Small Grants Support Research in FP/RH
The MEASURE Evaluation PRH Associate Award is pleased to be supporting a small grants program to build the evidence base in family planning and reproductive health (FP/RH), advance the research efforts of developing country researchers and their institutions, and maximize opportunities to use research findings for decision-making. The small grants are intended to support primary and secondary data analysis, especially program or policy evaluation, and data use activities based on research findings.
Research activities have begun for the four MEASURE Evaluation PRH sub-grantees.
Université Catholique du Graben, Democratic Republic of the Congo (DRC)
Dr. Jeff Kambale Mathe and his team of researchers at the Université Catholique du Graben are assessing healthy timing and spacing of pregnancies (HTSP) among postpartum women in Butembo, Eastern DRC, and barriers to adopting FP methods.
The National Reproductive Health Program (PNSR) has made reducing maternal mortality its top priority but has received little financial support from the government or outside sources, making it difficult for them to effectively achieve this goal. Furthermore, FP programs are not well-integrated into the DRC’s health system, and as the nation’s population continues to swell, particularly in Butembo which has experienced relative peace and prosperity, little is known about why there is low uptake of FP. This research will assess the extent of the knowledge, attitudes and practice of HTSP among postpartum women in Butembo to assist policy makers in developing appropriate evidence-based strategies to promote HTSP by using FP.
The results of the study will be disseminated at a one-day workshop aimed at all the senior staff (district medical officers, supervisors, and in-charges of all the referral areas) of the two health districts that cover the city of Butembo. A presentation will be made during the quarterly or bi-annual reports review meetings of all the district medical officers of the North-Kivu Province. These meetings include all local and international NGOs as well as representative from the Provincial Ministry of Health, churches, and other stakeholders in the health domain. Copies of the report will be distributed to all the hospitals and health learning institutions in Butembo.
African Population and Health Research Center (APHRC), Kenya
APHRC will be conducting spatial analysis of contraceptive use in the Korogocho and Viwandani slums of Nairobi under the guidance of Dr. Remare Ettarh. Using data from DHS surveys in Kenya and the ongoing APHRC-supported Maternal and Child Health project in the Nairobi Urban Health and Demographic Surveillance System (NUHDSS), the study is examining the spatial variation in access to and use of modern contraceptives among women in Kenya and the role of community-level factors in the geographic distribution.
From the two datasets, specific variables on socio-demographic characteristics, fertility preferences and FP choices will be analyzed and GPS coordinates will be used to link data to the districts and sampled households.
The key results of the secondary analysis will be summarized in a short briefing paper for the purpose of dissemination to non-technical audiences and will include recommendations with which to address disparities in contraceptive use across Kenya. Dissemination meetings will also be held with program managers who are actively involved in FP programs in Kenya, policy makers, and parliamentary networks.
Rakai Health Sciences Program (RHSP), Uganda
Hormonal contraceptive (HC) methods are among the most effective methods of pregnancy prevention. Current guidelines place no restrictions on use of HC by HIV positive women, including those on antiretroviral therapy (ART), except for not recommending HC to women on ritonavir-boosted protease inhibitors due to concerns about potential decreased contraceptive effectiveness. However, little is known about potential interactions between HC and ART. HC methods may interact with antiretroviral drugs to decrease ART efficacy, decrease HC efficacy, or increase risk of side effects. Decreased ART efficacy could lead to decreased ARV drug levels, emergence of drug resistance, or treatment failure.
A research team at RHSP in Uganda’s Rakai District, led by Dr. Gertrude Nakigozi, in collaboration with Dr. Chelsea Polis at the Johns Hopkins Bloomberg School of Public Health, is studying the relationship between HC use and ART. Their research is investigating if HC use influences the length of time from ART initiation until immunologic treatment failure or death; the likelihood that women using HC and initiating ART treatment will achieve virologic suppression six months after beginning therapy; and if HC use is associated with ART adherence.
Data use plans will include RHSP submitting a manuscript for publication in peer reviewed scientific literature and presenting the findings at the Ugandan Ministry of Health and at an international FP conference and/or an international AIDS conference. Brief fact sheets will also be developed for providers summarizing the evidence and clarifying best practices for counseling HIV+ women on ART who wish to prevent pregnancy.
Moi University, Kenya
Moi University, in collaboration with The George Washington School of Public Health and Health Services, is conducting qualitative research to better understand and explain the complex interrelationship among factors that influence postpartum FP uptake and women’s decisions surrounding childbirth. In Western Kenya an interesting situation exists in that health facilities report high antenatal clinic attendance and high child health visits, yet despite these positive health-seeking behaviors, a surprisingly high percentage of women have an unmet need for FP and deliver without a skilled attendant (and even on their own).
To better understand how to address this issue in an attempt to decrease maternal and infant mortality, researchers Dr. Violet Naanyu and Joyce Baliddawa are working with their research team in the rural site of Port Victoria and bustling Eldoret town to study the key factors, beliefs, and perceptions that affect postpartum FP use, contribute to where women choose to deliver, and decide who attends the delivery.
Following the completion of the study, the findings will be shared with policy makers, health care providers, researchers, and local community leaders. The research team intends to publish the findings so that the international community of practitioners and researchers can learn from this study. Findings will also be disseminated during two stakeholder meetings, one in Bunyala District where Port Victoria is located, and one in Eldoret town. Participants – ranging from village chiefs and elders to staff from governmental ministries – will discuss strategies on how to use the findings to help achieve MDG 4 (reducing child mortality) and MDG 5 (improving maternal health) along with how to meet the Kenyan government’s own safe motherhood targets.