Recorded presentation

Jennifer Wesson, MPA¹, Violet Bukusi, MBA², Alice Olawo, MA², Marsden Solomon, MB CHB, M MED³, and Job Obwaka, MB CHB, M MED⁴. (1) Health Services Research, Family Health International, PO Box 13950, Research Triangle Park, NC 27709, 919-544-7040 x373, jwesson@fhi.org, (2) Institute for Family Health, Family Health International, P.O. BOX 38835-00623, Nairobi, Kenya, (3) Division of Reproductive Health, Ministry of Health, P.O. BOX 43319, Nairobi, Kenya, (4) AMKENI, P.O. BOX 10414-00100, Nairobi, Kenya

Although the number of women of reproductive age is increasing and the amount of funds available for providing contraceptive commodities has decreased, the safe, effective, low-cost intra-uterine device (IUD) has fallen into disuse in Kenya. In 1984, IUD use comprised 31 percent of the total modern contraceptive use in Kenya; by 1998, that had declined to 9 percent. One of the major barriers to IUD use in Kenya is provider attitudes. This study tested a practical approach to reducing IUD-related biases of clinic providers and community based distribution (CBD) agents while at the same time giving them information and tools to better counsel their clients regarding this method. Ministry of Health district supervisors were trained in “academic detailing” – a practice similar to pharmaceutical representative promotional office visits – and were sent out to clinics and CBD programs to promote increased and improved counseling about IUDs to clients. The presentation will present the results of a study that used an quasi-experimental pre/post-intervention factorial design to test whether the detailing intervention was more effective in increasing IUD use when applied to clinic-based providers, CBD agents, or both groups at the same time, as compared to a control group. The number of IUDs provided and provider knowledge and attitudes were measured before and six months after the intervention in 40 sites. The detailing intervention was designed to fit into the existing Ministry of Health supervisory system, to enhance its sustainability. This intervention model can also be applied to other initiatives sponsored by health departments.

Learning Objectives: At the conclusion of the session, the participant will be able to

• Describe the key aspects of an academic detailing intervention.
• Assess the detailing intervention's effect in changing provider behaviors and attitudes.

Keywords: Intervention, International Family Planning

Related Web page: www.fhi.org

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Family Health International
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation