Testing a proof of concept model for group couples counseling in family planning in Northern Uganda

• Published in: The Pan African medical journal Vol. 30; no. 179; p. 179
• Main Authors: Ojanduru, Lillian, Ojamuge, Dickens, DuComb, Lauren, Cachan, Jeannette, Spindler, Esther
• Format: Journal Article
• Language: English
• Published: Uganda African Field Epidemiology Network 2018; The African Field Epidemiology Network; The Pan African Medical Journal
• Subjects: Adolescent; Adult; Amenorrhea; Births; Community; Counseling; Counseling - methods; couples counseling; Family planning; Family Planning Services - methods; Female; Fertility; Fertility - physiology; fertility awareness methods; Focus Groups; group counseling; Health Knowledge, Attitudes, Practice; Health Services Accessibility; Humans; lactational amenorrhea method; Male; Methods; Models, Theoretical; Patient Satisfaction - statistics & numerical data; Pregnancy; proof of concept; Proof of Concept Study; Reproductive health; Rural Population; standard days method; twoday method; Uganda; Womens health; Young Adult; Uganda; Family planning; fertility awareness methods; couples counseling; Lactational Amenorrhea Method; group counseling; Uganda; TwoDay Method; proof of concept; Standard Days Method
• ISSN: 1937-8688; 1937-8688
• DOI: 10.11604/pamj.2018.30.179.12670

The post-conflict Acholi sub-region of Uganda is undergoing a period of transition that is influencing access, acceptability and use of family planning (FP). Low FP use and high unmet need for FP in Uganda's northern region provides a unique opportunity to test a community-based group counseling approach to reduce unintended pregnancies among young couples. We share findings from a proof of concept testing model in delivering fertility awareness methods (FAM) to groups of couples by trained non-health community youth agents. The group counseling model was developed for couples interested in two FAM-standard days method (SDM) and TwoDay Method-within rural communities in Northern Uganda. WALAN was tested in a three-month proof of concept phase, employing 24 direct observations of group counseling sessions; quantitative interviews with 9 couples using either SDM or TwoDay Method; 2 focus group discussions with youth facilitators, and; 9 key informant interviews with providers and leaders. The proof of concept results suggest model feasibility and acceptability among participating communities. Couples learned how to use FAM correctly. All 9 interviewed female users reported 100% correct knowledge of method use. Couples also reported high levels of satisfaction for both methods. SDM and TwoDay Method participants reported comfort and satisfaction in learning about FAM in small groups with other couples. The proof of concept phase confirmed intervention feasibility, albeit with some model adjustments. The results were used to inform the pilot intervention, launched in April 2016 within 15 other villages in the same region.