Effect of Interventions in Improving Awareness, Knowledge and Practices of PPFP among Women and Health-Care Providers in Bihar; a Pre- and Post-Intervention Study

Background: Post-partum family planning (PPFP) within first 12 months of childbirth is known to improve maternal and neonatal health outcomes. This study evaluates the effect a package of PPFP interventions in improving level of awareness, knowledge and practices of post-partum women. Methods: A before and after intervention cross sectional study was conducted in 18 public health facilities and their catchment areas across 5 districts of Bihar. Participants included randomly selected postpartum women and purposively selected health service providers. A standard questionnaire was used to assess the level of knowledge, awareness and practices related to post-partum family planning before and after the intervention. Results: A total of 972postpartum women,27 doctors, 46 nurses, 89 Auxiliary Nurse Midwives (ANM) and 89 Accredited Social Health Activists (ASHA) as well as 981 postpartum women, 18 doctors, 53 nurses, 90 ANMs and 90 ASHAs were interviewed during baseline and end line respectively. This intervention package increased knowledge regarding postpartumreturn to fertility, modern FP methods and criteria of lactational amenorrhoea method. Also, the proportion of post-partum women who reported receiving FP counselling were increased. Conclusion: The findings of this study demonstrate that effective implementation of a package of PPFP interventions at a scale can lead to improvement in the knowledge and awareness levels of both health workers and post-partum women.