title: Increasing postpartum contraception in rural India: evaluation of a community-based behavior change communication intervention.
abstract: BACKGROUND
  The Indian family planning program, though successful in increasing contraceptive use among couples who have achieved their desired family size, has not been equally successful in educating couples about the use of contraceptive methods for birth spacing.
  
  
  METHODS
  An evaluation was conducted of a behavior change communication intervention integrated into the existing government program to increase knowledge and use of the lactational amenorrhea method and postpartum contraception through counseling by community workers. The intervention, which ran between September 2006 and January 2007, was conducted among 959 pregnant women aged 15-24 who lived in Uttar Pradesh, India. The evaluation used logistic regression analyses to measure differences in knowledge and contraceptive use between baseline and the four- and nine-month postpartum follow-up surveys within and between the intervention and comparison groups.
  
  
  RESULTS
  The follow-up data show increases in knowledge of the lactational amenorrhea method and spacing methods and in use of spacing methods. At four months postpartum, women in the intervention group were more likely to know the healthy spacing messages than those in the comparison group (odds ratio, 2.1). At nine months postpartum, women in the intervention group, those with higher knowledge of healthy spacing practices and those with correct knowledge of two or more spacing methods were more likely than others to be using a contraceptive method (1.5-3.5). Use of modern contraceptives for spacing at nine months postpartum was 57% in the intervention group versus 30% in the comparison group.
  
  
  CONCLUSIONS
  Targeted behavior change communication using community workers is an effective and feasible strategy for promoting postpartum contraception.
authors: Population Council, New Delhi, India. msebastian@popcouncil.org
authors: Mary Philip
authors: MP
authors: Sebastian
authors: Mohammed Ejazduin
authors: ME
authors: Khan
authors: Kaushal
authors: K
authors: Kumari
authors: Rukma
authors: R
authors: Idnani
mesh_terms: D000293:Adolescent; D000568:Amenorrhea / Q000209:etiology; D001721:Birth Intervals / Q000706:statistics & numerical data; D003150:Community Health Workers / Q000193:education / Q000639:trends*; D003267:Contraception / Q000379:methods* / Q000706:statistics & numerical data / Q000639:trends; D004522:Educational Status; D005193:Family Planning Services / Q000379:methods* / Q000639:trends; D005260:Female; D006266:Health Education / Q000379:methods; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007774:Lactation / Q000502:physiology*; D049590:Postpartum Period; D011247:Pregnancy; D015397:Program Evaluation; D012423:Rural Health; D012959:Socioeconomic Factors; D000078329:Workforce; D055815:Young Adult