A multi-sectoral intervention model to scale up family planning services utilization at the primary health care level: evidence from a priority district, Fayoum governorate, Egypt

N. M. Elden, W. Khairy, Tarek Tawfik Amin
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Abstract

Background: Egypt is one of the most populous countries in the Middle East and Africa. Evidence from developing countries revealed that increasing family planning use is associated with substantial declines in fertility and population growth. The objective of this study was to assess the impact of implementing a multisectoral intervention model on the family planning utilization at the Primary Health Care (PHC) level in a priority district, Fayoum governorate, Egypt.  Methods: A quasi-experimental design was conducted from July 2016 to September 2016. The model targeted 10 PHC units out of 23 at Tamia district, with two types of interventions; health sector and non-health sector related interventions carried out in the intervention units and their catchment areas. The family planning utilization of the intervention units (n=10) was compared to the control units (n=13). Additionally, the overall family planning utilization at the district level was measured.  Results: Following the implementation of the interventions, the overall family planning utilization at the district level showed a significant increase in mean ± Standard Error of the Mean (SEM) of new family planning clients (44.4±11.0vs. 63.3±13.8; P= 0.006) recording 43% change. The mean ± SEM of intrauterine devices dispensed from the intervention units significantly increased by 391% (3.5±1.0 vs. 17.2±3.3; P=0.002). Findings from the control units didn't reveal significant increase regarding the dispense of any family planning method.  Conclusion: Mobilizing and optimizing resources use, empowering district authorities and strengthening collaboration across sectors were key drivers of the success of this model in scaling up family planning services utilization.   
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在初级卫生保健一级扩大计划生育服务利用的多部门干预模式:来自埃及法尤姆省一个重点地区的证据
背景:埃及是中东和非洲人口最多的国家之一。来自发展中国家的证据表明,计划生育使用的增加与生育率和人口增长的大幅下降有关。本研究的目的是评估在埃及法尤姆省一个重点地区实施多部门干预模式对初级卫生保健(PHC)一级计划生育利用的影响。方法:2016年7月~ 2016年9月采用准实验设计。该模式针对塔米亚县23个初级保健单位中的10个,采取两种干预措施;在干预单位及其集水区开展与卫生部门和非卫生部门有关的干预。将干预单位(n=10)与对照单位(n=13)的计划生育利用率进行比较。此外,还测量了地区一级计划生育的总体利用情况。结果:干预措施实施后,区级计划生育总体利用率显著提高,新增计划生育客户的均数±标准误差(SEM)为44.4±11.0vs。63.3±13.8;P= 0.006),变化43%。干预单元配发的宫内节育器平均±SEM显著增加391%(3.5±1.0 vs. 17.2±3.3;P = 0.002)。控制单位的调查结果没有显示任何计划生育方法的使用有显著增加。结论:动员和优化资源利用、赋予地区当局权力和加强跨部门合作是该模式在扩大计划生育服务利用方面取得成功的关键驱动因素。
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Epidemiology Biostatistics and Public Health
Epidemiology Biostatistics and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
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期刊介绍: Epidemiology, Biostatistics, and Public Health (EBPH) is a multidisciplinary journal that has two broad aims: -To support the international public health community with publications on health service research, health care management, health policy, and health economics. -To strengthen the evidences on effective preventive interventions. -To advance public health methods, including biostatistics and epidemiology. EBPH welcomes submissions on all public health issues (including topics like eHealth, big data, personalized prevention, epidemiology and risk factors of chronic and infectious diseases); on basic and applied research in epidemiology; and in biostatistics methodology. Primary studies, systematic reviews, and meta-analyses are all welcome, as are research protocols for observational and experimental studies. EBPH aims to be a cross-discipline, international forum for scientific integration and evidence-based policymaking, combining the methodological aspects of epidemiology, biostatistics, and public health research with their practical applications.
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