1. Impact of Interpersonal Communication on uptake of Birth Spacing in Somaliland November 25 th, 2014

2. Health Consortium for the Somali People (HCS) The Health Consortium for the Somali People (HCS) provides innovative and collaborative health solutions, bringing health experts together to deliver a holistic approach to better serve the Somali people. HCS was designed with both the public and private health sector in mind, ensuring equitable and efficient access to quality products and services. HCS is the most responsive implementing health partner operating in all 3 zones of Somalia. HCS has a proven track record of implementing EPHS service delivery in collaboration with the ministries of health

3. Background I n 2010, PSI/Somaliland as part of the UKAID funded Essential Package of Health Services pilot, launched a maternal and child health interpersonal communication program covering antenatal care, facility delivery, postnatal care, infant and young child feeding, and modern birth spacing I n 2014, PSI/Somaliland conducted a study to evaluate the effect of the program on behaviors and knowledge; this presentation focuses on birth spacing. R esearch objectives, among others: - To assess the impact of the PSI IPC intervention on antenatal care (ANC), postnatal care (PNC), safe delivery and infant and young child feeding (IYCF) practices among WRA - To assess the impact of the PSI IPC intervention on birth spacing and uptake of modern contraception methods among WRA - To assess correlates of ANC, PNC, safe delivery, IYCF, and birth spacing/family planning practices in the PSI IPC intervention areas compared to non-intervention areas

4. Research methodology A post-test intervention-comparison design was used. Married Somali women with a child 6-11 months living in the four regions where the program is active were included in the study: - women who participated in the program when pregnant (N=327) - women who participated in the program while lactating with a child under six months (N=328) - Comparison women (N=307) recruited from households in non-intervention areas A questionnaire was administered covering birth spacing behaviors, knowledge, and attitudes The data were analyzed using logistic regression to measure differences between groups

5. Study participants

6. Participant Sociodemographics

8. Main findings

9. Knows 3 or more methods of birth spacing

10. Knows LAM is effective for 6 months

11. Attitudes about pills

12. Attitudes about injectibles

13. Ever used birth spacing

14. Currently using birth spacing

15. Participants’ exposure to other MCH communications

17. Summary results Women who had been exposed to IPC were significantly more likely than the comparison group to currently be using any form of birth spacing Among those currently using birth spacing, the lactating group was significantly more likely than the other two to be using a modern method Intervention women had significantly better knowledge and attitudes about modern birth spacing than comparison women on all measures

18. Conclusions The program appears to be effective in changing knowledge, attitudes, and behaviors around modern birth spacing, though the design does not account for self-selection bias These types of program should be taken to scale in similar contexts The increased adoption of MBS among the lactating group (who more recently received the intervention) suggests that recency of messaging may be key to motivating uptake of MBS

19. Thank You! To learn more visit www.hcsshare.org