Contraception Clinical Trial
Official title:
Development and Evaluation of an Intervention to Increase Family Planning Use Among Female Sex Workers in Kenya
-Purpose: To develop and evaluate an intervention designed to improve consistent
contraceptive use and dual method use in particular, among female sex workers (FSWs) in Rift
Valley Province in Kenya.
Design: A qualitative descriptive study will be conducted to develop the intervention. A
quasi-experimental, non-randomized, two-group, pre-/post-intervention design will be used to
evaluate the intervention.
Study Population: FSWs living in Naivasha, Gilgil, and Nanyuki, Rift Valley Province.
Study Duration: Phase I - 3 months Phase II - 12 months Objectives: Develop an intervention
designed to increase contraceptive use among FSWs by incorporating formative data and
behavioral theory and by involving the target audience and service providers in the
development of the intervention.
Examine the effectiveness of the intervention at increasing non-barrier modern contraceptive
use and dual method use among FSWs.
Assess the feasibility and acceptability of the intervention, on the parts of both the
clients (FSW) and service providers.
Estimate the unit cost to provide these services to one client. Study Site: Rift Valley
Province, Kenya
The goal of this study is to develop and evaluate a theory-based intervention that could be
incorporated into routine health services to improve the sexual and reproductive health of
women who engage in sex work if demonstrated to be effective. To accomplish this goal, the
study will be conducted in two phases. During the first phase of the study, FSWs and service
providers in the study sites will assist in the design of the intervention, in an effort to
increase the likelihood that it will be accepted, feasible, and effective. Brief formative
research will be conducted with FSWs and service providers, followed by working group
meetings with self-selected FSWs, service providers, and GSKenya representatives who will
review data and work with study investigators and/or their designees to design the
intervention. During the second phase of this study, the intervention will be implemented and
evaluated.
The study is planned for two sites within Rift Valley Province, Kenya. The first "site" is
comprised of two adjacent towns, Naivasha and Gilgil. The town of Nanyuki will serve as the
second site.
Based on findings from the formative phase of this study, and on observations and feedback
from providers, a package of enhancements to the current package of services delivered to FSW
will be implemented and evaluated.
- Family Planning (FP) Messaging for peer educators and informational materials material -
Peer educators will be trained using existing materials to deliver accurate messaging on
FP/dual method use, during individual encounters and in group sessions.
- Screening for unmet FP need in drop-in centers - Integration of FP needs screening in
the service delivery points will increase the number of FSW accessing FP. This will be
done through sensitization of service providers and provision of a brief job aid that
can be used to screening clients for unmet need, including unmet need for dual method
use.
- Providers FP counseling job aid - The AIDS, Population and Health Integrated Assistance
(APHIA) Plus project will adapt the existing Balanced Counseling Strategy Plus: A
Toolkit for Family Planning Service Providers Working in High HIV/Sexually Transmitted
Infection (STI) Prevalence Settings for providers to use within the context of the DICs
and in referral sites in the catchment area.
- Commodities - increasing method mix - The methods that will be available to all women
attending services at the DIC will be expanded. In addition to the current oral
contraceptive pills, DMPA, male and female condoms, both the intra-uterine contraceptive
devices (IUCD) and implants will be added to the mix of methods available.
Hours of DIC operation - Based on findings from the formative phase of the study, the hours
of operation for DICs will be extended into the late evening hours to accommodate the
schedules of FSW.
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