Impact of a Provider Job Aid Intervention on Injectable Contraceptive Continuation in South Africa
Studies in Family Planning
Social and Behavioral Health Sciences, FHI 360, 1825 Connecticut Avenue NW, Washington, DC 20009, United States; Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, South Africa; Health Services Research, Biostatistics, FHI 360, Durham, NC, United States; Biostatistics, FHI 360, Durham, NC, United States; Department of Obstetrics and Gynaecology, Walter Sisulu University, Mthatha, South Africa
Arriving late for scheduled contraceptive reinjections is common in many countries and contributes to discontinuation when providers are unsure how to manage such clients. A clinic-randomized cohort and cross-sectional study with more than 5,000 clients using injectable contraceptives was conducted in the Eastern Cape province of South Africa to test the effectiveness of a provider job aid for managing late-returning clients and promoting continued use of the method. A marginally significant difference in reinjection rates between intervention and control groups was found for those up to two weeks late, and reanalysis excluding one clinic that experienced stockout issues revealed a significant difference. The difference in reinjection rates for those 2-12 weeks late was also found to be significant. The one-reinjection cycle continuation rate for the intervention group was higher than that for the control group, but the difference was not statistically significant. Appropriate management of late-returning clients is critical, and this study illustrates that reinjection rates can be significantly increased with a low-resource provider job aid. © 2012 The Population Council, Inc.
contraceptive agent; accessibility; aid flow; contraceptive use; population policy; adult; article; clinical protocol; controlled clinical trial; controlled study; counseling; cross-sectional study; health promotion; human; in service training; intramuscular drug administration; multicenter study; organization and management; outpatient department; patient attitude; practice guideline; randomized controlled trial; socioeconomics; South Africa; statistics; time; Adult; Ambulatory Care Facilities; Clinical Protocols; Contraceptive Agents, Female; Counseling; Cross-Sectional Studies; Health Promotion; Humans; Injections, Intramuscular; Inservice Training; Patient Acceptance of Health Care; Practice Guidelines as Topic; Public Sector; Socioeconomic Factors; South Africa; Time Factors; Eastern Cape; South Africa