Clinical Trials Logo

Clinical Trial Summary

This study aims to generate evidence on the feasibility and effectiveness of engaging for-profit private sector family physicians and pharmacies to include family planning (FP) as a routine service in rural areas of Pakistan. The study will enlist family physicians and pharmacies in rural areas of Islamabad, Pakistan. Physicians will be randomly assigned to intervention and control groups. Those in intervention arm will received training on family planning and technical support for six months during the duration of the study, to evaluate the impact of training and support in expanding family planning coverage and impact.


Clinical Trial Description

Pakistan has an overall national goal under the National Plan of Action on Population Growth and the national commitment for the international FP2030 goals to expand family planning services by raising Contraceptive Prevalence Rate (CPR) to 60 percent by 2030 in Pakistan . Based on the Population Council's earlier Landscape study of Family planning services, the total market approach has not been fully adopted in Pakistan (The Population Council, 2016). It called for the inclusion of the private sector and pharmacies to expand access to family planning services and commodities. Another study by the Council also explored the potential of including the private sector and proposed the case for engaging family physicians in family planning . The National Plan of Action on Population Growth's recommendation no. 2 calls for engaging the for-profit private sector, especially family physicians in efforts to expand family planning services . However, a review of evidence in 2020 noted that no determined effort was found to engage private physicians to provide family planning in a sustainable and for-profit model. Internationally, the involvement of the private sector in family planning has been proposed as a High Impact Practice (HIP). The ultimate goal of this study is to provide a model for a successful engagement of male family physicians and pharmacies in family planning and, thereby, expanding family planning services in rural areas to achieve universal access to FP. The engagement of for-profit (male) family physicians in the provision of FP services in linkage with pharmacies will combine three high-impact practices (HIPs) in family planning: (i) private sector engagement (ii) male participation in family planning (Khan, K & Sathar, Z, 2020) and (iii) integrating pharmacies in the health system. This study aims to generate evidence on the feasibility and effectiveness of engaging for-profit private sector family physicians and pharmacies to include family planning (FP) as a routine service. It aims to fill the knowledge gap about the effectiveness of engaging private sector family physicians, and also the optimal approach of integrating family physicians' and pharmacies in Pakistan. Given that the lack of family planning services is particularly dire in rural areas, we situate the study in the rural areas of Islamabad. The study outcomes would provide evidence for advocacy for a sustainable model that can be scaled up to both rural and urban areas. The study involves an intervention to test the feasibility of engaging male family physicians and pharmacies in expanding the provision of family planning services in the rural areas, on the basis of a review of previous studies, and discussions with a number of private providers, pharmacists, government officials and researchers, The impact of the intervention is to be tested through a randomized control study. The study will enlist family physicians and pharmacies in rural Islamabad Capital Territory (ICT) , who will give their written and informed consent to participate in the study. Physicians will be randomly assigned to intervention and control groups with equal chances of falling into each group. - The intervention will provide male family physicians with training and technical support and integrates them with the nearest pharmacies or drug shops for vertical referrals. Technical support will include: - Supportive supervision - Peer-to-peer support - Strengthening referrals for long-acting reversible contraceptives (LARC) and permanent methods - Provision of information, education, and communication (IEC) material and LCD for display of visual material. - Branding of clinics with signboards - Provision of family planning prescription booklets The providers in the intervention group will receive the intervention package, the providers in the control group will continue to provide their services as usual with no exposure to intervention activities. After the end of the intervention period, providers that fall into control areas will be provided the same training. We hypothesize that the proposed intervention will enable male family physicians to provide information, counselling, family planning prescriptions, and referrals, as requested by clients and will result in increased uptake of contraceptive methods. To evaluate intervention outcomes, baseline assessments in both intervention and control arms will obtain quantitative data from family physicians and pharmacies. We will assess our primary and secondary outcomes using the Management Information System (MIS) tool for obtaining routine service statistics data from clinics and contraceptive sales data from pharmacies. After 6 months of completing the intervention, end-line assessments will be conducted with family physicians in both intervention and control arms to measure changes in providers' KAP towards FP due to intervention. We will also interview family physicians in the intervention arm to get their feedback on the intervention's effectiveness and feasibility through in-depth interviews. In addition, data on contraceptive availability and sales trends, monitoring stock positions, will be obtained from pharmacies, those nearest to; and linked with participating clinics, at the start, at 3 months, and at 6 months of intervention. The regular availability of contraceptives at the participating pharmacies will be ensured, and mechanisms to address declining stocks or stock outs would be addressed by linking with manufacturers and distributors and with health or population welfare department facilities if needed. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT05644886
Study type Interventional
Source Population Council
Contact Manager Research
Phone +92(051)9205566
Email abaloch@popcouncil.org
Status Recruiting
Phase N/A
Start date November 21, 2022
Completion date August 30, 2023

See also
  Status Clinical Trial Phase
Completed NCT02577601 - Impact of Combined Hormonal Contraceptives on UPA Phase 4
Completed NCT03153644 - Improving Contraceptive Care for Women With Medical Conditions
Completed NCT04112095 - Adherence With Continuous-dose Oral Contraceptive: Evaluation of Self-Selection and Use Phase 3
Recruiting NCT05521646 - Implementing Best Practice Postpartum Contraceptive Services Through a Quality Improvement Initiative N/A
Active, not recruiting NCT04291001 - Ovarian Function With ENG Implant and UPA Use Early Phase 1
Completed NCT04568980 - Assessment of Contraceptive Safety and Effectiveness in Cystic Fibrosis
Completed NCT03438682 - Real World Effectiveness and Safety of Hysteroscopic (Essure®) Compared to Laparoscopic Sterilization
Active, not recruiting NCT01948882 - Evaluation of Safety and Effectiveness of the Essure (Model ESS505) Device to Prevent Pregnancy in Women N/A
Enrolling by invitation NCT04997499 - Adolescent Subcutaneous (SQ) Injection Video Validation N/A
Recruiting NCT03589040 - Darunavir and Rilpivirine Interactions With Etonogestrel Contraceptive Implant Phase 2
Completed NCT04463680 - Rifampin and the Contraceptive Implant Phase 4
Completed NCT03154125 - Sayana® Press Extension Study Phase 3
Withdrawn NCT03725358 - A Cluster-RCT to Increase the Uptake of LARCs Among Adolescent Females and Young Women in Cameroon. N/A
Completed NCT02957630 - "E4/DRSP Endocrine Function, Metabolic Control and Hemostasis Study" Phase 1/Phase 2
Completed NCT02718222 - Impact and Performance of Institutionalizing Immediate Post-partum IUD Services N/A
Completed NCT02456584 - Pharmacodynamics and Pharmacokinetics Study of Existing DMPA Contraceptive Methods Phase 1
Recruiting NCT02121067 - LNG-IUS at 2 Weeks Postpartum Phase 4
Terminated NCT02169869 - Immediate Postplacental IUD Insertion N/A
Recruiting NCT02292056 - Medication Safety and Contraceptive Counseling for Reproductive Aged Women With Psychiatric Conditions N/A
Withdrawn NCT01930994 - Kenya Sino-implant (II) PK Study N/A