Impact of training on uptake of family planning methods in four hospitals in Rwanda

Abstract

Background Availability of health care providers trained in family planning delivery increase uptake of family planning methods and this increased uptake is needed to address the problem of unmet needs for family planning. Unmet needs for family planning in Rwanda are currently estimated at 14%. Center for Reproductive Health Training at the University of Michigan (UM-CIRHT) together with University of Rwanda has conducted a training ( in multiple sessions ) of health care providers in four hospitals in Rwanda hosting obstetrics and gynecology residents ,medical , nurse and midwives students. This study was aimed to assess the impact of training on family planning uptake in family planning services in four hospitals which have benefited from the very training. Methods We have conducted a cross-sectional study in four hospitals namely, data were collected from family planning clinics. Data about uptake of family planning methods before and after training have been collected, paired t-test has been used to determine the difference in uptake of family planning before and after training and p value <0.05 has been considered as statistically significant. Results There has been an increase in uptake of family planning methods after training and this increase is statistically significant at one study site (Rwamagana Hospital) with p value of 0.01. In addition, there has been a statistically significant decrease in uptake of IUD after training at Muhima hospital, p=0.016. The decrease in IUD uptake after the training was not statistically significant at Rwamagana and CHUB (p values were respectively 0.264 and 0.15). One hospital (CHUK) has no recorded data before training. After training, there has been an increase in uptake of implants (implanon and jadelle) in all three hospitals with p values of 0.158;0.013 and 0.85 for Muhima, Rwamagana and CHUB respectively. This change from IUD to implants might have resulted from provider competences and from change of client’s preferences after counseling and discussion of different methods with the health care provider. Conclusion After training of providers on family planning, there is an increase in family planning uptake and a selective shift to some specific methods according to their competences. Intervention to improve family planning uptake should include capacity building of health care providers.