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Facility-level characteristics associated with family planning and child immunization services integration in urban areas of Nigeria: a longitudinal analysis.
Sheahan, Kate L; Speizer, Ilene S; Orgill-Meyer, Jennifer; Curtis, Siân; Weinberger, Morris; Paul, John; Bennett, Antonia V.
Afiliación
  • Sheahan KL; Supported by the Durham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), (CIN 13-410) at the Durham VA Health Care System, Durham, USA. kate.sheahan@va.gov.
  • Speizer IS; Department of Maternal and Child Health, University of North Carolina at Chapel Hill, Chapel Hill, USA.
  • Orgill-Meyer J; Department of Government and Public Health, Franklin and Marshall College, Lancaster, USA.
  • Curtis S; Department of Maternal and Child Health, University of North Carolina at Chapel Hill, Chapel Hill, USA.
  • Weinberger M; Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, USA.
  • Paul J; Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, USA.
  • Bennett AV; Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, USA.
BMC Public Health ; 21(1): 1379, 2021 07 12.
Article en En | MEDLINE | ID: mdl-34247607
BACKGROUND: Unmet need for postpartum contraception is high. Integration of family planning with routine child immunization services may help to satisfy unmet need. However, evidence about the determinants and effects of integration has been inconsistent, and more evidence is required to ascertain whether and how to invest in integration. In this study, facility-level family planning and immunization integration index scores are used to: (1) determine whether integration changes over time and (2) identify whether facility-level characteristics, including exposure to the Nigerian Urban Reproductive Health Initiative (NURHI), are associated with integration across facilities in six urban areas of Nigeria. METHODS: This study utilizes health facility data collected at baseline (n = 400) and endline (n = 385) for the NURHI impact evaluation. Difference-in-differences models estimate the associations between facility-level characteristics, including exposure to NURHI, and Provider and Facility Integration Index scores. The two outcome measures, Provider and Facility Integration Index scores, reflect attributes that support integrated service delivery. These indexes, which range from 0 (low) to 10 (high), were constructed using principal component analysis. Scores were calculated for each facility. Independent variables are (1) time period, (2) whether the facility received the NURHI intervention, and (3) additional facility-level characteristics. RESULTS: Within intervention facilities, mean Provider Integration Index scores were 6.46 at baseline and 6.79 at endline; mean Facility Integration Index scores were 7.16 (baseline) and 7.36 (endline). Within non-intervention facilities, mean Provider Integration Index scores were 5.01 at baseline and 6.25 at endline; mean Facility Integration Index scores were 5.83 (baseline) and 6.12 (endline). Provider Integration Index scores increased significantly (p = 0.00) among non-intervention facilities. Facility Integration Index scores did not increase significantly in either group. Results identify facility-level characteristics associated with higher levels of integration, including smaller family planning client load, family planning training among providers, and public facility ownership. Exposure to NURHI was not associated with integration index scores. CONCLUSION: Programs aiming to increase integration of family planning and immunization services should monitor and provide targeted support for the implementation of a well-defined integration strategy that considers the influence of facility characteristics and concurrent initiatives.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Educación Sexual / Servicios de Planificación Familiar Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Child / Female / Humans País/Región como asunto: Africa Idioma: En Revista: BMC Public Health Asunto de la revista: SAUDE PUBLICA Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Educación Sexual / Servicios de Planificación Familiar Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Child / Female / Humans País/Región como asunto: Africa Idioma: En Revista: BMC Public Health Asunto de la revista: SAUDE PUBLICA Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido