Exposure to family planning messages and contraceptive use among women of reproductive age in Sub-Saharan Africa: a cross-sectional program impact evaluation study

Many women of reproductive age in sub Saharan Africa are not utilizing any contraceptive method which is contributing to the high burden of maternal mortality. This study determined the prevalence, trends, and the impact of exposure to family planning messages (FPM) on contraceptive use (CU) among women of reproductive age in sub-Saharan Africa (SSA). We utilized the most recent data from demographic and health surveys across 26 SSA countries between 2013 and 2019. We assessed the prevalence and trends and quantified the impact of exposure to FPM on contraceptive use using augmented inverse probability weighting with regression adjustment. Sensitivity analysis of the impact estimate was conducted using endogenous treatment effect models, inverse probability weighting, and propensity score with nearest-neighbor matching techniques. The study involved 328,386 women of reproductive age. The overall prevalence of CU and the percentage of women of reproductive age in SSA exposed to FPM were 31.1% [95% CI: 30.6-31.5] and 38.9% [95% CI: 38.8-39.4] respectively. Exposure to FPM increased CU by 7.1 percentage points (pp) [95% CI=6.7, 7.4; p<0.001] among women of reproductive age in SSA. The impact of FPM on CU was highest in Central Africa [6.7 pp; 95% CI: [5.7-7.7; p<0.001] and lowest in Southern Africa [2.2 pp; 95% CI: [1.3-3.0; p<0.001]. There was a marginal decline in the impact estimate among adolescents (estimate=6.0 pp [95% CI=5.0, 8.0; p<0.001]). Exposure to FPM has contributed to an increase in CU among women of reproductive age. Programs that are geared towards intensifying exposure to FPM through traditional media in addition to exploring avenues for appropriate use of electronic media remain critical

Impact of mobile health on maternal and child health service utilization and continuum of care in Northern Ghana

Maternal and child mortality are of public health concern. Most of these deaths occur in rural communities of developing countries. Technology for maternal and child health (T4MCH) is an intervention introduced to increase Maternal and Child Health (MCH) services utilization and continuum of care in some health facilities across Ghana. The objective of this study is to assess the impact of T4MCH intervention on MCH services utilization and continuum of care in the Sawla-Tuna-Kalba District in the Savannah Region of Ghana. This is a quasi-experimental study with a retrospective review of records of MCH services of women who attended antenatal services in some selected health centers in the Bole (comparison district) and Sawla-Tuna-Kalba (intervention district) of the Savannah region, Ghana. A total of 469 records were reviewed, 263 in Bole and 206 in Sawla-Tuna-Kalba. A multivariable modified Poisson and logistic regression models with augmented inverse-probability weighted regression adjustment based on propensity scores were used to quantify the impact of the intervention on service utilization and continuum of care. The implementation of T4MCH intervention increased antenatal care attendance, facility delivery, postnatal care and continuum of care by 18 percentage points (ppts) [95% CI - 17.0, 52.0], 14 ppts [95% CI 6.0%, 21.0%], 27 ppts [95% CI 15.0, 26.0] and 15.0 ppts [95% CI 8.0, 23.0] respectively compared to the control districts. The study showed that T4MCH intervention improved antenatal care, skilled delivery, postnatal services utilization, and continuum of care in health facilities in the intervention district. The intervention is recommended for a scale-up in other rural areas of Northern Ghana and the West-African sub-region