Evaluating the Effectiveness of Two Behavior Change Communication Interventions for Safe Abortion Services in Bihar and Jharkhand, India

Erin Pearson, Johns Hopkins Bloomberg School of Public Health
Sushanta Banerjee, Ipas
Kathryn Andersen, Ipas
Janardan Warvadekar, Ipas

Though abortion has been legal in India since 1971, it is estimated that over half of the 3.6 million abortions performed in India each year are unsafe. This study evaluates the effectiveness of two behavior-change communication interventions, a high-intensity model (HIM) and a low-intensity model (LIM), that aimed to improve knowledge about safe abortion services and increase uptake of services. A quasi-experimental pre-post design was used. Cross-sectional household surveys were conducted at baseline and endline in HIM, LIM and comparison districts. Logistic regression difference-in-differences (DD) models were used to assess program effectiveness. Between baseline and endline, knowledge about legal status (OR=2.2) and sources of safe abortion services (OR=1.7) increased in HIM districts. However, the LIM model was only associated with improved knowledge of medical methods of abortion (OR=1.8). Though both interventions improved some aspects of abortion knowledge, the HIM model was more effective in improving comprehensive knowledge about abortion.