From Efficacy to Effectiveness: Selecting Indicators for a Community-Based Lactational Amenorrhoea Method Promotion Programme

Abstract

This paper reviews the results of clinical trials and community studies of lactational amenorrhoea and its role as a contraceptive method (LAM). Indicators which are used in efficacy trials and effectiveness interventions are compared and sets of indicators of effectiveness appropriate to community-based LAM programmes are recommended. A five-tiered ecological framework is used to facilitate selection of indicators which range from individual to policy level outcomes. The indicator framework is intended as a tool for health practitioners in family planning and maternal and child health service delivery settings who are interested in designing programmatic interventions for the promotion of LAM, particularly among less well-educated women of lower socioeconomic communities.

Promotion of lactation amenorrhea method intervention trial, Kazakhstan

“…There is also evidence to suggest that LAM is not too difficult for most women Promotion of Lactation Amenorrhea Method Intervention Trial (PLAMIT) to learn (e.g. Bender et al 1998, Hight-Laukaran et al 1997. In Ecuador, 77 percent of LAM users learned the method correctly after only one visit with a family planning worker, and 90 percent adopted the method correctly after two visits (Wade et al 1994).…”