Programme Strategies for Postpartum Family Planning: A new resource for FP programmes

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Programme Strategies forPostpartum Family Planning: Anew resource for FP programmes

Mary Lyn Gaffield, PhD

November 2013

Scientist, Human Reproduction Team

Background

Since 2010, WHO has been approached by MemberStates, USAID, and other development partners topromote and strengthen family planning services forwomen during the postpartum period

–Clinically defined period (6 weeks)

–WHO guidelines address contraceptive safety and servicedelivery during 6 week period

Recognition that programmes need to consider anextended postpartum period – the first 12 months afterchildbirth

Identifying and addressing the need

Development of a plan of work and products through…

–Brainstorming meetings at WHO and MCHIP (March & November2010, April 2011)

–Panel sessions at international conferences

•First Global Forum for Health Services Research (Montreux, Switzerland), 2010

•2nd International Conference on Family Planning (Dakar, Senegal), 2011

The products

–Statement for Collective Action

–Programme Strategies for Postpartum Family Planning: A newresource for FP programmes managers and policy makers toimplement the Statement

Statement for collective action

Highlights importance thatfamily planning programmesreach postpartum women

Defines the issue, offers broadstrategies to address unmetfamily planning needs forthese women

Numerous endorsementsobtained

Available in French, Spanishtranslation underway

WHO’s commitment at the Family PlanningSummit – July 2012

Facilitating the delivery of family planning to womenduring the year postpartum identified as one of theessential components of health care.

The goal of the resource

Tailored for users withdifferent needs

–For comprehensiveprogrammingor

–To strengthen single ormultiple elements within thehealth system

Recognizes programmeinterventions requireholistic perspective andneed to be evidence-informed

The method of work

The process

–'Map' existing guidance on the topic

–Interview public health officials from selected countriesfor contextual input

–Synthesize the published evidence

–Develop the draft document

•Meeting of expert to review draft document in July 2012(Washington .DC)

•WHO Technical consultation to finalize document in September2012 (Geneva, Switzerland)

•Multiple reviews of drafts among experts to produce finaldocument

Drawing upon existing guidelinesDrawing upon existing guidelines

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Keeping the needs of users in mind

Reminders of the unique needs of postpartumwomen

Understanding the landscape for programme design:

–Question-driven process

–Applying a health systems framework

–Illustrative examples

Integration points within the system

Examples from country programmes

Developed for the needs of users – cont.

Users guided to assesstheir national healthsystem based upon WHOframework for action tounderstand their setting:

–health services

–HMIS

–health workforce

–medicines/technology

–leadership/governance

–health financing

Linking assessment to potential interventions

Illustrative findings

Potential programme interventions

High rates of breastfeeding

Introduce LAM and counsel ontransitioning to other effectivecontraceptive methods

High rates of staff rotation within andamong facilities

Strengthen policies and practices toaddress staff development and retentionto ensure that providers with FP skills areavialable within ANC, labour and delvieryand postnatal care.

Low modern contraceptive prevalence

Train community health workers tointegrate community education andindividual counseling about LAM, healthytiming and spacing, and exclusivebreastfeeding with referral for other FPmethods as a routine part of care