Reproductive Health: Behaviour change techniques and contraceptive use in LMICs

This review concluded that ‘the most effective interventions were those that involve male partner involvement in the decision to initiate contraceptive use… Our findings suggest that when information and contraceptives are provided, contraceptive use improves.’

Below is the citation, abstract and selected extracts. The full text is freely available here: http://www.reproductive-health-journal.com/content/12/1/100#

CITATION: Mwelwa Phiri, R. King, J. N. Newell. Behaviour change techniques and contraceptive use in low and middle income countries: a review

Reproductive Health 2015, 12:100  doi:10.1186/s12978-015-0091-y

Corresponding author: Mwelwa Phiri muleba@gmail.com

ABSTRACT

‘We aimed to identify effective behaviour change techniques to increase modern contraceptive use in low and middle income countries (LMICs). Literature was identified in Global Health, Web of Science, MEDLINE, PsycINFO and Popline, as well as peer reviewed journals. Articles were included if they were written in English, had an outcome evaluation of contraceptive use, modern contraceptive use, contraceptive initiation/uptake, contraceptive adherence or continuation of contraception, were a systematic review or randomised controlled trial, and were conducted in a low or middle income country. We assessed the behaviour change techniques used in each intervention and included a new category of male partner involvement. We identified six studies meeting the inclusion criteria. The most effective interventions were those that involve male partner involvement in the decision to initiate contraceptive use. The findings also suggest that providing access to contraceptives in the community promotes their use. The interventions that had positive effects on contraceptive use used a combination of behaviour change techniques. Performance techniques were not used in any of the interventions. The use of social support techniques, which are meant to improve wider social acceptability, did not appear except in two of the interventions. Our findings suggest that when information and contraceptives are provided, contraceptive use improves. Recommendations include reporting of behaviour change studies to include more details of the intervention and techniques employed. There is also a need for further research to understand which techniques are especially effective.’

EXTRACTS (selected by Neil PW)

‘Information techniques were used in all the interventions and included providing information on the available methods, importance and advantages of methods, ill effects of large families, misconceptions about methods and explanations of methods, including side effects and efficacy [11]–[16]. This information was mostly provided orally and face-to-face. Two interventions used a video to provide information with one adding a description of the methods on the patient consent form. One intervention also used drama, role playing and music to provide information. Peers, authority figures such as healthcare professionals, and community health workers (CHWs) provided this information.’

‘Media techniques consisted of using short videos to provide information, illustrating scenarios using drama and role plays, music and print media such as flip charts, leaflets, booklets and posters. Print media was provided as a supplement to the oral information in two of the interventions. None of the interventions used mass media. One intervention also contained a brief description of the methods on the patient consent form. Media techniques were used by three of the six interventions.’

Best wishes, Neil

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org  

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