Positive deviance for dual-method promotion among women in Uganda: study protocol for a cluster randomized controlled...

Area of Science:

• Public Health
• Reproductive Health
• Behavioral Science

Background:

• Dual-method use is the most effective strategy for preventing unintended pregnancies and sexually transmitted infections (STIs), including HIV.
• Despite its effectiveness, dual-method use is underutilized in sub-Saharan Africa, particularly among women using highly effective contraceptives.
• This study protocol outlines an intervention to promote dual-method use in Uganda.

Purpose of the Study:

• To evaluate the effect of a positive deviance-informed intervention on dual-method use uptake and adherence among women in Uganda.
• To identify unique practices and solutions employed by women already using dual methods to overcome barriers.

Main Methods:

• A cluster randomized controlled trial involving 20 health facilities and 960 women (480 per group) over 8 months.
• Initial qualitative interviews with 150 women to identify dual-method users, followed by in-depth interviews to understand their practices.
• Randomization of health facilities to either an intervention or control arm to assess the impact of the positive deviance approach.

Main Results:

• This section is not applicable as the abstract describes a study protocol and not results.

Conclusions:

• The positive deviance approach can uncover unique, locally relevant solutions to promote dual-method use, potentially overcoming barriers missed by external experts.
• This intervention has the potential to significantly reduce unintended pregnancies and STIs, offering a novel solution where traditional approaches have fallen short.
• The study could provide evidence for the efficacy of the positive deviance approach in addressing complex public health issues.