Community-based postpartum contraceptive counselling in rural Nepal: a mixed-methods evaluation

Figures & data

Figure 1. Map of Nepal

Figure 2: Conceptual model

Figure 3. Study enrolment

Table 1. Sample characteristics of pre- and post-intervention groups

Characteristic	Pre-intervention (n = 445)	Post-intervention (n = 508)^a
Age (years), median (Q1, Q3)	25 (21, 30)	24 (20, 30)
Age (years), n (%)*
15–19	43 (10)	87 (17)
20–34	350 (79)	325 (64)
35–49	52 (12)	96 (19)
Caste
“Upper” n (%)	281 (63)	323 (64)
Monthly household (HH) expenditure^b, n (%)
<5000/month	226 (51)	238 (47)
5000–9999/month	155 (35)	177 (35)
>/= 10,000/month	64 (14)	87 (17)
Sex of child in index pregnancy
Female, n (%)	230 (52)	237 (49)
Time since delivery (days), mean (SD)	188 (107)	193 (119)
Early postpartum (0-5 mo), n (%)	215 (48)	240 (47)
Institutional birth rate, n (%)*	227 (51)	414 (82)

^aForty-eight repeated measures. These are women who were in both the pre-intervention and post-intervention groups. Represents 5% of the total sample size.

^bMonthly household expenditure measured in Nepali Rupees (NPR). 110 NPR = 1 USD

*Statistically significant (p < 0.05) differences between the two groups with Chi-square test.

Table 2. Unadjusted modern contraceptive use and method mix pre- and post-intervention

Contraceptive Method	Pre-intervention (n = 445) n (%)	Post-intervention (n = 508) n (%)	p-value
Any modern method	131 (29.4)	235 (46.3)	<0.0001
LAM	74 (16.6)	135 (26.6)	0.003
Condom	20 (4.5)	8 (1.6)	0.01
Combined oral pills	2 (0.5)	1 (0.2)	0.6
Injectables	23 (5.2)	63 (12.4)	<0.0001
IUD	5 (1.1)	3 (0.6)	0.48
Implant	2 (0.5)	15 (3.0)	0.003
Female sterilisation	3 (0.7)	8 (1.6)	0.24
Male sterilisation	2 (0.5)	2 (0.4)	1.00
Non-use	314 (70.6)	273 (53.7)	<0.0001
Traditional methods	16 (3.6)	9 (1.8)	0.1
None	298 (67)	264 (52.0)	<0.0001

Figure 4. Modern contraceptive use by time since delivery

Table 3. Multivariable logistic regression for modern contraceptive use by time since delivery

Variable	Early postpartum		Late postpartum
	OR	95% CI	OR	95% CI
Post-intervention (Ref: Pre-intervention)	2 . 3**	1.5, 3.5	2.0*	1.3, 3.2
Covariates
Age (Ref: 15–19 years)
Age 20–34	1.2	0.7, 2.2	0.6	0.4, 1.2
Age 35–49	1.1	0.5, 2.2	0.6	0.3, 1.2
Monthly HH expenditure, (NPR) (Ref: <5k/month)
5000–9999/month	1.1	0.7, 1.7	1.0	0.6, 1.7
>/=10,000/month	2.0*	1.1, 3.6	1.2	0.7, 2.2
Caste (Ref: “other”)
“Upper”, n (%)	0.8	0.5, 1.2	1.3	0.8, 2.0
Sex of child in index pregnancy (Ref: male)
Female	1.0	0.6, 1.4	1.2	0.8, 1.9
Institutional Birth Rate (IBR), n (%) (Ref: home birth)	1.1	0.7, 1.8	1.4	0.9, 2.3

*p-value <= 0.5.

**p-value <= 0.0001.

Data availability statement

De-identified quantitative data are available on request by emailing: [email protected] and will be posted in a publicly-accessible data repository. Full transcripts of qualitative data are not available as they contain quotes and identifiable information that could compromise the identity of participants.