Evaluation of the effect of the Momentum project on family planning outcomes among first-time mothers aged 15-24 years in Kinshasa, DRC

Anastasia J Gage; Pierre Z Akilimali; Francine E Wood; Rianne Gay; C Olivia Padis; Jane T Bertrand

doi:10.1016/j.contraception.2023.110088

Evaluation of the effect of the Momentum project on family planning outcomes among first-time mothers aged 15-24 years in Kinshasa, DRC

Contraception. 2023 Sep:125:110088. doi: 10.1016/j.contraception.2023.110088. Epub 2023 Jun 16.

Authors

Anastasia J Gage¹, Pierre Z Akilimali², Francine E Wood³, Rianne Gay⁴, C Olivia Padis⁵, Jane T Bertrand⁶

Affiliations

¹ Department of Health Policy and Management, Tulane University, School of Public Health and Tropical Medicine, New Orleans, LA, United States. Electronic address: agage@tulane.edu.
² University of Kinshasa, School of Public Health, Kinshasa, Democratic Republic of the Congo. Electronic address: pierretulanefp@gmail.com.
³ Department of Health Policy and Management, Tulane University, School of Public Health and Tropical Medicine, New Orleans, LA, United States. Electronic address: fwood@tulane.edu.
⁴ Tulane International, LLC, Kinshasa, Democratic Republic of the Congo. Electronic address: rianne_gay@yahoo.fr.
⁵ Department of Health Policy and Management, Tulane University, School of Public Health and Tropical Medicine, New Orleans, LA, United States. Electronic address: cpadis@tulane.edu.
⁶ Department of Health Policy and Management, Tulane University, School of Public Health and Tropical Medicine, New Orleans, LA, United States. Electronic address: bertrand@tulane.edu.

PMID: 37331463
DOI: 10.1016/j.contraception.2023.110088

Abstract

Objectives: This article presents the effect of Momentum, a nursing student-led community-based service delivery project, on postpartum family planning (FP) outcomes among first-time mothers in Kinshasa, Democratic Republic of the Congo.

Study design: We employed a quasi-experimental design, with three intervention and three comparison health zones (HZ). Data were collected through interviewer-administered questionnaires in 2018 and 2020. The sample consisted of 1927 nulliparous women aged 15-24 years who were 6 months pregnant at baseline. Random effects and treatment effects models were used to assess the effect of Momentum on 14 postpartum FP outcomes.

Results: The intervention group was associated with a unit increase of 0.6 (95% confidence interval [CI]: 0.4, 0.8)) in contraceptive knowledge and personal agency (95% CI: 0.3, 0.9), a unit decrease of 0.9 (95% CI: -1.2, -0.5) in the number of FP myths/misconceptions endorsed, and percentage point increases of 23.4 (95% CI: 0.2, 0.3) in FP discussion with a health worker, 13.0 (95% CI: 0.1, 0.2) in obtaining a contraceptive method within 6 weeks of delivery, and 13.3 (95% CI: 0.1, 0.2) in modern contraceptive use within 12 months of delivery. Intervention effects included percentage point increases of 5.4 (95% CI: 0.0, 0.1) in partner discussion and 15.4 (95% CI: 0.1, 0.2) in perceived community support for postpartum FP use. The level of exposure to Momentum was significantly associated with all behavioral outcomes.

Conclusions: The study demonstrated the effect of Momentum on increased postpartum FP-related knowledge, perceived norms, personal agency, partner discussion, and modern contraceptive use.

Implications: Community-based service delivery by nursing students can potentially lead to improved postpartum FP outcomes among urban adolescent and young first-time mothers in other provinces of the Democratic Republic of the Congo and other African countries.

Keywords: Democratic Republic of the Congo; Evaluation; Longitudinal; Postpartum family planning; Urban.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Contraception Behavior
Contraceptive Agents
Democratic Republic of the Congo
Family Planning Services* / methods
Female
Humans
Mothers*
Pregnancy
Sex Education

Substances

Contraceptive Agents