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Tara Kedia, MD

  • Graduate 2023
Current Position Information

General Preventive Medicine Resident, Johns Hopkins University,  Baltimore, Maryland

Scholarly Research Project

Improving Access to Contraception in Rural Honduras

Tara Kedia, MD; Rajwinder Kaur, DO; Jessica Goddard, DO; Tania Castillo, MD; Veronica Guevara, RN; Carolina Hernandez, RN; Mark Meyer, MD; N. Randall Kolb, MD; Cyndy Salter, PhD

Unintended and short interval pregnancy are associated with negative outcomes, including preterm and low birth weight infants, and increased maternal and infant mortality. In young Honduran women, 45% of pregnancies are unintended, and 42% of women have an unmet need for contraception. Although contraception is publicly funded in Honduras, it is often out of stock. In San José, a rural town in northwestern Honduras, the community health board and doctor have identified high rates of teenage pregnancy, inadequate knowledge about reproductive health, inadequate contraception access, and inadequate postpartum care as key issues.

Progesterone intramuscular injections, intra-uterine devices, and oral contraceptive tablets were purchased for the clinic, initially using funds from US-Honduran nonprofit Shoulder to Shoulder and now with a mixed grant- and patient-funded model. Data were collected using paper forms.

153 patients received contraception as of March 2023. 96% received their first-choice method; 77% of patients received Depo-Provera. In 2023, 12% of multips had short inter-conception interval (<18 months), which was similar to 2020. In 2020, primips used birth control prior to pregnancy about half as often as multips (25% primips versus 50% multips), and this rate decreased by 3-fold from 2020 to 2023, down to only 7% of primips in 2023. From 2020 to 2023, the rate of teen pregnancy quadrupled, from 6% to 23% of pregnant patients. In the long term, data will be captured on continuous use of contraception, unintended pregnancy, and birth spacing.

Through this initiative, patients without prior access were able to access contraception. The project has also reinforced the need for outreach and reproductive education to teens and patients who have never been pregnant. Work is underway to provide lectures to young and pregnant people to improve reproductive health knowledge.

Ellicott City, MD