A facility birth can be the time to start family planning: Postpartum intrauterine device experiences from six countries

  • International Journal of Gynecology and Obstetrics, Volume 130, No. S2, Year 2015

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Study Justification:
– Initiation of family planning at the time of birth is crucial in low-resource settings where women may not return for further care.
– Postpartum family planning (PPFP) and postpartum intrauterine device (PPIUD) services were integrated into maternal care in six low- and middle-income countries.
– The study aimed to assess the effectiveness and feasibility of integrating PPFP/PPIUD services into routine care.
Highlights:
– Facilities with high delivery volume were selected to integrate PPFP/PPIUD services into routine care.
– Training and mentoring of providers assisting women at the time of birth was conducted for effective integration.
– Ongoing monitoring generated data for advocacy.
– The percentages of PPIUD acceptors ranged from 2.3% to 5.8% among women counseled in different countries.
– Rates of complications among women returning for follow-up were low.
– Expulsion rates ranged from 1.7% to 3.7% in different countries.
– Infection rates did not exceed 1.3%, and some countries recorded no cases.
– Offering PPFP/PPIUD at birth improves access to contraception.
Recommendations:
– Integrate PPFP/PPIUD services into routine maternal care in low-resource settings.
– Provide training and mentoring to healthcare providers on assisting women with PPFP/PPIUD at the time of birth.
– Advocate for ongoing monitoring to generate data on the effectiveness and feasibility of PPFP/PPIUD integration.
– Promote the availability of PPFP/PPIUD services at birth to improve access to contraception.
Key Role Players:
– Healthcare providers: Require training and mentoring to assist women with PPFP/PPIUD at the time of birth.
– Maternal care facilities: Need to integrate PPFP/PPIUD services into routine care.
– Advocacy organizations: Can support ongoing monitoring and data generation for PPFP/PPIUD integration.
Cost Items for Planning Recommendations:
– Training and mentoring programs for healthcare providers.
– Integration of PPFP/PPIUD services into routine maternal care facilities.
– Ongoing monitoring and data collection for advocacy purposes.

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Initiation of family planning at the time of birth is opportune, since few women in low-resource settings who give birth in a facility return for further care. Postpartum family planning (PPFP) and postpartum intrauterine device (PPIUD) services were integrated into maternal care in six low- and middle-income countries, applying an insertion technique developed in Paraguay. Facilities with high delivery volume were selected to integrate PPFP/PPIUD services into routine care. Effective PPFP/PPIUD integration requires training and mentoring those providers assisting women at the time of birth. Ongoing monitoring generated data for advocacy. The percentages of PPIUD acceptors ranged from 2.3% of women counseled in Pakistan to 5.8% in the Philippines. Rates of complications among women returning for follow-up were low. Expulsion rates were 3.7% in Pakistan, 3.6% in Ethiopia, and 1.7% in Guinea and the Philippines. Infection rates did not exceed 1.3%, and three countries recorded no cases. Offering PPFP/PPIUD at birth improves access to contraception.

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The recommendation to improve access to maternal health is to initiate family planning at the time of birth. This recommendation is based on experiences from six countries where postpartum family planning (PPFP) and postpartum intrauterine device (PPIUD) services were integrated into maternal care. Facilities with high delivery volume were selected to integrate these services into routine care.

To effectively integrate PPFP/PPIUD services, it is important to provide training and mentoring to the providers assisting women at the time of birth. Ongoing monitoring of the services also helps generate data for advocacy.

The results from the six countries showed that offering PPFP/PPIUD at birth improved access to contraception. The percentages of PPIUD acceptors ranged from 2.3% to 5.8% among women counseled. Rates of complications among women returning for follow-up were low, with expulsion rates ranging from 1.7% to 3.7% and infection rates not exceeding 1.3%.

This recommendation, as described in the publication “A facility birth can be the time to start family planning: Postpartum intrauterine device experiences from six countries” in the International Journal of Gynecology and Obstetrics, Volume 130, No. S2, Year 2015, highlights the potential of integrating PPFP/PPIUD services into routine maternal care to improve access to maternal health.
AI Innovations Description
The recommendation to improve access to maternal health is to initiate family planning at the time of birth. This recommendation is based on the experiences from six countries where postpartum family planning (PPFP) and postpartum intrauterine device (PPIUD) services were integrated into maternal care. The facilities with high delivery volume were selected to integrate these services into routine care.

To effectively integrate PPFP/PPIUD services, it is important to provide training and mentoring to the providers assisting women at the time of birth. Ongoing monitoring of the services also helps generate data for advocacy.

The results from the six countries showed that offering PPFP/PPIUD at birth improved access to contraception. The percentages of PPIUD acceptors ranged from 2.3% to 5.8% among women counseled. Rates of complications among women returning for follow-up were low, with expulsion rates ranging from 1.7% to 3.7% and infection rates not exceeding 1.3%.

This recommendation, as described in the publication “A facility birth can be the time to start family planning: Postpartum intrauterine device experiences from six countries” in the International Journal of Gynecology and Obstetrics, Volume 130, No. S2, Year 2015, highlights the potential of integrating PPFP/PPIUD services into routine maternal care to improve access to maternal health.
AI Innovations Methodology
To simulate the impact of the main recommendations outlined in the abstract on improving access to maternal health, a possible methodology could involve the following steps:

1. Selection of study sites: Identify a diverse range of healthcare facilities in low- and middle-income countries with high delivery volume. These facilities should represent different geographic regions and varying levels of resources.

2. Intervention implementation: Integrate postpartum family planning (PPFP) and postpartum intrauterine device (PPIUD) services into routine maternal care at the selected facilities. Provide training and mentoring to healthcare providers to ensure they are equipped to assist women at the time of birth and offer PPFP/PPIUD services.

3. Data collection: Establish a system for ongoing monitoring and data collection to track the implementation of PPFP/PPIUD services. Collect information on the number of women counseled, the percentage of PPIUD acceptors, and any complications or adverse events.

4. Analysis: Analyze the collected data to assess the impact of offering PPFP/PPIUD at birth on access to contraception. Calculate the percentage of PPIUD acceptors among women counseled and examine rates of complications, such as expulsion and infection.

5. Comparison: Compare the findings from the simulation to the results reported in the publication. Assess the similarities and differences to determine the effectiveness and feasibility of implementing the recommendations in different settings.

6. Recommendations: Based on the simulation results, provide recommendations for scaling up the integration of PPFP/PPIUD services into routine maternal care to improve access to maternal health. Consider factors such as training requirements, resource allocation, and potential barriers to implementation.

By following this methodology, researchers and policymakers can gain insights into the potential impact of integrating PPFP/PPIUD services into routine maternal care and make informed decisions regarding strategies to improve access to maternal health.


Statistics:
Citations: 42
Identifiers:
DOI: 10.1016/j.ijgo.2015.03.008
ISSN: 00207292
Research Areas:
Health System and Policy, Maternal and Child Health, Quality of Care, Sexual and Reproductive Health, Social Determinants
Study Countries:
Ethiopia, Guinea, Multi-Countries
Study Design:
Cohort Study
Participants Gender:
Female
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