Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #113751

Jennifer Wesson, MPA¹, Alice Olawo, MA², Violet Bukusi, MBA², 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

In the face of declines in the use of the intra-uterine device (IUD) the Kenyan Ministry of Health is leading an IUD Reintroduction Initiative. In 1984, IUD use comprised 31 percent of the total modern contraceptive use in Kenya; by 2003, that had declined to 8 percent. Previous research has shown that 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 the promotional office visits made by pharmaceutical representatives – and were sent out to clinics and CBD programs to promote increased and improved counseling about IUDs to clients. The study used an 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. In 2004, the authors presented the design of the intervention and baseline data. This presentation will present the analysis of follow-up data collected in February 2005 demonstrating the impact of the intervention on provider attitudes and knowledge and IUD uptake in the 45 study sites. The costs, replicability and sustainability of the intervention will also be discussed.

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

• Assess the detailing intervention's effect in changing provider behaviors and attitudes.
• Summarize the costs of implementing the intervention and its prospects for replication by the Ministry of Health.

Keywords: Family Planning, Service Delivery

Related Web page: www.fhi.org

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation