22% vs 6%; adjusted prevalence ratio: 4.36, 95% CI = 1.96–9.70) [6]

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