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Effect of Deploying Trained Community Based Reproductive Health Nurses (CORN) on Long‐Acting Reversible Contraception (LARC) Use in Rural Ethiopia: A Cluster Randomized Community Trial
Author(s) -
Zerfu Taddese Alemu,
Ayele Henok Taddese,
Bogale Tariku Nigatu
Publication year - 2018
Publication title -
studies in family planning
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.529
H-Index - 68
eISSN - 1728-4465
pISSN - 0039-3665
DOI - 10.1111/sifp.12054
Subject(s) - medicine , long acting reversible contraception , reproductive health , grassroots , randomized controlled trial , family planning , psychological intervention , community health , intervention (counseling) , cluster (spacecraft) , cluster randomised controlled trial , community health center , family medicine , population , demography , nursing , environmental health , public health , surgery , sociology , politics , political science , law , research methodology , computer science , programming language
To investigate the effect of innovative means to distribute LARC on contraceptive use, we implemented a three arm, parallel groups, cluster randomized community trial design. The intervention consisted of placing trained community‐based reproductive health nurses (CORN) within health centers or health posts. The nurses provided counseling to encourage women to use LARC and distributed all contraceptive methods. A total of 282 villages were randomly selected and assigned to a control arm (n = 94) or 1 of 2 treatment arms (n = 94 each). The treatment groups differed by where the new service providers were deployed, health post or health center. We calculated difference‐in‐difference (DID) estimates to assess program impacts on LARC use. After nine months of intervention, the use of LARC methods increased significantly by 72.3 percent, while the use of short acting methods declined by 19.6 percent. The proportion of women using LARC methods increased by 45.9 percent and 45.7 percent in the health post and health center based intervention arms, respectively. Compared to the control group, the DID estimates indicate that the use of LARC methods increased by 11.3 and 12.3 percentage points in the health post and health center based intervention arms. Given the low use of LARC methods in similar settings, deployment of contextually trained nurses at the grassroots level could substantially increase utilization of these methods.