Figure 1
Quasi-experimental design of quantitative method.
Table 1
Study variables.
| INDICATOR | OPERATIONAL DESCRIPTION OF INDICATOR | NUMERATOR | DENOMINATOR |
|---|---|---|---|
| 1. Contraceptive prevalence | Percentage of mothers of children ages 0–23 months who are using (or whose partner is using) a modern contraceptive method | Number of mothers of children ages 0–23 months who are using (or whose partner is using) a modern contraceptive method | Number of mothers of children ages 0–23 months |
| 2. Future fertility intentions | Percentage of mothers of children ages 0–23 months who report wanting to wait – at least 2 years from now or after the birth of the child they are expecting – to have another child | Number of mothers of children ages 0–23 months who report wanting to wait – at least 2 years from now or after the birth of the child they are expecting – to have another child | Number of mothers of children ages 0–23 months in the survey |
| 3. Method mix | Percent distribution of modern contraceptive users among mothers of children ages 0–23 months | Number of mothers of children ages 0–23 months who report currently using contraception by a modern method | Number of mothers of children ages 0–23 months who are currently using any contraception |
| 4. Reasons for non-use | Percent distribution of mothers of children ages 0–23 months – who want to either postpone or avoid their next child but are not using a contraceptive method – by reasons for non-use | Number of mothers of children ages 0–23 months who want to either postpone or avoid their next child but are not using a contraceptive method, by reasons for non-use | Number of mothers of children ages 0–23 months who are not pregnant at the time of the survey – and who want to either postpone or avoid their next child – but are not using a contraceptive method |
| 5. Total unmet need for family planning | Percentage of mothers of children ages 0–23 months – who are either (i) pregnant and want to either postpone or avoid their next child, or are (ii) fecund and want to either postpone or avoid their next child – but are not using a contraceptive method | Number of mothers of children ages 0–23 months – who are either (i) pregnant and want to either postpone or avoid their next child, or are (ii) fecund and want to either postpone or avoid their next child – but are not using a contraceptive method | Number of mothers of children ages 0–23 months in the survey |
| 6. Unmet need for spacing | Percentage of mothers of children ages 0–23 months – who are either (i) pregnant and want to postpone their next child, or (ii) fecund and want to postpone their next child – but are not using a contraceptive method | Number of mothers of children ages 0–23 months – who are either (i) pregnant and want to postpone their next child, or (ii) fecund and want to postpone their next child – but are not using a contraceptive method | Number of mothers of children ages 0–23 months in the survey |
| 7. Knowledge of modern family planning methods | Percentage of mothers of children ages 0–23 months who know at least 3 modern methods of family planning | Number of mothers of children ages 0–23 months who know at least 3 modern methods of family planning | Number of mothers of children ages 0–23 months in the survey |
| 8. Knowledge of sources of modern contraceptive methods | Percentage of mothers of children ages 0–23 months who know at least one place or person where they can obtain a modern contraceptive method | Number of mothers of children ages 0–23 months who know at least one place or person where they can obtain a modern contraceptive method | Number of mothers of children ages 0–23 months in the survey |
| 9. Knowledge of adequate birth spacing | Percentage of mothers of children ages 0–23 months who know that a woman should wait at least 24 months after she gives birth before attempting to become pregnant again | Number of mothers of children ages 0–23 months who know that a woman should wait at least 24 months after she gives birth before attempting to become pregnant again | Number of mothers of children ages 0–23 months in the survey |
| 10. Knowledge of benefits of adequate birth spacing | Percentage of mothers of children ages 0–23 months who know one or more benefits of waiting at least 24 months after giving birth before attempting to become pregnant again | Number of mothers of children ages 0–23 months who know one or more benefits of waiting at least 24 months after giving birth before attempting to become pregnant again | Number of mothers of children ages 0–23 months in the survey |
| 11. Knowledge of benefits of delaying a pregnancy until the age of 18 years | Percentage of mothers of children ages 0–23 months who know at least one benefit of a woman delaying a pregnancy until the age of 18 years | Number of mothers of children ages 0–23 months who know at least one benefit of a woman delaying a pregnancy until the age of 18 years | Number of mothers of children ages 0–23 months in the survey |
| 12. Knowledge of increased risk in pregnancies over the age of 34 years | Percentage of mothers of children ages 0–23 months who know at least one health problem that may occur when a woman becomes pregnant when she is older than 34 years. | Number of mothers of children ages 0–23 months who know at least one health problem that may occur when a woman becomes pregnant when she is older than 34 years. | Number of mothers of children ages 0–23 months in the survey |
| 13. Knowledge of increased risk for high parity women | Percentage of mothers of children ages 0–23 months who know at least one health problem that can occur when a woman who has ≥4 children becomes pregnant | Number of mothers of children ages 0–23 months who know at least one health problem that can occur when a woman who has ≥4 children becomes pregnant | Number of mothers of children ages 0–23 months in the survey |
Figure 2
Theory of Change of Channels of Hope model.
Table 2
Description of all sampled study subjects in Kenya and Ghana combined, by age of mothers, age of children, and sex of children, 2015–2018.
| CHARACTERISTICS | BASELINE SURVEY | ENDLINE SURVEY | TOTAL (BASELINE AND ENDLINE) | |||
|---|---|---|---|---|---|---|
| NUMBER | PERCENTAGE | NUMBER | PERCENTAGE | NUMBER | PERCENTAGE | |
| Age of Mothers | ||||||
| <20 | 167 | 7.7 | 139 | 6.3 | 306 | 7.0 |
| 20–24 | 645 | 29.7 | 583 | 26.5 | 1,228 | 28.1 |
| 25–29 | 709 | 32.6 | 669 | 30.4 | 1,378 | 31.5 |
| 30–34 | 414 | 19.0 | 491 | 22.3 | 905 | 20.7 |
| 35+ | 239 | 11.0 | 316 | 14.4 | 555 | 12.7 |
| Total | 2,174 | 100 | 2,198 | 100 | 4,372 | 100 |
| Age of the children | ||||||
| <12 months | 1,202 | 55.3 | 1,160 | 52.8 | 2,362 | 54.0 |
| 12–23 months | 972 | 44.7 | 1,038 | 47.2 | 2,010 | 46.0 |
| Total | 2,174 | 100.0 | 2,198 | 100.0 | 4,372 | 100.0 |
| Sex of the children | ||||||
| Girl | 1,049 | 48.3 | 1,045 | 47.5 | 2,094 | 47.9 |
| Boy | 1,125 | 51.7 | 1,153 | 52.5 | 2,278 | 52.1 |
| Total | 2,174 | 100.0 | 2,198 | 100.0 | 4,372 | 100.0 |
Table 3
Before and After Comparison in Knowledge on Contraceptive Methods by Country, 2015–2018.
| KNOWLEDGE ON | KENYA | GHANA | TOTAL | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BASELINE | ENDLINE | BASELINE | ENDLINE | BASELINE | ENDLINE | TOTAL | ||||||||
| N | % OF N1 | N | % OF N2 | N | % OF N3 | N | % OF N4 | N | % OF N5 | N | % OF N6 | N | % OF N7 | |
| Female sterilization | 209 | 21.2 | 414 | 41.7 | 721 | 60.7 | 770 | 63.8 | 930 | 42.8 | 1,184 | 53.9 | 2,114 | 48.4 |
| Male sterilization | 126 | 12.8 | 136 | 13.7 | 366 | 30.8 | 263 | 21.8 | 492 | 22.6 | 399 | 18.2 | 891 | 20.4 |
| IUD | 214 | 21.7 | 275 | 27.7 | 474 | 39.9 | 500 | 41.5 | 688 | 31.6 | 775 | 35.3 | 1,463 | 33.5 |
| Injectable | 677 | 68.7 | 880 | 88.7 | 1,056 | 88.9 | 1,137 | 94.3 | 1,733 | 79.7 | 2,017 | 91.8 | 3,750 | 85.8 |
| Implants | 429 | 43.5 | 673 | 67.8 | 822 | 69.2 | 996 | 82.6 | 1,251 | 57.5 | 1,669 | 75.9 | 2,920 | 66.8 |
| Pills | 487 | 49.4 | 647 | 65.2 | 993 | 83.6 | 1,097 | 91.0 | 1,480 | 68.1 | 1,744 | 79.3 | 3,224 | 73.7 |
| Male condom | 735 | 74.5 | 882 | 88.9 | 1,038 | 87.4 | 1,062 | 88.1 | 1,773 | 81.6 | 1,944 | 88.4 | 3,717 | 85.0 |
| Female condom | 284 | 28.8 | 365 | 36.8 | 791 | 66.6 | 723 | 60.0 | 1,075 | 49.4 | 1,088 | 49.5 | 2,163 | 49.5 |
| LAM | 611 | 62.0 | 457 | 46.1 | 304 | 25.6 | 434 | 36.0 | 915 | 42.1 | 891 | 40.5 | 1,806 | 41.3 |
| SDM/CycleBeads® | 496 | 50.3 | 443 | 44.7 | 365 | 30.7 | 542 | 44.9 | 861 | 39.6 | 985 | 44.8 | 1,846 | 42.2 |
| Emergency contraceptive | 169 | 17.1 | 294 | 29.6 | 343 | 28.9 | 411 | 34.1 | 512 | 23.6 | 705 | 32.1 | 1,217 | 27.8 |
| Other method | 65 | 6.6 | 102 | 10.3 | 27 | 2.3 | 23 | 1.9 | 92 | 4.2 | 125 | 5.7 | 217 | 5.0 |
| At least three methods | 695 | 70.5 | 855 | 86.2 | 1,068 | 89.9 | 1,128 | 93.5 | 1,763 | 81.1 | 1,983 | 90.2 | 3,746 | 85.7 |
| At least three modern methods | 564 | 57.2 | 786 | 79.2 | 1,061 | 89.3 | 1,119 | 92.8 | 1,625 | 74.7 | 1,905 | 86.7 | 3,530 | 80.7 |
[i] % = Percentage;
N1 = Number of women respondents in Kenya, at baseline = 986; N2 = Number of women respondents in Kenya, at endline = 992;
N3 = Number of women respondents in Ghana, at baseline = 1,188; N4 = Number of women respondents in Ghana, at endline = 1,206; N5 = Combined number of women respondents in Kenya and Ghana, at baseline = 2,174; N6 = Combined number of women respondents in Kenya and Ghana, at endline = 2,198; N7= Total number of women respondents in Kenya and Ghana, at baseline and endline, combined = 4,372.
Table 4
Number and proportion changes of type of contraceptive used in Kenya and Ghana study areas, 2015–2018.
| CONTRACEPTIVE METHODS USED | KENYA | GHANA | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ISIOLO/OLDONYIRO (COMPARISON) | LAISAMIS (INTERVENTION) | WEST GONJA (INTERVENTION) | ZABZUGU (COMPARISON) | TOTAL† | |||||||||||
| BASELINE | ENDLINE | CHANGE* | BASELINE | ENDLINE | CHANGE* | BASELINE | ENDLINE | CHANGE* | BASELINE | ENDLINE | CHANGE* | BASELINE | ENDLINE | CHANGE* | |
| Injectable | 105 | 115 | +9.5% | 7 | 24 | +242.9% | 62 | 51 | –17.7% | 39 | 58 | +48.7% | 213 | 248 | +16.4% |
| Implants | 27 | 32 | +18.5% | 4 | 6 | +50.0% | 29 | 46 | +58.6% | 8 | 9 | +12.5% | 68 | 93 | +36.8% |
| Pills | 16 | 11 | –31.3% | 3 | 4 | +33.3% | 26 | 18 | –30.8% | 5 | 11 | +120.0% | 50 | 44 | –12% |
| LAM | 44 | 31 | –29.5% | 185 | 19 | –89.7% | 11 | 7 | –36.4% | 1 | 2 | +100.0% | 241 | 59 | –75.5% |
| SDM | 24 | 4 | –83.3% | 16 | 3 | –81.3% | 9 | 8 | –11.1% | 0 | 5 | N/A | 49 | 20 | –59.2% |
| Male condom | 11 | 1 | –90.9% | 10 | 23 | +130.0% | 5 | 1 | –80.0% | 3 | 1 | –66.7% | 29 | 26 | –10.3% |
| Other modern methods | 3 | 2 | –33.3% | 1 | 1 | zero | 3 | 1 | –66.7% | 0 | 0 | N/A | 7 | 3 | –57.1% |
| Other method | 2 | 1 | –50.0% | 3 | 27 | +800% | 2 | 7 | +250% | 3 | 6 | +100% | 10 | 41 | +310.0% |
| Any FP method | 234 | 196 | –16.2% | 233 | 107 | –54.1% | 140 | 139 | –0.7% | 57 | 92 | +61.4% | 664 | 534 | –19.6% |
| Modern CP Mix | 162 | 160 | –1.2% | 25 | 58 | +132.0% | 119 | 117 | –1.7% | 53 | 79 | +49.1% | 359 | 414 | +15.3% |
[i] * As a proportion of Baseline; N/A Not applicable, as a proportion of zero cannot be determined; †Comparison and intervention districts in both Kenya and Ghana, combined.
Table 5
Family Planning Methods Used and Needs and Ideal Pregnancy Interval, Benefits and Health Problems-Related Knowledge by Survey and Intervention Status in Kenya and Ghana, combined.
| INDICATOR | BASELINE SURVEY | ENDLINE SURVEY | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| COMPARISON | INTERVENTION | TOTAL | COMPARISON | INTERVENTION | TOTAL | |||||||
| N | % OF N1 | N | % OF N2 | N | % OF N3 | N | % OF N4 | N | % OF N5 | N | % OF N6 | |
| Used modern FP method | 215 | 20.0 | 144 | 13.1 | 359 | 16.5 | 239 | 21.4 | 177 | 16.4 | 416 | 18.9 |
| Future fertility intention | 342 | 31.8 | 336 | 30.6 | 678 | 31.2 | 640 | 57.3 | 733 | 67.8 | 1373 | 62.5 |
| FP method mix | 214 | 19.9 | 142 | 12.9 | 356 | 16.4 | 239 | 83.0 | 177 | 71.4 | 416 | 18.9 |
| Total unmet need | 325 | 30.2 | 260 | 23.7 | 585 | 26.9 | 532 | 21.4 | 610 | 16.4 | 1142 | 52.0 |
| Unmet need for spacing | 215 | 20.0 | 180 | 16.4 | 395 | 18.2 | 431 | 38.6 | 514 | 47.5 | 945 | 43.0 |
| Knew ≥3 modern FP methods | 884 | 82.1 | 741 | 67.5 | 1625 | 74.7 | 971 | 86.9 | 934 | 86.4 | 1905 | 86.7 |
| Knew ≥1 source for modern FP (Health Facility/Pharmacist) | 729 | 67.7 | 678 | 61.8 | 1407 | 64.7 | 759 | 67.9 | 630 | 58.3 | 1389 | 63.2 |
| Next pregnancy ideal waiting time (≥2 years) | 493 | 45.8 | 490 | 44.7 | 983 | 45.2 | 848 | 75.9 | 897 | 83.0 | 1745 | 79.4 |
| Reported one or more benefits of ≥24 months spacing for next pregnancy | 477 | 44.3 | 557 | 50.8 | 1034 | 47.6 | 640 | 57.3 | 733 | 67.8 | 1373 | 62.5 |
| Mentioned at least one benefit of age ≥18 years for first pregnancy | 602 | 55.9 | 731 | 66.6 | 1333 | 61.3 | 710 | 63.6 | 777 | 71.9 | 1487 | 67.7 |
| Mentioned at least one health problem for pregnancy after age 34 years | 568 | 52.7 | 666 | 60.7 | 1234 | 56.8 | 764 | 68.4 | 826 | 76.4 | 1590 | 72.3 |
| Mentioned at least one health problem for pregnancy after having four children | 378 | 35.1 | 280 | 25.5 | 658 | 30.3 | 227 | 20.3 | 225 | 20.8 | 452 | 20.6 |
[i] n = Number; % = Percentage; N1 = Number of women respondents at baseline in comparison districts in Kenya and Ghana combined = 1,077; N2 = Number of women respondents at baseline in intervention districts in Kenya and Ghana combined = 1,097; N3 = Number of women respondents at baseline in comparison and intervention districts in Kenya and Ghana combined = 2,174; N4 = Number of women respondents at endline in comparison districts in Kenya and Ghana combined = 1,117; N5 = Number of women respondents at endline in intervention districts in Kenya and Ghana combined = 1,081; N6 = Number of women respondents at endline in comparison and intervention districts in Kenya and Ghana combined = 2,198.