Effects of Postpartum Family Planning Counselling on Contraceptives Knowledge, Attitude and Intention Among Women Attending a General Hospital in The Gambia: A Randomized Controlled Trial

Figures & data

Figure 1 Study design.

Table 1 Socio-Demographic Characteristics of Participants (n=647)

Variables	Intervention (n=310)	Comparison (n=337)	p-value
	n (%)	n (%)
Age group (years)
≤20	91 (29.4)	92 (27.3)	0.71
21–25	81 (26.1)	80 (23.7)
26–30	81 (26.1)	97 (28.8)
31–35	35 (11.3)	46 (13.6)
36–40	19 (6.1)	21 (6.2)
41+	3 (1.0)	1 (0.3)
Mean (±SD)	25.4 (±6.3)	25.8 (±6.1)	0.51
Parity
1	82 (26.5)	100 (29.7)	0.51
2–5	164 (52.9)	170 (50.4)
6–10	64 (20.6)	65 (19.3)
11+	0 (0.0)	2 (0.6)
Mean (±SD)	3.5 (±2.2)	3.4 (±2.4)	0.61
Age at marriage^†
≤15	73 (23.9)	54 (16.5)	0.089
16–20	199 (65.0)	236 (72.2)
21–25	28 (9.2)	34 (10.4)
26–30	5 (1.6)	3 (0.9)
31+	1 (0.3)	0 (0.0)
Mean (±SD)	17.7 (±2.9)	17.8 (±2.5)	0.46
Ethnicity
Fulla	102 (32.9)	135 (40.1)	<0.001*
Mandinka	99 (31.9)	162 (48.1)
Wollof	96 (31.0)	23 (6.8)
Others	7 (2.3)	4 (1.2)
Sarahule	5 (1.6)	10 (3.0)
Jolla	1 (0.3)	3 (0.9)
Marital status
Married	306 (98.7)	321 (95.3)	0.035*
Single	4 (1.3)	10 (3.0)
Divorced	0 (0.0)	3 (0.9)
Widow	0 (0.0)	3 (0.9)
Cohabiting	0 (0.0)	0 (0.0)
Educational level
None	114 (36.8)	141 (41.8)	0.059
Elementary	121 (39.0)	99 (29.4)
Junior secondary	47 (15.2)	52 (15.4)
Senior secondary	21 (6.8)	38 (11.3)
Tertiary	7 (2.3)	7 (2.1)
Religion
Islam	309 (99.7)	334 (99.1)	1.00
Christianity	1 (0.3)	2 (0.6)
African tradition	0 (0.0)	1 (0.3)
Employment status
Unemployed	297 (95.8)	301 (89.3)	0.002*
Employed	13 (4.2)	36 (10.7)

Notes: ^†Age at marriage intervention (n=306), Comparison group (n=327). *Fisher’s exact test.

Table 2 Pre- and Post-Test Knowledge Between the Study Groups

Variables	Pre-Test			Post-Test
	Intervention (n=310)	Comparison (n=337)	P-value	Intervention (n=310)	Comparison (n=337)	P-value
	n (%)	n (%)		n (%)	n (%)
Definition*
Correct	262 (84.5)	269 (79.8)	0.12	297 (95.8)	271 (80.4)	<0.001**
Incorrect	48 (15.5)	68 (20.2)		13 (4.2)	66 (19.6)
Benefits of FP*
Correct	252 (81.2)	269 (79.8)	0.64	293 (94.5)	269 (79.8)	<0.001**
Incorrect	58 (18.8)	68 (20.2)		17 (5.5)	68 (20.2)
Importance of FP
Correct	249 (80.3)	273 (81.1)	0.83	288 (92.9)	277 (82.2)	<0.001**
Incorrect	61 (19.7)	64 (18.9)		22 (7.1%)	60 (17.8)
Types of FP*
Correct	232 (74.8)	282 (83.7)	0.005*	307 (99.0)	284 (84.3)	<0.001**
Incorrect	78 (25.2)	55 (16.3)		3 (1.0)	53 (15.7)
Location to obtain contraceptives
Correct	233 (75.2)	271 (80.4)	0.11	273 (88.1)	271 (80.4)	0.008*
Incorrect	77 (24.8)	66 (19.6)		37 (11.9)	66 (19.6)
Appropriate place to obtain contraceptives
Correct	224 (72.3)	252 (74.7)	0.47	246 (79.4)	238 (70.6)	0.011*
Incorrect	86 (27.7)	85 (25.2)		64 (20.6)	99 (29.4)
Mean (SD) Knowledge score	12.4 (5.8)	12.5 (5.4)	0.86	19.0 (5.3)	13.6 (6.4)	<0.001**

Table 3 Difference in Differences (DID) Analysis on Knowledge

	Pretest (%)	Posttest (%)	Change (%)
Intervention group (Good Knowledge)	18.4	61.3	42.9
Comparison group (Good Knowledge)	14.8	25.2	10.4
DID	3.6	36.1	32.5

Table 4 Binary Logistic Regression for Knowledge Between Study Groups, Post Intervention (n=647)

Variables	B (Regression Coefficient)	Adjusted Odds Ratio	95% CI for OR		p-value
			Lower	Upper
Study group
Intervention	1.55	4.69	3.356	6.566	<0.001*
Comparison Ref

Table 5 Pre- and Post-Test Attitude Between the Study Groups

Variable	Pretest			Post-Test
	Intervention (n=310)	Comparison (n=337)	P-value	Intervention (n=310	Comparison (n=337)	P-value
	Mean (±SD)	Mean (±SD)		Mean (±SD)	Mean (±SD)
The ideal interval between two consecutive pregnancies is 24 months	3.6 (1.3)	3.5 (1.4)	0.793	4.2 (1.2)	3.5 (1.5)	<0.001**
Intention to have any pregnancy within 1 year	2.8 (1.4)	2.8 (1.7)	0.886	2.1 (1.5)	2.8 (1.8)	<0.001**
Using postpartum contraceptive is shame	2.5 (1.5)	2.5 (1.3)	0.938	2.3 (1.4)	2.6 (1.3)	0.002*
PPFP use good for standards of living	3.5 (1.3)	3.3 (1.4)	0.110	4.0 (1.1)	3.3 (1.4)	<0.001**
Small family size makes family happy	3.5 (1.5)	3.5 (1.4)	0.480	4.2 (1.3)	3.4 (1.4)	<0.001**
Religion forbids contraceptive	3.1 (1.4)	3.2 (1.4)	0.129	2.7 (1.4)	3.2 (1.4)	<0.001**
FP is good for mother and child health	3.5 (1.4)	3.6 (1.5)	0.459	4.3 (1.2)	3.5 (1.5)	<0.001**
Discuss about FP with your partner	3.4 (1.4)	3.5 (1.3)	0.504	4.1 (1.2)	3.4 (1.4)	<0.001**
Unmarried women can use contraceptive	2.6 (1.5)	2.5 (1.3)	0.122	3.4 (1.2)	2.6 (1.3)	<0.001**
Attitude score	28.7 (3.9)	28.3 (5.1)	0.226	30.4 (4.3)	28.2 (4.6)	<0.001**

Table 6 DID Analysis on Attitude

	Pretest (%)	Posttest (%)	Change (%)
Intervention group (Positive Attitude)	57.1	79.0	21.9
Comparison Group (Positive attitude)	53.7	58.2	4.5
DID	3.4	37.2	17.4

Table 7 Binary Logistic Regression for Attitude Between Study Groups, Post Intervention (n=647)

Variables	B (Regression Coefficient)	Adjusted Odds Ratio	95% C.I. for OR		p-value
			Lower	Upper
Study group
Intervention	0.998	2.712	1.913	3.843	<0.001**
Comparison Ref.

Table 8 Pre- and Post-Test Intention Between the Study Groups

Variable	Pretest			Post-Test
	Intervention (n=310)	Comparison (n=337)	P-value	Intervention (n=310)	Comparison (n=337)	P-value
	Mean (±SD)	Mean (±SD)		Mean (±SD)	Mean (±SD)
Getting pregnant again at this time could cause health problem for me	2.5 (1.0)	2.4 (1.3)	0.26	3.8 (0.7)	2.3 (1.3)	<0.001**
Becoming pregnant now would be a serious problem for my family	2.0 (1.0)	1.9 (1.2)	0.11	3.8 (0.6)	1.9 (1.2)	<0.001**
Getting pregnant again now could be dangerous to baby	2.4 (1.2)	2.3 (1.3)	0.14	3.1 (1.3)	2.3 (1.3)	<0.001**
If I am sexually active and not using FP I’ d likely get pregnant	3.2 (1.0)	3.3 (1.0)	0.20	3.7 (0.8)	3.2 (1.0)	<0.001**
FPM are effective at preventing an unplanned pregnancy	3.3 (1.0)	3.4 (0.9)	0.20	3.9 (0.5)	3.4 (0.9)	<0.001**
Delay getting pregnant again allows me to spend more time with baby	3.3 (1.0)	3.3 (0.9)	0.60	3.9 (0.3)	3.2 (1.0)	<0.001**
Using FPM to space my pregnancies will help me have a healthier again	3.4 (1.0)	3.5 (0.9)	0.21	3.9 (0.4)	3.5 (0.8)	<0.001**
Having children is expensive and FP allows families care for them	3.4 (1.0)	3.4 (0.9)	0.78	3.8 (3.6)	3.5 (0.9)	<0.001**
Intention score	23.5 (3.5)	23.5 (3.5)	0.91	39.9 (2.9)	23.3 (3.6)	<0.001**

Table 9 Analysis on Intention

	Pretest (%)	Posttest (%)	Change (%)
Intervention group (High Intention)	29.0	98.4	69.4
Comparison group (High Intention)	28.8	20.5	−8.3
DID	0.2	77.9	77.7

Table 10 Binary Logistic Regression for Intention Between Study Groups, Post Intervention (n=647)

Variables	B (Regression Coefficient)	Adjusted Odds Ratio	95% CI for OR		p-value
			Lower	Upper
Study group
Intervention	3.595	36.419	22.305	59.464	<0.001**
Comparison Ref

Note: The significance is at **p<0.05