title: Evidence from cluster surveys on the association between home-based counseling and use of family planning in conflict-affected Darfur.
abstract: OBJECTIVE
  To examine the association between home counseling and awareness and use of modern family planning (FP) methods among women in internally displaced person (IDP) camps in conflict-affected West Darfur, Sudan.
  
  
  METHODS
  In a community-based cross-sectional study, two questionnaire-based surveys were performed in three camps. Home-based counseling had been introduced in March 2006. An initial survey (February 2007) and a follow-up survey (April 2009) targeted women of child-bearing age. A sample of 640 randomly selected women aged 15-49 years who had experienced pregnancy after joining the camp were interviewed for each survey.
  
  
  RESULTS
  Overall, modern FP use increased from 10.9% (70/640) in 2007 to 21.6% (138/640) in 2009 (P<0.001). As compared with the initial survey, women in the follow-up survey were more likely to be aware of and to use any modern FP method (adjusted odds ratio [aOR] 5.4, 95% confidence interval [CI] 3.9-7.4; and aOR 2.8, 95% CI 2.0-4.1, respectively). Contraceptive pills were the most common modern method used. Home counseling and loss of a child under 5years were the most significant predictors of awareness and use of modern FP methods.
  
  
  CONCLUSIONS
  After the introduction of home-based FP counseling for couples and FP services in clinics, women's awareness and use of modern FP methods increased in a conflict-affected setting.
authors.affiliation: Department of International Health and Medicine, Graduate School of Tokyo Medical and Dental University, Tokyo, Japan; Department of Epidemiology, Faculty of Public and Environmental Health, University of Khartoum, Khartoum, Sudan. Electronic address: izzoff@gmail.com.
authors.forename: Izzeldin F
authors.initials: IF
authors.lastname: Adam
mesh_terms: D000293:Adolescent; D000328:Adult; D003267:Contraception / Q000145:classification / Q000706:statistics & numerical data*; D003376:Counseling; D003430:Cross-Sectional Studies; D005193:Family Planning Services / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009938:Organizations; D011247:Pregnancy; D012036:Refugees; D060728:Reproductive Health; D013397:Sudan; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Darfur; Home counseling; Internally displaced persons; Maternal mortality ratio; Minimum initial service package; Modern family planning; Non-governmental organizations; Reproductive health; Sudan