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'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
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Figure 1

'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.

Forest plot of comparison: 1 Effectiveness of community‐based family planning programme: community workers versus control, outcome: 1.1 Uptake of IUD.
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Figure 2

Forest plot of comparison: 1 Effectiveness of community‐based family planning programme: community workers versus control, outcome: 1.1 Uptake of IUD.

Forest plot of comparison: 1 Effectiveness of community‐based family planning programme: community workers versus control, outcome: 1.2 Knowledge of IUD.
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Figure 3

Forest plot of comparison: 1 Effectiveness of community‐based family planning programme: community workers versus control, outcome: 1.2 Knowledge of IUD.

Forest plot of comparison: 2 Effectiveness of contraceptive counselling provision among postpartum population: postnatal counselling versus control, outcome: 2.1 Uptake of IUD.
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Figure 4

Forest plot of comparison: 2 Effectiveness of contraceptive counselling provision among postpartum population: postnatal counselling versus control, outcome: 2.1 Uptake of IUD.

Forest plot of comparison: 3 Effectiveness of contraceptive counselling provision among postpartum population (short‐term): antenatal counselling versus control, outcome: 3.1 Uptake of IUD.
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Figure 5

Forest plot of comparison: 3 Effectiveness of contraceptive counselling provision among postpartum population (short‐term): antenatal counselling versus control, outcome: 3.1 Uptake of IUD.

Forest plot of comparison: 6 Effectiveness of family planning counselling among postabortion population, outcome: 6.1 Uptake of IUD.
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Figure 6

Forest plot of comparison: 6 Effectiveness of family planning counselling among postabortion population, outcome: 6.1 Uptake of IUD.

Comparison 1 Effectiveness of community‐based family planning programme: community workers versus control, Outcome 1 Uptake of IUD.
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Analysis 1.1

Comparison 1 Effectiveness of community‐based family planning programme: community workers versus control, Outcome 1 Uptake of IUD.

Comparison 1 Effectiveness of community‐based family planning programme: community workers versus control, Outcome 2 Knowledge of IUD.
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Analysis 1.2

Comparison 1 Effectiveness of community‐based family planning programme: community workers versus control, Outcome 2 Knowledge of IUD.

Comparison 2 Effectiveness of contraceptive counselling provision among postpartum population: postnatal counselling versus control, Outcome 1 Uptake of IUD.
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Analysis 2.1

Comparison 2 Effectiveness of contraceptive counselling provision among postpartum population: postnatal counselling versus control, Outcome 1 Uptake of IUD.

Comparison 3 Effectiveness of contraceptive counselling provision among postpartum population (short‐term): antenatal counselling versus control, Outcome 1 Uptake of IUD.
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Analysis 3.1

Comparison 3 Effectiveness of contraceptive counselling provision among postpartum population (short‐term): antenatal counselling versus control, Outcome 1 Uptake of IUD.

Comparison 4 Effectiveness of family planning counselling among postabortion population, Outcome 1 Uptake of IUD.
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Analysis 4.1

Comparison 4 Effectiveness of family planning counselling among postabortion population, Outcome 1 Uptake of IUD.

Summary of findings for the main comparison. Community‐based contraceptive counselling

Contraceptive counselling and referral by community workers for married women 15 to 49 years old

Patient or population: married women aged 15 to 45/49
Settings: home
Intervention: contraceptive counselling and referral by community workers

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Control

Contraceptive counselling and referral by the community workers

Uptake of IUD
Number of women who use IUD as a contraceptive

12 per 1000

24 per 1000
(17 to 34)

OR 2.00
(1.4 to 2.85)

6224
(3 studies)

⊕⊕⊕⊝
moderate1,2

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; IUD: intrauterine device; OR: odds ratio

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 These studies have 'high' risk of bias for two categories or higher.
2 Unexplained heterogeneity of I2 = 86%; two studies suggested benefit, however the confidence intervals do not overlap.

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Summary of findings for the main comparison. Community‐based contraceptive counselling
Summary of findings 2. Antenatal contraceptive counselling for postpartum contraceptive use

Antenatal contraceptive counselling for postpartum contraceptive use

Patient or population: women receiving antenatal care
Settings: healthcare facilities (hospitals/clinics)
Intervention: antenatal contraceptive counselling

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Control

Antenatal contraceptive counselling

Uptake of IUD
Number of women who use IUD as a contraceptive

28 per 1000

64 per 1000
(39 to 102)

OR 2.33
(1.39 to 3.9)

1491
(2 studies)

⊕⊕⊕⊝
moderate1,2

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; IUD: intrauterine device; OR: odds ratio

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 Unclear and high risk of bias detected for both studies.
2 Pooled data showed Peto OR 2.33 with 95% CI 1.39 to 3.90.

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Summary of findings 2. Antenatal contraceptive counselling for postpartum contraceptive use
Summary of findings 3. Postnatal contraceptive counselling and information leaflet prior to discharge

Postnatal contraceptive counselling and information leaflet prior to discharge

Patient or population: postpartum
Settings: healthcare facilities (hospital, maternity ward)
Intervention: postnatal contraceptive counselling and information leaflet prior to discharge from maternity ward

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Control

Postnatal contraceptive counselling and information leaflet prior to discharge

Uptake of IUD
Number of women who use IUD as a contraceptive

33 per 1000

165 per 1000
(110 to 239)

OR 5.73
(3.59 to 9.15)

600
(1 study)

⊕⊕⊕⊝
moderate1,2

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; IUD: intrauterine device; OR: Odds ratio

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 Outcome measures were not specified; knowledge mentioned in the aim and reported for the baseline but not reported postintervention.
2 Large effect: uptake of IUD is large for the intervention group compared to the control.

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Summary of findings 3. Postnatal contraceptive counselling and information leaflet prior to discharge
Summary of findings 4. Contraceptive counselling during postnatal home visits

Postnatal home visits for postpartum care including contraception

Patient or population: postpartum
Settings: home
Intervention: postnatal home visits and contraceptive counselling during the visits

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Control

Postnatal home visits

Uptake of IUD
Number of women who use IUD as a contraceptive

59 per 1000

92 per 1000
(54 to 152)

OR 1.6
(0.9 to 2.85)

849
(1 study)

⊕⊕⊝⊝1
low

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; IUD: intrauterine device; OR: odds ratio

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 The study power calculation was performed to detect postpartum morbidity, namely haemorrhoids. Although contraceptive uptake was one of the outcomes, all other (five) outcomes of the study were neonatal outcomes.

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Summary of findings 4. Contraceptive counselling during postnatal home visits
Summary of findings 5. Enhanced contraceptive counselling and provision postabortion

Enhanced contraceptive counselling and provision for postabortion

Patient or population: postabortion
Settings: healthcare facilities
Intervention: enhanced contraceptive counselling and provision

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Control

Enhanced contraceptive counselling and provision

Uptake of IUD
Number of women using IUD as a contraceptive

31 per 1000

43 per 1000
(21 to 84)

OR 1.39
(0.68 to 2.83)

855
(2 studies)

⊕⊕⊝⊝
low1,2,3,4,5

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; IUD: intrauterine device; OR: odds ratio

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 Low and statistically not significant heterogeneity.
2 One of the studies was a trial of one‐to‐one counselling versus group counselling; also another study recruited participants specifically from low‐income group.
3 One of the studies includes no effect with 95% confidence interval 0.00 to 6.60.
4 High risk of bias for one of the studies.
5 The control group for one of the studies received group counselling and the discontinuation rate was 45%, given that only one IUD uptake for the control group and none among the intervention group, the results may be affected by the high discontinuation rate.

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Summary of findings 5. Enhanced contraceptive counselling and provision postabortion
Comparison 1. Effectiveness of community‐based family planning programme: community workers versus control

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Uptake of IUD Show forest plot

3

6224

Peto Odds Ratio (Peto, Fixed, 95% CI)

2.00 [1.40, 2.85]

2 Knowledge of IUD Show forest plot

1

Odds Ratio (M‐H, Random, 95% CI)

Subtotals only

2.1 Knowledge of method

1

1650

Odds Ratio (M‐H, Random, 95% CI)

39.00 [15.91, 95.62]

2.2 Knowledge of availability

1

1650

Odds Ratio (M‐H, Random, 95% CI)

2.68 [2.19, 3.27]

Figuras y tablas -
Comparison 1. Effectiveness of community‐based family planning programme: community workers versus control
Comparison 2. Effectiveness of contraceptive counselling provision among postpartum population: postnatal counselling versus control

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Uptake of IUD Show forest plot

2

Peto Odds Ratio (Peto, Fixed, 95% CI)

Subtotals only

1.1 Counselling and leaflet before discharge

1

600

Peto Odds Ratio (Peto, Fixed, 95% CI)

5.73 [3.59, 9.15]

1.2 Postnatal home visits

1

849

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.60 [0.90, 2.85]

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Comparison 2. Effectiveness of contraceptive counselling provision among postpartum population: postnatal counselling versus control
Comparison 3. Effectiveness of contraceptive counselling provision among postpartum population (short‐term): antenatal counselling versus control

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Uptake of IUD Show forest plot

2

1491

Peto Odds Ratio (Peto, Fixed, 95% CI)

2.33 [1.39, 3.91]

1.1 Edinburgh

1

385

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.26 [0.36, 4.45]

1.2 Shanghai

1

517

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.90 [0.32, 2.52]

1.3 Cape Town

1

389

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.4 Mansoura

1

200

Peto Odds Ratio (Peto, Fixed, 95% CI)

4.22 [2.14, 8.32]

Figuras y tablas -
Comparison 3. Effectiveness of contraceptive counselling provision among postpartum population (short‐term): antenatal counselling versus control
Comparison 4. Effectiveness of family planning counselling among postabortion population

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Uptake of IUD Show forest plot

2

855

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.39 [0.68, 2.83]

1.1 IUD insertion arrangement made vs no arrangement

1

613

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.51 [0.73, 3.10]

1.2 One‐to‐one vs group counselling

1

242

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.13 [0.00, 6.60]

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Comparison 4. Effectiveness of family planning counselling among postabortion population