Context-(intervention)-actor-mechanism-outcome configurations across two time points
| Theme: fear of side effects of MCMs | |
| Round 1 CAMO1_R1 Women hear rumours of side effects of modern FP methods (C) and women (A) fear side effects of MCMs (M) so they choose natural methods for birth spacing and have reduced uptake of MCMs (O) | Round 2 CIAMO1_R2 Where rumours about the side effects of MCMs persist (C), side effects are managed by healthcare workers providing FP services (I) and women (A) understand and believe that side effects can be minimised and managed (M) and choose MCMs (O) |
| Intervention components that contributed to changes: management of side effects by healthcare workers | |
| Theme: preference for natural FP methods | |
| Round 1 CAMO2_R1 Women have peers who use natural methods of birth spacing (C) women (A) trust natural methods for birth spacing (M) such that women choose natural methods for birth spacing and have reduced uptake of MCMs (O) | Round 2 CIAMO1_R2 Where rumours about the side effects of MCMs persist (C), side effects are managed by healthcare workers providing FP services (I) and women (A) understand and believe that side effects can be minimised and managed (M) and choose MCMs (O) CAMO1_R2 Men spend more time in the home than in the kraal (C) and men and women (A) understand and believe that traditional methods for birth spacing no longer work (M) so they choose MCMs over natural FP methods (O) |
| Intervention components that contributed to changes: management of side effects by healthcare workers | |
| Theme: pastoralist lifestyles of men in the community | |
| Round 1 CAMO3_R1 Male partners oppose the use of MCMs (C) and women (A) are reluctant (M) to take up MCMs which leads to low MCM uptake (O) | Round 2 CAMO2_R2 Where pastoralist lifestyles are changing and male partners spend more time in the household (C), men (A) can see the impact of having too many children and believe that MCMs will have a positive impact (M) and support their wives in uptake of MCMs (O) |
| Intervention components that contributed to changes: N/A | |
| Theme: food insecurity in Karamoja | |
| Round 1 context CAMO4_R1 WFP offers food distribution at some health facilities linked to child immunisations (C) and women (A) feel food rations are an immediate priority (M); therefore women attend health facilities that distribute food and may not offer FP services (O) | Round 2 context CAMO2_R3 Where food insecurity influences health seeking behaviour (C), women (A) can see the need to limit their family size in order to be able to provide food for all their children (M) and they therefore choose to take up MCMs (O) |
| Intervention components that contributed to changes: N/A | |
CAMO, context-actor-mechanism-outcome; CIAMO, context-intervention-actor-mechanism-outcome; FP, family planning; MCMs, modern contraceptive methods; N/A, not applicable; WFP, World Food Programme.