EFFECTIVENESS OF TARGETED ANTENATAL FAMILY PLANNING INFORMATION PROVISION ON EARLY POSTPARTUM FAMILY PLANNING UPTAKE IN KISUMU COUNTY, KENYA

Abstract

The need. for. early. Postpartum. Family. Planning. (PPFP). is. often. overlooked, resulting. in. missed. opportunities. to. achieve. inter-birth. interval. of. at. least. three. years. to. improve. maternal, perinatal. and. neonatal. outcomes. As. such, the. unmet. need. for. early. PPFP. remains. high. especially. in. West. and. Central. Africa. where. it. is. estimated. to. be. 75%. In. Kenya, the. unmet. need. for. PPFP. is. 73%. The. maternal. and. child. health. continuum. presents. an. opportunity. for. PPFP. interventions. to. be. integrated, particularly. through. targeted. information. giving. Currently, there's. no. structured. protocol. for. information. delivery, and. evidence. on. fertility. intentions. and. optimal. early. PPFP. strategies. is. insufficient. or. non-replicable. This. study. therefore. examined. the. effectiveness. of. antenatal. FP. information. provision. on. early. PPFP. uptake. using. a. pragmatic. randomized. control. trial. in. Kisumu. guided. by. Theory. of. Planned. Behaviour. (TPB). to. guarantee. replicability. The. study. compared. early. PPFP. uptake. between. control. and. intervention. groups, assessed. the. effect. of. the. intervention. on. individual. attitude. towards. early. PPFP. uptake, evaluated. the. effect. of. the. intervention. on. of. perceived. social. normative. beliefs. towards. early. PPFP. uptake, measured. the. effect. of. the. intervention. on. perceived. individual. control. of. early. PPFP. choice, analyzed. the. effect. of. the. intervention. on. intentions. for. early. PPFP. and. established. the. determinants. of. early. PPFP. uptake. among. the. 246. study..participants..in..Kisumu..County..after..at..least..6..months..of..intervention..and..3..m onths..of..postpartum..followup..Case..Report..Forms,.client..exit..interview,.and..questionna ire..were..used..to..collect..data..which.was.analyzed.using.SPSS.version.26..ANOVA.with. post.hoc.tests,.Chisquare.statistic,.ordinal.logistic.regression.analysis,.and.binary.logistic.reg ression.analysis.were.the.main.statistical.tests.with.α<0.05..There.was.a.high.PPFP.uptake. (85.8%),.positive.attitude.(96.4%),.positive.normative.beliefs.(75.2%),.perceived.control. (92.3%).and.intention. (96.3%).for.early.PPFP.with.a.significantly.higher.early.PPFP.uptake.within.the.intervention .arm.(90.9%).than.the.control.arm.(75.6%). (OR:3.2;.95%.CI:1.5.to.6.7;.P<0.0001)..Nurses’.arm.showed.higher.rates.of.early.PPFP.com mencement.(95.1%).as.compared.to.control.75.6%.OR=6.3.and.community.arms. (86.6%).OR=3.0..Likewise,.the.intervention.had.a.significant.effect.on;.perceived.social.nor mative.beliefs.(P=0.015),.perceived.control.of.PPFP.choice. (P<0.0001).and.intention.for.early.PPFP. (P<0.0001)..The.nurses’.arm.had.a.superior.influence.on.these.constructs.compared.to.the.co ntrol.and.community.arms..The.determinant.of.early.PPFP.uptake.were;.being.health.educat ed.in.pregnancy.(P=0.03,.OR:4.6),.good.intimate.partner.relationship. (P<0.0001,.OR:2.3),.setting.a.postnatal.appointment.for.PPFP. (P=0.021,.OR:2.6),.perceived.normative.belief.about.early.PPFP. (P<0.0001,.OR:3.6),.perceived.behavioural.control.of.PPFP.choice. (P<0.0001,.OR:6.6),.intention.to.use.early.PPFP. (P<0.0001,.OR:3.3),.high.FP.counselling.turnaround.time. (P=0.032,.OR:0.94).and.being.counselled.in.group. (P=0.002,.OR:0.28)..The.study.demonstrated.effectiveness.of.nurse.led.antenatal.FP.informa tion.provision.on.early.PPFP.uptake.by.enhancing;.positive.social.normative.beliefs.on.early .PPFP,.perceived.individual.control.of.early.PPFP.choice,.and.intention.for.early.PPFP..The. study.recommends.promotion.of.nurse.led.targeted.antenatal.FP.counselling.for.early.PPFP. uptake,.streamlining.counselling.processes.to.enhance.quality.and.client.satisfaction.by;.tail oring.interventions.to.address.comorbidity.related.attitudes.and.individual.preferences,.with. future.research.focusing.on.inclusive.participant.recruitment..The.study.presents.a.practical. model.for.targeted.antenatal.FP.information provision to foster early PPFP uptake.