title: Community mobilization and service strengthening to increase awareness and use of postabortion care and family planning in Kenya.
abstract: OBJECTIVE
  To evaluate whether a community engagement and service-strengthening intervention raised awareness of family planning (FP) and early pregnancy bleeding (EPB), and increased FP and postabortion care (PAC) use.
  
  
  METHODS
  The intervention was carried out in 3 communities in Kenya over 18months; 3 additional communities served as the comparison group. A pre-post, contemporaneously controlled, quasi-experimental evaluation was conducted independently from the intervention.
  
  
  RESULTS
  Baseline characteristics were similar. Awareness of FP methods increased (P≤0.001) in the intervention group. The incidence of reported EPB (before 5months of pregnancy) in the comparison group was 13.3% at baseline and 6.0% at endline (P=0.02); 79% at baseline and 100% at endline sought care (P>0.05). In the intervention group, recognition and reporting of EPB increased from 9.8% to 13.1% (P>0.05); 65% sought PAC at baseline and 80% at endline (P=0.11). The relative increase in EPB reports after the intervention was over 3 times greater in the intervention group (P≤0.01).
  
  
  CONCLUSIONS
  The intervention raised FP and EPB awareness but not FP and PAC services use. As fewer comparison group respondents reported experiencing EPB, the PAC impact of the intervention is unclear. Mechanisms to improve EPB reporting are needed to avoid this reporting bias.
authors.affiliation: Reproductive Health Program, Population Council, Nairobi, Kenya. Electronic address: cundie@popcouncil.org.
authors.forename: Chi-Chi
authors.initials: CC
authors.lastname: Undie
authors.affiliation: Center for Communication Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
authors.forename: Lynn M
authors.initials: LM
authors.lastname: Van Lith
authors.affiliation: Programs Division, EngenderHealth, Nairobi, Kenya.
authors.forename: Mercy
authors.initials: M
authors.lastname: Wahome
authors.affiliation: Reproductive Health Program, Population Council, Nairobi, Kenya.
authors.forename: Francis
authors.initials: F
authors.lastname: Obare
authors.affiliation: Programs Division, EngenderHealth, Nairobi, Kenya.
authors.forename: Esther
authors.initials: E
authors.lastname: Oloo
authors.affiliation: Bureau for Global Health, United States Agency for International Development, Washington, USA.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Curtis
mesh_terms: D000328:Adult; D000359:Aftercare; D019058:Community Networks; D005193:Family Planning Services; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007630:Kenya; D011247:Pregnancy; D011248:Pregnancy Complications
keywords: Community action cycle; Community health workers; Community mobilization; Family planning; Kenya; Postabortion care; Safe motherhood; Unsafe abortion