PROJECT DATES: JUNE 2012 – PRESENT
Impact of Comprehensive Family Planning and Post Abortion Care in Luanda, Angola
The Bixby Center is collaborating with the Ministry of Health and PSI Angola to provide, for the first time in a post war country, the necessary empirical evidence to support investment in family planning and safe abortion as part of a larger strategy to reduce maternal mortality and decrease unwanted fertility. Through this collaboration we aim: (1) to increase awareness and use of modern contraceptive methods; (2) to reduce the number of unwanted pregnancies and abortion-related morbidity and mortality; (3) to assess the cost effectiveness of the intervention. By improving distribution of contraceptives in private pharmacies, strengthening facility-based family planning and PAC resources, and extending key facility-based services and education into the least accessible communities using a network of health outreach workers, this project will hopefully achieve these goals. The evidence from the findings will be used for fundraising, empowering communities and supporting the current decentralization process by giving districts evidence-driven recommendations for determining level of spending to achieve reductions in maternal and child mortality, fertility and ultimately slow population growth in Angola.
To assess the current state of reproductive health services in Luanda in order to design the appropriate interventions, as well as monitor the effects of the interventions, data were collected at both community and facility levels in September 2012. Baseline community-level data were gathered by conducting in-depth interviews with a sample of approximately 1,500 adult women throughout the Luanda Province, while baseline facility-level data included retrospective review of the most recent year of aggregated data from all participating health facilities (N=36) in two key municipalities (Viana and Cacuaco) of Luanda where future interventions will be tested. The Bixby Center has analyzed the data and made recommendations for improving comprehensive family planning in Luanda. These recommendations were presented to the Ministry of Health and other key stakeholders in February 2014. The full reports and presentations of the data can be found here:
- Angola Health Facility Assessment Report
- Angola Facility Assessment Presentation
- Angola Community Level Assessment Report
- Angola Community Survey Presentation
In addition to the collection of quantitative community- and facility-level data, a qualitative study was also conducted by the Bixby Center. The goal of this qualitative study was to better understand the context in which Angolan women make decisions about how many children to have, when to have them, and how to prevent an unwanted or mistimed pregnancy. In-depth interviews were conducted with 27 women, focusing on the influence of partners, family members, and other members of the community on fertility intentions; current knowledge and attitudes about methods of contraception; use of contraceptive methods; and perceptions of community norms and attitudes toward family planning services. Additional interviews were conducted with local key informants to better understand the historical and cultural context in which women make such decisions. We hope to publish these data with recommendations in the near future.
The Bixby Center continues to provide technical support to the Ministry of Health and PSI Angola, as programs are designed based on the findings from the quantitative and qualitative research. Researchers at the Bixby Center are currently working on manuscripts related to the following topics: 1) Return on investment for providing comprehensive family planning and post-abortion care services in Angola; 2) Pregnancy intentions and need for contraception among women in Luanda Province, Angola; 3) Social support, exposure to family planning messaging, and family planning use among women in Angola; 4) Varying family planning strategies across age categories; and 5) Health systems strengthening through health worker training.