Evaluation of Community Education Interventions in Sexual and Reproductive Health Services in Urban-Marginal Areas of La Paz, Bo

Published by the Frontiers in Reproductive Health Program at the Population Council, this 41-page publication describes a community-based reproductive health education and outreach
intervention that was tested in clinics in marginalised rural areas
around La Paz. The study evaluated the intervention's impact on
service utilisation, particularly by adolescents, men, and non- pregnant women, and community satisfaction. Findings showed
that efforts to increase knowledge of and demand for reproductive
health services must be accompanied by service strengthening measures.

From the Summary

The purpose of this study was to strengthen community strategies to improve quality of care services first implemented as part of a Ministry of Health and Prevention (MSPS) and World Health Organization (WHO) project in 1997-98. That intervention focused on health facilities, and the accompanying community interventions were found to be insufficient. Groups that do not regularly attend health facilities, such as adolescents, men, and women with older or no children, remained out of reach. To reach these target audiences and improve community demand for services, CIDEM [Centro de Información y Desarrollo de la Mujer (Center for Information and Development of Women)] implemented a community education intervention focusing on sexual and reproductive health and rights. Research was carried out in public health centers of urban and marginalized rural areas in La Paz.

CIDEM collected both qualitative and quantitative data for this study with a quasi-experimental design. Four health centers were selected, with two assigned to receive the intervention and two monitored as control sites. All four centers previously participated in the MSPS/WHO quality improvement program.

A baseline analysis was conducted during the first phase of the project. Using this information, researchers designed and implemented educational community strategies and interventions in the health service centers. They also developed information, education, and communication (IEC) materials to support the educational sessions and the orientation activities in the health centers. After 15 months, staff conducted a post-intervention impact evaluation. Informed consent was obtained from all participants.

Results showed that the interventions improved access to and utilization of sexual and reproductive health services among men, women, and adolescents. They also increased beneficiaries’ reproductive health knowledge, and improved client attitudes and satisfaction with services. Researchers found that efforts to increase knowledge of and demand for reproductive health services must be accompanied by service strengthening measures.