Evaluation of 'Pregnant not now!'; a personal approach to prevent pregnancy in vulnerable parents.
Projectomschrijving
Evaluatie van Nu Niet Zwanger (NNZ): een persoonlijke aanpak voor kwetsbare vrouwen
Vraagstuk
Het programma Nu Niet Zwanger (NNZ) ondersteunt kwetsbare mensen (m/v) bij het maken van een bewuste keuze over hun kinderwens, zodat zij niet onbedoeld zwanger raken. Dit gebeurt door actieve begeleiding, beginnend bij een gesprek over kinderwens, seksualiteit en anticonceptie tijdens bestaande contactmomenten met de hulpverlening. NNZ heeft zich in enkele jaren ontwikkeld van een pilot in Tilburg tot een landelijk programma. Dit project onderzocht het bereik van het programma in Tilburg/Midden-Brabant, de ervaringen van hulpverleners en cliënten met het programma en de verbeterpunten.
Onderzoek
Het onderzoek is uitgevoerd vanuit de Academische Werkplaats Publieke Gezondheid Brabant (Tranzo) tussen oktober 2018 - mei 2021. Registratiegegevens (van de GGD en ketenpartners) gaven inzicht in het bereik. Vragenlijsten en interviews met hulpverleners en cliënten gaven inzicht in de ervaringen met het programma en verbeterpunten.
Uitkomst
Het bereik in de regio neemt toe: steeds meer cliënten worden vanuit NNZ ondersteund. De resultaten laten enkele verbeterpunten zien voor de uitvoering, implementatie en borging van het programma en de samenwerking tussen ketenpartners. Cliënten zijn erg positief over de begeleiding vanuit NNZ. De onderzoeksresultaten worden samen met de inhoudelijk coördinator NNZ Midden-Brabant en het landelijk team NNZ GGD GHOR Nederland verspreid.
Lees verder
- Bekijk de resultaten van het project in de factsheet
- Meer over preconceptiezorg
Verslagen
Eindverslag
Samenvatting van de aanvraag
Health promotion and optimal care before and during pregnancy reduce maternal and perinatal morbidity and mortality. However, sometimes (potential) parents are in such a vulnerable situation that the best way to prevent problems, is to prevent pregnancy. Such a vulnerable situation may arise if parents have serious psychosocial-, psychiatric- or financial problems, if they have intellectual disabilities, or if they are addicted to alcohol or drugs. Most of these parents are in contact with divers organizations and professionals due to their specific problems, but family planning and adequate contraception are rarely discussed. A more coordinated, (pro)active approach applied by professionals working within birth-care, health-care or the social domain would avoid lots of unintended, unwanted pregnancies, abortions and lots of other (health) problems for the parents and the child. In 2014, GGD Hart voor Brabant started a pilot in Tilburg, in which vulnerable parents were approached personally and supported to start adequate contraception on a voluntary basis. The pilot was successful. It appeared that most of these parents don’t want a pregnancy in their current situation. In general, they appreciate the support and are quite willing to start contraception. By now, ‘Nu Niet Zwanger (NNZ)’ is implemented as a regional program in 8 cooperating municipalities in Midden-Brabant. Approximately 280 women and a few men already participated in the program. Rotterdam and Nijmegen have started similar projects and national implementation, coordinated by GGD/GHOR Netherlands starts from February 2018 onwards. With the proposed research project we aim to generate evidence- and practice based recommendations and tools to optimize the implementation of NNZ within birth-care and non birth-care related networks and organizations. The research goals are: 1) To identify and describe the different relevant regional networks and organizations in which the target population can be found. 2) For each relevant organization or network, explore opportunities to: - improve the implementation of NNZ among professionals - improve alignment and interaction with other organizations and networks - improve target population's awareness of the program’s existence. 3) Translate findings into evidence- and practice based recommendations and tools to support further regional and national implementation of NNZ. In a two year research project, a researcher will conduct individual and small group interviews with regional experts to define and frame the target population and to describe the regional networks and organizations in which they can be found. Opportunities to improve implementation are gathered from analyses of existing client registration data, a short digital questionnaire among regional professionals involved in NNZ, in-depth interviews with NNZ professionals and interviews with NNZ participants. Based on all information, recommendations for optimal implementation of NNZ - such as embedding the approach in relevant multidisciplinary guidelines - will be formulated, presented and reported. Where applicable, subsequent actions to improve implementation will be initiated during the project. A small group of 3-5 former NNZ participants will be actively involved in this research project. This team of client experts will meet several times during the project. The intention is to involve them as expert-by-experience in interviewing current NNZ participants, developing communication materials and organizing a small symposium at the end of the project. The project team combines a variety of relevant experience and expertise and consists of representatives of all project partners AWPG Brabant, GGD Hart voor Brabant, GCMN, GGD/GHOR NL, municipality Tilburg and MEE Tilburg. The project team will supervise and monitor the project’s progress. A representative of a relevant client organization will be requested to join the project team. The NNZ approach received a lot of publicity, which will enhance the dissemination of the project’s results. The results are relevant to the ZonMw program ‘Pregnancy and birth’, to the further regional and national dissemination of NNZ, to society and especially to future participants. The support for parents in complex, vulnerable situations to arrange adequate contraception helps them to gain control over their own future and, if desired, to postpone pregnancy until they have created a more stable, favorable environment for a child to grow up.