Bungoma County Woman’s Study: A Pilot Randomized Evaluation To Estimate The Impact Of A Screening and Referral Service On Contraceptive Use
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Background: An estimated 225 million women globally have an unmet family planning need, three-quarters of whom live in low and middle-income countries. Addressing this need requires new and innovative approaches, such as digital health solutions. We examined the impact of a new phone-based screening and referral service on the take-up of family planning as part of a pilot study to prepare for a full trial of the intervention.
Methods: This pilot study tested the procedures for a randomized encouragement trial. We recruited 112 women with an unmet need for family planning from local markets in Western Kenya, conducted an eligibility screening, and randomized half of the women to receive an encouragement to try the investigational intervention. Four months after sending an encouraging to the treatment group, we attempted to conduct a follow-up survey with all enrolled participants.
Results: The encouragement sent via text message to the treatment group led to differential rates of intervention uptake between the treatment and control groups, but take-up among the group was lower than anticipated (33.9% vs 1.8% in the control group). Study attrition was also substantial. We obtained follow-up data from 44.6% of enrolled participants. Among those in the treatment group who tried the intervention, however, the instrumental variables estimate of the Local Average Treatment Effect was an increase of 41 percentage points in the probability of contraceptive take-up.
Conclusion: This randomized encouragement design and study protocol is feasible but requires modifications to the encouragement and follow-up data collection procedures. The investigational intervention appears to have a positive impact on contraceptive take-up among women with an unmet need despite a number of contextual challenges.
Randomized Encouragement Evaluation
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