The Effect of Performance-based Financing of Home Visitation in Overcoming Barriers to the Use of Modern Methods of Contraception in the Kumbo East Health District, Cameroon

Background: The use of modern methods of contraception (MMC) still remains a challenge in much of Sub-Saharan Africa including Cameroon. Performance-based Financing (PBF) home visitation was introduced in the Kumbo East Health District (KEHD), Cameroon, to increase the use of modern methods of contraception.

Objective: To determine the comparative advantage, on the one hand, of PBF home visits, and, on the other hand, the absence of such home visits, in overcoming barriers to the use of modern methods of contraception (MMC) in the Kumbo East Health District (KEHD), in Cameroon.

Materials and Methods: This was a cross-sectional study carried out in the KEHD during the period February 1 – May 31, 2015. A multistage cluster sampling method was used to recruit 262 and 221 women aged 15-49 in the intervention and non-intervention health areas respectively. A structured closed-ended questionnaire was used. Data was analyzed using STATA at 95% confidence interval, power of 80% and design effect of 2. Statistical significance was set at P<0.05.

Results: The average age of women was similar in both groups: 30.40 (SD 8.57) in the intervention group and 30.49 (SD 7.84) in controls. Computing logistic regression showed that home visitation had an effect on both groups in terms of where women heard about MMC (OR 13.64, 95% CI: 3.31-56.03) and (aOR 14.95, 95% CI: 3.52-62.16). Women in health areas with home visits were 2.34 times more likely to have cultural approval to use MMC than their counterparts without home visits (OR 2.34, 95% CI: 1.37-3.99) and (aOR 2.29, 95% CI: 1.33-3.94). Women in health areas with home visitation were less likely to have disapproval from their partners to use MMC (OR 0.48, 95% CI: 0.32-0.73) and (aOR 0.47, 95% CI 0.31-0.71)

Conclusion: PBF home visitation was effective in overcoming barriers to the use of modern methods of contraception.