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International Conference for Family Planning, Ethiopia Dr Zonobia & Dr Fauzia 13th November 2013
Slow progress towards achieving MDGs 4 &5 Limited information on pregnancy risk and contraceptive choices during postpartum period Evidence shows 64% unmet need among women in the first year postpartum Inefficient dissemination of LAM information Low utilization rate of IUCD in postpartum period
Source: PDHS 200607
Infecund 2%
Using FP 22%
Mandi Bahauddin
Improving effectiveness of counseling by incorporating key messages on healthy timing and spacing, return to fertility and benefits of PPFP.
Secondary data analysis of monthly Facility Reports (Sep 2012 Aug 2013)
Baseline Assessment
Physical resources for 50 provision of PPFP 45 services were 40 inadequate. Inappropriate knowledge35 about PPFP Services 30 25 IUCD insertion skills 20 needs improvement 15 Infection Prevention is 10 poor 5
0
FP Counseling PPIUCD Resources & HTSP CoCs Injectables Interval IUCDs Infection Implants Prevention
27
18
17 14
% Scores achieved
Interventions
Stakeholder Involvement
Advocacy
Capacity building
Supportive Supervision 7
Postnatal Counseling
Training of PPFP Counselors Provision of FP supplies at Delivery Room/ Postnatal ward Involving Vaccinators
Gradual increase in clients counseled for PPFP. Antenatal counseling rates increased from 21%91% Postnatal counseling increased from 24%86%
100 90 81 80 70 60 51 50 42 40 32 30 20 10 0
Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 Feb-13 Mar-13
94 87 90
76 66 69 65
25
Apr-13
May-13
Jun-13
Jul-13
Aug-13
PPFP method acceptance has increased from 18-55% in the postpartum period Increased PPFP acceptance with increased client counseling
79 80 70 70 60 66
55 46 43 47 44 49
50
40 30 20 10 0
Sep-12 Oct-12 Nov-12
35 25 18
Dec-12
Jan-13
Feb-13
Mar-13
Apr-13
May-13
Jun-13
Jul-13
Aug-13
10
LAM 17%
Conclusion
Effective counseling in the extended postpartum period of mothers is a major factor influencing their acceptance to use postpartum contraception; Knowledge on extended postpartum contraceptives is very important to enable mothers make informed choices Remarkable effect on FP methods uptake due to improved PPFP counseling by vaccinators, general physician (male) and Lady Health Workers at community level. Need for family planning programs and policies to focus on the use PPFP as a measure to increase usage of modern contraceptive methods.
12
13
14
Jhpiego Pakistan
15