Feasibility testing of a community dialogue approach for promoting the uptake of family planning and contraceptive services in Zambia

摘要

Background: Community dialogues have been used in participatory approaches in various health prevention andawareness programs, including family planning interventions, to increase understanding and alignment of particularissues from different peoples’ perspectives. The main objective of this paper is to document the feasibility of acommunity dialogue approach, which aimed to promote dialogue between healthcare providers and communitymembers. The feasibility testing was part of formative-phase research needed to design an intervention, with theultimate goal of increasing the uptake of family planning and contraception. The community dialogue interventiongenerated discussions on key approaches to improve family planning and contraception provision and uptake.Methods: Key stages of the community dialogue were undertaken, with representation from healthcare providersand community members. Participants included frontline and managerial health care providers, community healthworkers, family planning and contraception users, the youth, other stakeholders from the education sector, and civilsociety. How the dialogue was implemented (operational feasibility) as well as the cultural feasibility of thecommunity dialogue content was evaluated through participant observations during the dialogue, using astandardised feasibility testing tick-list, and through focus group discussions with the stakeholders who participatedin the community dialogue.Results: Overall, 21 of the 30 invited participants attended the meeting- 70% attendance. The approach facilitateddiscussions on how quality care could be achieved in family planning and contraception provision, guided by theground rules that were agreed upon by the different stakeholders. A need for more time for the discussion wasnoted. Participants also noted the need for more balanced representation from adolescents as well as other familyplanning stakeholders, such as community members, especially in comparison to healthcare providers. Someparticipants were not comfortable with the language used. Young people felt older participants used complicatedterminologies while community members felt the health care providers outnumbered them, in terms ofrepresentation.Conclusion: Generally, the community dialogue was well received by the community members and the healthcareproviders, as was observed from the sentiments expressed by both categories. Some key considerations for refiningthe approach included soliciting maximum participation from otherwise marginalized groups like the youth wouldprovide stronger representation.