Kathryn Church


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    Objectives: In Bangladesh, women undergoing menstrual regulation (MR) (an approved procedure to regulate menstruation in women at risk of pregnancy) are a key group to target with contraceptive services. We used a randomised controlled trial to evaluate an intervention delivered by mobile phone which was designed to promote contraceptive use among MR clients in Bangladesh.

    Methods: In 2015/2016, we recruited 972 women after their MR procedure from 41 facilities, and randomised them to intervention or control groups. The intervention group were sent 11 automated, interactive voice messages with optional call centre counselling over 4-months post-MR. The primary outcome was self-reported LARC (long acting reversible contraceptive) use at four months post-MR; secondary outcomes were use of any effective modern method, subsequent pregnancy or MR and intimate partner violence (IPV).


    We used Logistic regression modelling to calculate odds ratios, allowing adjustment for baseline differences between the groups among pre-defined variables. In 2017, we conducted in-depth interviews (IDIs) with 30 trial participants to explore the intervention effects/non-effects.

    Results: We interviewed 773 participants (80%) at 4-months. Full details of the results from the trial and IDIs will be presented at the conference. Many IDI participants reported that they learnt more about contraception from the intervention however some women faced barriers to accessing the automated content due to low phone literacy. IDIs indicated a high frequency of phone sharing and that women’s phone use is sometimes monitored or controlled by others in the home. The majority of IDI participants had told their husbands about the study and their MR.

    Conclusions: These findings highlight the importance of considering familial contexts when designing interventions that reach into homes. The results of this trial will help us to understand whether this type of intervention can be successfully translated to the Bangladesh context.