Service Integration
- Operationalizing Integrated Immunization and Family Planning Services in Rural Liberia: Lessons Learned From Evaluating Service Quality and Utilization
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.
- Postabortion Care and the Voluntary Family Planning Component: Expanding Contraceptive Choices and Service Options
Universal access to voluntary postabortion family planning is a critical and compelling component of postabortion care. Such access should be joined with postpartum family planning services in national programs, health information systems, and training programs. The same providers and facilities deliver both services, and integration could yield cost efficiencies and increased coverage for women receiving postabortion care.
- Findings and Lessons Learned From Strengthening the Provision of Voluntary Long-Acting Reversible Contraceptives With Postabortion Care in Guinea
Integrating voluntary long-acting reversible contraceptive (LARC) methods within postabortion care (PAC) in Guinea has increased LARC uptake among PAC clients, compared with non-PAC clients. With aid from government champions and leveraging of resources, Guinea has incorporated PAC into national policies and guidelines and trained providers on PAC and LARCs to expand service provision.
- The Unit and Scale-Up Cost of Postabortion Care in Tanzania
Given the high burden and cost of postabortion care (PAC) in Tanzania, health policy should strengthen voluntary family planning programs and the availability of a variety of contraceptive methods to PAC clients. A particular focus should be placed on decentralizing PAC to lower-level facilities, including health centers and dispensaries, which can provide safe, accessible, and appropriate PAC at the lowest cost including surgical or medical options.
- Rapid Integration of Zika Virus Prevention Within Sexual and Reproductive Health Services and Beyond: Programmatic Lessons From Latin America and the Caribbean
During the 2015–16 Zika virus outbreak, IPPF member association providers reached clients and affected populations faster by integrating critical information and services within existing sexual and reproductive health platforms. Challenges included: (1) communicating rapidly evolving evidence to providers; (2) overcoming restrictive social norms on gender and sexuality and a related lack of public messaging on preventing sexual transmission; and (3) addressing disability stigma and breaching service gaps to support children and caregivers affected by congenital Zika syndrome.
- What Factors Contribute to Postabortion Contraceptive Uptake By Young Women? A Program Evaluation in 10 Countries in Asia and sub-Saharan Africa
Across the 10 countries, 77% of 921,918 women left with a contraceptive method after receiving abortion care. While contraceptive uptake was high among all age groups, adolescents ages 15–19 were less likely to choose a method than women 25 years or older.
- Seeking Synchrony Between Family Planning and Immunization: A Week-10 DMPA Start Option for Breastfeeding Mothers
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.
- Infant Feeding Policy and Programming During the 2014–2015 Ebola Virus Disease Outbreak in Sierra Leone
Policies on breastfeeding and possible mother-to-child transmission of Ebola Virus Disease (EVD) during the outbreak evolved depending on public health priorities and the evidence available at that particular time. To improve responses to future outbreaks, research on vertical transmission of EVD should be prioritized; infant and young child feeding experts should be integrated into the outbreak response; and a digital repository of national policies and associated messages should be created.
- Meeting Postpartum Women’s Family Planning Needs Through Integrated Family Planning and Immunization Services: Results of a Cluster-Randomized Controlled Trial in Rwanda
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.
- Successful Proof of Concept of Family Planning and Immunization Integration in Liberia
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.