Vernon Mochache 1 2, Eunice Irungu 3, Hajara El-Busaidy 4, Marleen Temmerman 3 5 6, Peter Gichangi 3 5 7
Affiliations
- 1International Centre for Reproductive Health, Mombasa, Kenya. vmochache@yahoo.com.
- 2University of Ghent, Ghent, Belgium. vmochache@yahoo.com.
- 3International Centre for Reproductive Health, Mombasa, Kenya.
- 4County Government of Kwale, Department of Health, Kwale, Kenya.
- 5University of Ghent, Ghent, Belgium.
- 6Aga Khan University, Nairobi, Kenya.
- 7University of Nairobi, Nairobi, Kenya.
PMID: 30514292 PMCID: PMC6280535
DOI: 10.1186/s12913-018-3739-9
Abstract
Background: Community-participatory approaches are important for effective maternal and child health interventions. A community-participatory intervention (the Dialogue Model) was implemented in Kwale County, Kenya to enhance uptake of select maternal and child health services among women of reproductive age.
Methods: Community volunteers were trained to facilitate Dialogue Model sessions in community units associated with intervention health facilities in Matuga, Kwale. Selection of intervention facilities was purposive based on those that had an active community unit in existence. For each facility, uptake of family planning, antenatal care and facility-based delivery as reported in the District Health Information System (DHIS)-2 was compared pre- (October 2012 – September 2013) versus post- (January – December 2016) intervention implementation using a paired sample t-test.
Results: Between October 2013 and December 2015, a total of 570 Dialogue Model sessions were held in 12 community units associated with 10 intervention facilities. The median [interquartile range (IQR)] number of sessions per month per facility was 2 (1-3). Overall, these facilities reported 15, 2 and 74% increase in uptake of family planning, antenatal care and facility-based deliveries, respectively. This was statistically significant for family planning pre- (Mean (M) = 1014; Standard deviation (SD) = 381) versus post- (M = 1163; SD = 400); t (18) = – 0.603, P = 0.04) as well as facility-based deliveries pre- (M = 185; SD = 216) versus post- (M = 323; SD = 384); t (18) = – 0.698, P = 0.03).
Conclusions: A structured, community-participatory intervention enhanced uptake of family planning services and facility-based deliveries in a rural Kenyan setting. This approach is useful in addressing demand-side factors by providing communities with a stake in influencing their health outcomes.
Keywords: Antenatal care; Community-participatory approaches; Dialogue model; Facility-based delivery; Family planning; Kenya; Kwale.
Conflict of interest statement
Authors’ information
At the time of the study, VM was the MOMI Project Manager at the International Centre for Reproductive Health, Kenya and is currently a doctoral candidate in Health Sciences at the University of Ghent, Belgium. EI was the MOMI Project Coordinator while HEB is the Kwale County Director of Health. MT is a Professor, Department of Obstetrics and Gynecology at the University of Ghent, Belgium and the Director of Women’s Health, Faculty of Heath Sciences, Aga Khan University in East Africa. PG is an Associate Professor at the University of Ghent and the Country Director at the International Centre for Reproductive Health, Kenya.
Ethics approval and consent to participate
Ethical approval for this study was obtained from the Ethics Review Committee of the University of Nairobi and Kenyatta National Hospital (P151/03/2014). To facilitate the conduct of research activities in the community, a research permit was obtained from the National Commission for Science, Technology and Innovation (#4703). This was presented to the local administration and community gatekeepers prior to study implementation. Participants in each DM sessions provided group, oral informed consent and any community member who did not wish to participate was given an opportunity to leave before each session started. This consenting process was approved by the ethics committee as a practical approach in the setting of open community meetings with repeated and varied attendance. Group consenting was captured in DM sessions’ meeting notes/event logs.
Consent for publication
Not applicable
Competing interests
The authors declare that they have no competing interests.
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