11
Programme Strategies for Postpartum Family Planning: A new resource for FP programmes
Mary Lyn Gaffield, PhD
November 2013
Scientist, Human Reproduction Team
22
Background
Since 2010, WHO has been approached by Member States, USAID, and other development partners to promote and strengthen family planning services for women during the postpartum period – Clinically defined period (6 weeks) – WHO guidelines address contraceptive safety and service delivery
during 6 week period
Recognition that programmes need to consider an extended postpartum period – the first 12 months after childbirth
33
Identifying and addressing the need Development of a plan of work and products through…
– Brainstorming meetings at WHO and MCHIP (March & November 2010, 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 new resource for FP programmes managers and policy makers to implement the Statement
44
Statement for collective action
Highlights importance that family planning programmes reach postpartum women
Defines the issue, offers broad strategies to address unmet family planning needs for these women
Numerous endorsements obtained
Available in French, Spanish translation underway
55
WHO’s commitment at the Family Planning Summit – July 2012
Facilitating the delivery of family planning to women during the year postpartum identified as one of the essential components of health care.
66
The goal of the resource
Tailored for users with different needs
– For comprehensive programmingor
– To strengthen single or multiple elements within the health system
Recognizes programme interventions require holistic perspective and need to be evidence-informed
77
The method of work
The process– 'Map' existing guidance on the topic– Interview public health officials from selected countries
for 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 September 2012 (Geneva, Switzerland)
• Multiple reviews of drafts among experts to produce final document
88
Drawing upon existing guidelines
99
Keeping the needs of users in mind
Reminders of the unique needs of postpartum women
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
1010
Developed for the needs of users – cont.
Users guided to assess their national health system based upon WHO framework for action to understand their setting:– health services– HMIS– health workforce– medicines/technology– leadership/governance– health financing
1111
Linking assessment to potential interventions
Illustrative findings Potential programme interventions
High rates of breastfeeding Introduce LAM and counsel on transitioning to other effective contraceptive methods
High rates of staff rotation within and among facilities
Strengthen policies and practices to address staff development and retention to ensure that providers with FP skills are avialable within ANC, labour and delviery and postnatal care.
Low modern contraceptive prevalence Train community health workers to integrate community education and individual counseling about LAM, healthy timing and spacing, and exclusive breastfeeding with referral for other FP methods as a routine part of care
1212
Content areas to guide programming
Antenatal care Labor and delivery/pre-discharge Postnatal Infant health and immunization services
CONTINUUM OF POINTS OF CONTACT FOR PPFP STAGE
Pregnancy
Labour and delivery, Pre-discharge (0–48 hours)
Postnatal, including prevention of mother-to-child transmission of HIV (PMTCT)
(48 hours–6 weeks)
Infant care (4–6 weeks through 12 months)
1313
Example of a strategy
Overall programme goals
Programme outcomes
Approaches to programme design– Illustrative programme strategies– illustrative programme activities– illustrative indicators
1414
Additional resources
Monitoring and evaluation Indicators, definitions, data source, frequency Sample indicators address
policy/enabling environment service delivery/capacity client/community/FP demand FP service coverage
Supporting evidence for program design
1515
Stay tuned Publication on WHO website:
– http://www.who.int/reproductivehealth/publications/family_planning/ppfp_strategies/en/index.html
Publication on USAID website:– http://www.usaid.gov/
Publication on MCHIP website: http://www.mchip.net/addisppfp
Questions ? Email us at: [email protected]
Translations into French and Spanish will be undertaken