Social and behavioral change activities.

Introduction
While urban areas are often perceived to have better access to healthcare services, including modern family planning (FP) services, urban dwellers including those with better socioeconomic status are faced with multidimensional challenges that shape their access to appropriate FP services. In Uganda’s urban spaces, there is currently a lack of understanding among service providers, civil society organizations, and individuals/communities regarding the implementation of interventions that promote informed choice and voluntary use of family planning services. This knowledge gap has profound implications for reproductive rights. This study seeks to enhance existing efforts towards increasing coverage and uptake of Voluntary Family Planning (VFP) in Jinja City and Iganga Municipality, central eastern Uganda. Our primary question is, “What interventions can effectively be packaged and delivered to increase the uptake of VFP among different segments of urban residents?”
Methods
We propose to use the Human-Centered Design (HCD) approach to understand the needs and challenges of users and community capabilities in ensuring access to VFP services. Co-creating with stakeholders’ engagement and a data-driven-centric approach will steer design and adaptation that respond to the different population segments within the urban space. As such, the study will be implemented in three phases: formative assessment, design and implementation, and implementation monitoring and evaluation. The implementation process will incorporate robust monitoring, learning, and adaptation mechanisms. The primary focus of these mechanisms will be to utilize gathered information effectively to inform the design of the implementation and facilitate continuous learning throughout the process. The study will apply a process monitoring and evaluation approach to address questions related to what package of FP interventions work, for whom, under what circumstances and why.
Discussion
Guided by strong learning and implementation flexibility, we hypothesize that our implementation will provide segmentation-specific high-impact interventions in an urban context.
Registration
This implementation research protocol has been registered on the Open Science Framework (OSF) repository Registries (https://osf.io/vqxu9; DOI: 10.17605/OSF.IO/VQXU9).

引言
尽管城市地区普遍被认为医疗服务可及性更佳，涵盖现代计划生育（Family Planning, FP）服务，但城市居民，乃至社会经济地位较高的群体，仍面临多维度挑战，这些挑战会制约其获取适宜计划生育服务的能力。当前乌干达城市区域内，服务提供者、民间社会组织以及个人与社区群体，对于如何落实旨在促进知情选择与自愿使用计划生育服务的干预措施，仍存在认知空白。这一认知缺口对生殖权利具有深远影响。本研究旨在加强现有工作，以提升乌干达中东部金贾市（Jinja City）与伊甘加市政区（Iganga Municipality）的自愿计划生育（Voluntary Family Planning, VFP）服务覆盖范围与使用率。我们的核心研究问题为：「应如何设计并落地有效的干预组合方案，以提升不同城市居民群体的自愿计划生育服务使用率？」

方法
本研究拟采用以人为中心的设计（Human-Centered Design, HCD）方法，以探明用户的需求与挑战，以及保障自愿计划生育服务可及性所需的社区能力。通过与利益相关方协作共创、以数据为核心的研究路径，将指导针对城市区域内不同人口群体的方案设计与适配调整。据此，本研究将分为三个阶段开展：形成性评估、方案设计与实施、实施监测与评估。实施过程将纳入健全的监测、学习与适配机制，其核心目标在于高效利用所收集的信息，为实施方案的设计提供依据，并推动全流程的持续学习。本研究将采用过程监测与评估方法，以解答「哪些计划生育干预组合方案切实有效、适用于哪些人群、在何种情境下生效以及其生效机制为何」这类问题。

讨论
依托健全的学习机制与灵活的实施策略，我们假设本研究的实施将在城市场景中，为不同细分人群提供高影响力的干预措施。

注册
本实施研究方案已在开放科学框架（Open Science Framework, OSF）仓储注册平台完成登记（https://osf.io/vqxu9; DOI: 10.17605/OSF.IO/VQXU9）。