Service Integration

  • Open Access
    Operationalizing Integrated Immunization and Family Planning Services in Rural Liberia: Lessons Learned From Evaluating Service Quality and Utilization
    Allyson R. Nelson, Chelsea M. Cooper, Swaliho Kamara, Nyapu D. Taylor, Topian Zikeh, Cefanee Kanneh-Kesselly, Rebecca Fields, Iqbal Hossain, Lolade Oseni, Birhanu S. Getahun, Anne Fiedler, Anne Schuster and Hannah Tappis
    Global Health: Science and Practice September 2019, 7(3):418-434; https://doi.org/10.9745/GHSP-D-19-00012

    Providers, managers, and clients valued the integrated service delivery model. Trends indicated slightly higher family planning uptake in intervention facilities, but that difference was not statistically significant. Intrafacility referrals by postpartum women did not negatively affect immunization utilization rates.

  • Open Access
    Seeking Synchrony Between Family Planning and Immunization: A Week-10 DMPA Start Option for Breastfeeding Mothers
    John Stanback
    Global Health: Science and Practice September 2017, 5(3):341-344; https://doi.org/10.9745/GHSP-D-17-00063

    Many mothers initiate DMPA injectables at 6 weeks postpartum, at the time of their baby's first immunization visit. Offering an optional delayed DMPA start at the next (10-week) immunization visit has potential advantages including a reduced follow-up schedule with DMPA visits synchronized with other immunization visits, and, possibly, improved contraceptive and immunization outcomes.

  • Open Access
    Meeting Postpartum Women’s Family Planning Needs Through Integrated Family Planning and Immunization Services: Results of a Cluster-Randomized Controlled Trial in Rwanda
    Lisa S Dulli, Marga Eichleay, Kate Rademacher, Steve Sortijas and Théophile Nsengiyumva
    Global Health: Science and Practice March 2016, 4(1):73-86; https://doi.org/10.9745/GHSP-D-15-00291

    Integrating contraceptive services into infant immunization services was effective, acceptable, and feasible without negatively affecting immunization uptake. Yet unmet need for contraception remained high, including among a substantial number of women who were waiting for menses to return even though, at 6 months or more postpartum, they were at risk of an unintended pregnancy. More effort is needed to educate women about postpartum return to fertility and to encourage those desiring to space or limit pregnancy to use effective contraception.

  • Open Access
    Successful Proof of Concept of Family Planning and Immunization Integration in Liberia
    Chelsea M Cooper, Rebecca Fields, Corinne I Mazzeo, Nyapu Taylor, Anne Pfitzer, Mary Momolu and Cuallau Jabbeh-Howe
    Global Health: Science and Practice March 2015, 3(1):71-84; https://doi.org/10.9745/GHSP-D-14-00156

    Mobilizing vaccinators to provide mothers key family planning information and referrals to co-located, same-day family planning services was feasible in resource-limited areas of Liberia, leading to substantial increases in contraceptive use. Conversely, impact on immunization rates was less clear, but at a minimum there was no decrease in doses administered.

  • Open Access
    Integrating family planning into postpartum care through modern quality improvement: experience from Afghanistan
    Youssef Tawfik, Mirwais Rahimzai, Malalah Ahmadzai, Phyllis Annie Clark and Evelyn Kamgang
    Global Health: Science and Practice May 2014, 2(2):226-233; https://doi.org/10.9745/GHSP-D-13-00166

    Modern quality improvement approaches enabled hospital staff to analyze barriers and identify solutions for “how” to integrate family planning into postpartum care. Private spaces for postpartum family planning (PPFP) counseling, along with involving husbands and mothers-in-law in counseling, substantially increased the percentage of women receiving PPFP counseling and their preferred method before discharge. Self-reported pregnancy was also significantly lower up to 18 months post-discharge compared with women receiving routine services.

  • Open Access
    Operations research to add postpartum family planning to maternal and neonatal health to improve birth spacing in Sylhet District, Bangladesh
    Salahuddin Ahmed, Maureen Norton, Emma Williams, Saifuddin Ahmed, Rasheduzzaman Shah, Nazma Begum, Jaime Mungia, Amnesty Lefevre, Ahmed Al-Kabir, Peter J Winch, Catharine McKaig and Abdullah H Baqui
    Global Health: Science and Practice August 2013, 1(2):262-276; https://doi.org/10.9745/GHSP-D-13-00002

    This quasi-experimental study integrated family planning, including the Lactational Amenorrhea Method, into community-based maternal and newborn health care and encouraged transition to other modern methods after 6 months to increase birth-to-pregnancy intervals. Community-based distribution of pills, condoms, and injectables, and referral for clinical methods, was added to meet women's demand.