Plain English summary
Background
Project setting
Study design
Study implementation
Methods
Quantitative data
Limitations
Results
Population characteristics
Variable | Baseline (2011) | Endline (2015) | |||||
---|---|---|---|---|---|---|---|
Treatment = 0 | Treatment = 1 | p-value | Treatment = 0 | Treatment = 1 | p-value | ||
Age | 15–24 | 592 (38.6%) | 595 (38.6%) | 0.11 | 471 (37.1%) | 467 (37.3%) | 0.82 |
25–29 | 231 (15.0%) | 208 (13.5%) | 161 (12.7%) | 141 (11.3%) | |||
30–34 | 215 (14.0%) | 243 (15.8%) | 166 (13.1%) | 173 (13.8%) | |||
35–39 | 242 (15.8%) | 207 (13.4%) | 173 (13.6%) | 179 (14.3%) | |||
40–49 | 255 (16.6%) | 287 (18.6%) | 298 (23.5%) | 292 (23.3%) | |||
Education | No education | 278 (18.1%) | 281 (18.2%) | 0.86 | 237 (18.7%) | 211 (16.9%) | 0.42 |
Less than secondary | 1031 (67.2%) | 1043 (67.7%) | 828 (65.2%) | 845 (67.5%) | |||
Secondary or more | 226 (14.7%) | 216 (14.0%) | 204 (16.1%) | 196 (15.7%) | |||
Wealth index/ SES Status | Poorest | 345 (22.5%) | 424 (27.5%) | 0.003** | 229 (18.0%) | 234 (18.7%) | 0.003** |
Poor | 313 (20.4%) | 279 (18.1%) | 174 (13.7%) | 232 (18.5%) | |||
Better | 268 (17.5%) | 289 (18.8%) | 282 (22.2%) | 224 (17.9%) | |||
Less poor | 343 (22.3%) | 287 (18.6%) | 228 (18.0%) | 240 (19.2%) | |||
Least poor | 266 (17.3%) | 261 (16.9%) | 295 (23.2%) | 276 (22.0%) | |||
Missing data | – | – | 61 (4.8%) | 46 (3.7%) | |||
Religion | Christian | 703 (45.9%) | 740 (48.1%) | 0.053 | 559 (44.1%) | 593 (47.4%) | 0.009** |
Muslim | 774 (50.5%) | 765 (49.7%) | 634 (50.0%) | 618 (49.4%) | |||
Traditional/ Other | 53 (3.5%) | 35 (2.3%) | 73 (5.8%) | 39 (3.1%) | |||
No response/ missing | 3 (0.2%) | 2 (0.2%) | |||||
Parity | 0 | 344 (22.4%) | 325 (21.1%) | 0.20 | 349 (27.5%) | 346 (27.6%) | 0.59 |
1–2 | 419 (27.3%) | 439 (28.5%) | 345 (27.2%) | 312 (24.9%) | |||
3–4 | 394 (25.7%) | 358 (23.3%) | 282 (22.2%) | 288 (23.0%) | |||
5+ | 378 (24.6%) | 417 (27.1%) | 293 (23.1%) | 306 (24.4%) | |||
Marital status | Married | 820 (53.4%) | 856 (55.6%) | 0.84 | 597 (47.0%) | 620 (49.5%) | 0.23 |
Living with partner | 172 (11.2%) | 162 (10.5%) | 165 (13.0%) | 156 (12.5%) | |||
Divorced | 87 (5.7%) | 87 (5.6%) | 77 (6.1%) | 94 (7.5%) | |||
Widowed | 33 (2.1%) | 28 (1.8%) | 28 (2.2%) | 31 (2.5%) | |||
Single | 421 (27.4%) | 406 (26.4%) | 400 (31.5%) | 347 (27.7%) | |||
No response/ Missing | 2 (0.1%) | 1 (0.1%) | 2 (0.2%) | 4 (0.3%) | |||
Modern use of FP | 496 (32.3%) | 508 (33.0%) | 0.69 | 388 (30.6%) | 393 (31.4%) | 0.66 | |
Number of respondents | 1535 | 1540 | 1269 | 1252 |
Modern contraceptive use
Variable | Baseline (2011) | Endline (2015) | ||
---|---|---|---|---|
Treatment = 0 | Treatment = 1 | Treatment = 0 | Treatment = 1 | |
emale Sterilization | 22 (1.42%) | 24 (1.68%) | 25 (1.97%) | 28 (2.24%) |
Male Sterilization | 1 (0.06%) | 4 (0.28%) | – | – |
Pill | 124 (8.02%) | 126 (8.81%) | 77 (6.07%) | 67 (5.35%) |
IUD | 16 (1.03%) | 17 (1.19%) | 18 (1.42%) | 17 (1.36%) |
Injectables | 216 (13.97%) | 197 (13.78%) | 148 (11.66%) | 178 (14.22%) |
Implants | 38 (2.46%) | 28 (1.96%) | 58 (4.57%) | 46 (3.67%) |
Male Condom | 63 (4.08%) | 63 (4.41%) | 51 (4.02%) | 46 (3.67%) |
Female Condom | 5 (0.32%) | 5 (0.35%) | 1 (0.08%) | 1 (0.08%) |
Emergency Contraception | 1 (0.06%) | 0 | 2 (0.16%) | 2 (0.16%) |
Lactation Amenorrhea Method | 0 | 1 (0.07%) | 4 (0.32%) | 2 (0.16%) |
Other Modern Method | 7 (0.45%) | 11 (0.77%) | 4 (0.32%) | 6 (0.48%) |
Total | 1546 | 1430 | 1269 | 1252 |
Variable | Baseline (2011) | Endline 2015 | |||||
---|---|---|---|---|---|---|---|
Mod FP = 0 | Mod FP = 1 | p-value | Mod FP = 0 | Mod FP = 1 | p-value | ||
Age | 15–24 | 869 (42.0%) | 318 (31.7%) | < 0.001* | 770 (43.8%) | 181 (22.8%) | < 0.001** |
25–29 | 257 (12.4%) | 182 (18.1%) | 175 (10.0%) | 129 (16.3%) | |||
30–34 | 258 (12.5%) | 200 (19.9%) | 191 (10.9%) | 152 (19.2%) | |||
35–39 | 278 (13.4%) | 171 (17.0%) | 196 (11.1%) | 160 (20.2%) | |||
40–49 | 409 (19.7%) | 133 (13.2%) | 426 (24.2%) | 171 (21.6%) | |||
Education | No education | 418 (20.2%) | 141 (14.0%) | < 0.001** | 321 (18.3%) | 134 (16.9%) | < 0.001** |
Less than secondary | 1341 (64.7%) | 733 (73.0%) | 1112 (63.3%) | 579 (73.0%) | |||
Secondary or more | 315 (15.2%) | 130 (12.9%) | 325 (18.5%) | 80 (10.1%) | |||
Wealth index/ SES Status | Poorest | 543 (26.2%) | 226 (22.5%) | <0.032* | 312 (17.7%) | 153 (19.3%) | < 0.001** |
Poor | 395 (19.0%) | 197 (19.6%) | 288 (16.4%) | 127 (16.0%) | |||
Better | 352 (17.0%) | 205 (20.4%) | 320 (18.2%) | 195 (24.6%) | |||
Less poor | 438 (21.1%) | 192 (19.1%) | 356 (20.3%) | 121 (15.3%) | |||
Least poor | 343 (16.5%) | 184 (18.3%) | 396 (22.5%) | 176 (22.2%) | |||
Missing data | 3 (0.1%) | 0 (0.0%) | 86 (4.9%) | 21 (2.6%) | |||
Religion | Christian | 955 (46.2%) | 488 (48.6%) | < 0.001** | 783 (44.5%) | 380 (47.9%) | < 0.001** |
Muslim | 1025 (49.5%) | 514 (51.2%) | 863 (49.1%) | 407 (51.3%) | |||
Traditional/ Other | 86 (4.2%) | 2 (0.2%) | 106 (6.0%) | 6 (0.8%) | |||
No response/ Missing | 3 (0.1%) | 0 (0.0%) | 6 (0.3%) | 0 (0.0%) | |||
Parity | 0 | 565 (27.3%) | 107 (10.7%) | < 0.001** | 561 (31.9%) | 143 (18.0%) | < 0.001** |
1–2 | 545 (26.3%) | 313 (31.2%) | 449 (25.5%) | 218 (27.5%) | |||
3–4 | 454 (21.9%) | 298 (29.7%) | 351 (20.0%) | 221 (27.9%) | |||
5+ | 509 (24.6%) | 286 (28.5%) | 397 (22.6%) | 211 (26.6%) | |||
Marital status | Married | 1066 (51.5%) | 610 (60.8%) | < 0.001** | 805 (45.8%) | 426 (53.7%) | < 0.001** |
Living with partner | 206 (9.9%) | 128 (12.7%) | 193 (11.0%) | 132 (16.6%) | |||
Divorced | 126 (6.1%) | 48 (4.8%) | 115 (6.5%) | 60 (7.6%) | |||
Widowed | 46 (2.2%) | 15 (1.5%) | 49 (2.8%) | 10 (1.3%) | |||
Single | 625 (30.2%) | 202 (20.1%) | 590 (33.6%) | 165 (20.8%) | |||
No response/ Missing | 2 (0.1%) | 1 (0.1%) | 6 (0.3%) | 0 (0.0%) | |||
In Treatment areas | 1032 (49.8%) | 508 (50.6%) | 0.69 | 859 (49.4%) | 393 (50.3%) | 0.66 | |
Number of Respondents | 2074 | 1004 | 1758 | 793 |
Covariates | Odds Ratio | P > t | [95% Conf. Interval] | |
---|---|---|---|---|
DiD (Ref: Baseline) | ||||
Post (Endline) | 1.026 | 0.779 | .857 | 1.229 |
Village (Ref: Control Village) | ||||
Treatment Village | 1.000 | 0.999 | .839 | 1.191 |
DiD Interaction (Post*Treatment) | 1.026 | 0.822 | .819 | 1.286 |
Age | 1.456 | 0.000** | 1.387 | 1.528 |
Age squared | .994 | 0.000** | .993 | .995 |
Education (ref: no education) | ||||
Less than secondary education | 1.438 | 0.000** | 1.202 | 1.719 |
Secondary education or more | 1.480 | 0.002** | 1.154 | 1.898 |
Religion (Ref: Christian) | ||||
Muslim | 1.000 | 0.992 | .879 | 1.140 |
Traditional or other | .072 | 0.000** | .035 | .149 |
Marital Status (Ref: Married) | ||||
Living with partner | 1.154 | 0.159 | .946 | 1.409 |
Divorced | .739 | 0.015* | .580 | .942 |
Widowed | .567 | 0.003** | .388 | .828 |
Single | .847 | 0.073 | .707 | 1.016 |
Wealth Quintile (Ref: Poorest) | ||||
Poor | 1.013 | 0.909 | .806 | 1.274 |
Better | 1.299 | 0.004** | 1.086 | 1.553 |
Less Poor | .940 | 0.591 | .751 | 1.177 |
Least Poor | 1.101 | 0.422 | .871 | 1.392 |
Parity | 1.075 | 0.000** | 1.035 | 1.118 |
_cons | .002 | 0.000** | .001 | .003 |
Difference in differences estimation
Qualitative data
CHA acceptance in the community
Facilitator: To what extent does the community accept your services?Respondent: In fact, the community has received us positively (…) they have seen the advantages [of our services]. For example, environmental cleanliness, family planning, and the treatment of children under the age of 5 years. They [the community] respond positively because they have seen the advantages.F: How have they received the services?R: They have received these services positively to a large extent because they are using them and the education that we have given them is applied.F: Have you ever received complaints or fear from the community towards your services?R: In fact, that has never happened.
Respondent: No one fears them [CHAs], everybody is satisfied based on their performance. In fact, these CHAs are trying their level best and they are doing a good job.Facilitator: there is no one who has a fear or worries?P6: No one has any fear or anxiety.
In short, we don’t have any fear with CHAs, we accept them and we want them to proceed with their job. We like them.
I interact with CHAs in the issue of family planning, so when I need (something), they come to give me education. They can also provide me with pills or condoms, they can advise me on the methods I want to use, or they can mention all methods and I can choose the preferred one because they help.
Contraceptive method preference
Others don’t prefer using pills because they worry that they will forget to take the pills daily. So they prefer to take injections because these last for three months.
You know, every drug of family planning has it fans, you may find others they tell you ‘I like pills more’ but there are very few. You may also find someone tell you to swallow pills every day is a problem if you travel. Me, I see injection is best because you get injection which works after three months ( … ). Many young girls use injections more.
Most of the time, I should be honest, the man is the one who makes the decision, and if is not, then he will think something wrong.
In my opinion, others have a lot of children because they are not allowed to use family planning pills. [(Facilitator: Who restricts them?] Their partners.
They [men] want [child] bearing. So they make women use [contraceptives] in secret. A woman may pretend she is sick, she may go to hospital and the nurse gives her an injection. And injections don’t show any sign that you have gotten it ( … ).
If your husband did not understand [about family planning] you will use injection ( … ).
Men should also be given education like this, because some men are so against contraceptives. They say family planning is against God, because God gives you the capability to reproduce, and if you force him to use contraceptives, you will be beaten and you should conceive.
We can use CHA at the time when they come. There should be announcements that CHA will be at certain area certain days, so every man and woman should attend. As you know nowadays even men are supposed to attend the clinic so as to be aware what their wives have been told. Other men have a clear understanding, so when they receive such education they agree with family planning methods.