Dr Niélé Hawa DIARRA, apprenant de la 8M1 va présenter un article intitulé “Increasing postpartum family planning uptake through group antenatal care : a longitudinal prospective design”, lors du prochain journal club prévu pour le jeudi 28 mars 2019, de 14h05 à 15h30 dans la salle de classe de la 8M1.
Qui est Dr Niélé Hawa DIARRA ?
Dr Niélé Hawa Diarra est titulaire d’un Doctorat d’Etat en médecine de la Faculté de Médecine et d’Odonstomatologie de l’Université des sciences, des techniques et technologiques de Bamako. Elle a d’abord travaillé comme Coordinatrice de recherche sur un certains nombres de projet du DERSP en santé maternelle et infantile (Les obstacles liés à la prise effective de la SP chez les femmes enceintes au Mali, La résilience des enfants malien…). Dr Diarra a ensuite évolué toujours dans la recherche mais avec les ONG internationales comme Save the Children et Water Aid, en tant que Manager de programme sur la santé et nutrition en milieu scolaire. Elle y a conduite des recherches opérationnelles sur une intervention intégrant la chimio prévention saisonnière du paludisme à la supplémentation en poudre de micronutriment, et sur la gestion de l’hygiène menstruelle en milieu scolaire. Depuis quelques mois, Dr Diarra est de retour au DERSP et est impliqué dans les activités de recherche du dit DER. Dr Diarra est point focale de l’observatoire en santé de la reproduction mis en place dans le cadre d’un partenariat entre le DERSP et le projet NICHE. Elle participe à l’élaboration des protocoles de recherche et d’outils de collecte des données, à la collecte, l’analyse et la rédaction de rapports. Elle participe également à l’encadrement des étudiants en Médecine en fin de cycle dans le cadre de la thèse.
Résumé de la Présentation en anglais
Background: Despite significant improvements, postpartum family planning uptake remains low for women in sub-Saharan Africa. Transmitting family planning education in a comprehensible way during antenatal care (ANC) has the potential for long-term positive impact on contraceptive use. We followed women for one-year postpartum to examine the uptake and continuation of family planning following enrollment in group versus individual ANC.
Methods: A longitudinal, prospective cohort design was used. Two hundred forty women were assigned to group ANC (n = 120) or standard, individual care (n = 120) at their first ANC visit. Principal outcome measures included intent to use family planning immediately postpartum and use of a modern family planning method at one-year postpartum. Additionally, data were collected on intended and actual length of exclusive breastfeeding at one-year postpartum. Pearson chi-square tests were used to test for statistically significant differences between group and individual ANC groups. Odds ratios and adjusted odds ratios were calculated using logistic regression.
Results: Women who participated in group ANC were more likely to use modern and non-modern contraception than those in individual care (59.1% vs. 19%, p < .001). This relationship improved when controlled for intention, age, religion, gravida, and education (AOR = 6.690, 95% CI: 2.724, 16,420). Women who participated in group ANC had higher odds of using a modern family planning method than those in individual care (AOR = 8.063, p < .001). Those who participated in group ANC were more likely to exclusively breastfeed for more than 6 months than those in individual care (75.5% vs. 50%, p < .001). This relationship remained statistically significant when adjusted for age, religion, gravida, and education (AOR = 3.796, 95% CI: 1.558, 9.247).
Conclusions: Group ANC has the potential to be an effective model for improving the uptake and continuation of post-partum family planning up to one-year. Antenatal care presents a unique opportunity to influence the
adoption of postpartum family planning. This is the first study to examine the impact of group ANC on family planning intent and use in a low-resource setting. Group ANC holds the potential to increase postpartum family planning uptake and long-term continuation.
Trial registration: Not applicable. No health related outcomes reported.
Keywords: Antenatal care, Family planning, Group antenatal care, Sub-Saharan Africa, Reproductive health
