Operations research to add postpartum family planning to maternal and neonatal health to improve birth spacing in Sylhet District, Bangladesh

Ahmed, Salahuddin; Norton, Maureen; Williams, Emma; Ahmed, Saifuddin; Shah, Rashed; Begum, Nazma; Mungia, Jaime; LeFevre, Amnesty; Al-Kabir, Ahmed; Winch, Peter J.; McKaig, Catharine; Baqui, Abdullah H

doi:10.9745/ghsp-d-13-00002

Cited by 39 publications

(38 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nevertheless, when postpartum women are exposed to postpartum family planning messages during other visits to health facilities, such as during labor and delivery, they are more likely to adopt a modern method [30,31]. In addition, community-based programs can increase the use of effective contraceptive methods in the postpartum period [32].…”

Section: Discussionmentioning

confidence: 99%

Missed opportunities for family planning: an analysis of pregnancy risk and contraceptive method use among postpartum women in 21 low- and middle-income countries

et al. 2015

View full text Add to dashboard Cite

Objectives: To analyze data from recent Demographic and Health Surveys (DHS) conducted in 21 low-and middle-income countries (LMICs) to examine patterns of interpregnancy intervals, unmet need, pregnancy risk and family planning method use and method mix among women 0-23 months postpartum. Study design: Secondary analysis of postpartum women aged 15-49 years in 22 DHS surveys from 21 LMICs conducted between 2005 and 2012. We applied an adapted unmet need definition for postpartum women to look at prospective fertility preferences. We also constructed a new composite pregnancy risk indicator for postpartum women who have been sexually active since their last birth. Results: In 9 of 22 surveys, 50% or more of nonfirst births occur at interpregnancy intervals that are too short. Overall prospective unmet need for family planning by postpartum women has not changed demonstrably since a 2001 analysis and is universally high: 61% of all postpartum women across the 21 countries have an unmet need for family planning. In 10 of 22 surveys, pregnancy risk rises steadily throughout the 2 years after birth. In the remaining 12 surveys, the risk of pregnancy peaks at 6-11 months after birth. Even when postpartum women are using family planning, they rely overwhelmingly on short-acting methods (51-96% in 21 of 22 surveys). Conclusion: Our approach of estimating pregnancy risk by postpartum timing confirms a high probability for pregnancies to be less than optimally spaced within 2 years of a prior birth and suggests that special consideration is needed to effectively reach this population with the right messages and services. Implications: Using recent, multicountry data for women within 2 years postpartum in LMICs, this paper updates existing estimates of high prospective unmet need for family planning and presents a new composite pregnancy risk analysis based on postpartum women's actual practices to demonstrate the magnitude of missed opportunities for programmatic intervention for the postpartum population.

show abstract

Section: Discussionmentioning

confidence: 99%

Missed opportunities for family planning: an analysis of pregnancy risk and contraceptive method use among postpartum women in 21 low- and middle-income countries

et al. 2015

View full text Add to dashboard Cite

show abstract

“…However, we emphasize that nearly all studies had short observation periods. With the exception of the Bangladesh study reported by Baqui (2011) and Ahmed et al (2013), no study covered here examined the continuation of contraceptive use following the intervention or the impact on pregnancy risk beyond the first postpartum year. Thus, we know little about continuation of contraceptive use after specific interventions and about the impact of interventions on birth spacing.…”

Section: Discussionmentioning

confidence: 99%

“…We identified ten projects, including three RCTs, that delivered interventions both before and after delivery ( Table 3). Five of these, in Bangladesh, Egypt, India (two), and South Africa, involved numerous activities, including home visits, domiciliary provision of contraceptive supplies, explicit incorporation of husbands, and community involvement (Kunene et al 2004;Varkey et al 2004;Abdel-Tawab, Loza, and Zaki 2008;Baqui et al 2011;Sebastian et al 2012;Ahmed et al 2013). The Bangladesh and Egyptian studies complemented facility-based counseling with home visits and community activities.…”

Section: Combined Ante-and Postnatal Interventionsmentioning

confidence: 99%

Interventions to Improve Postpartum Family Planning in Low‐ and Middle‐Income Countries: Program Implications and Research Priorities

Cleland

Shah

Daniele

2015

Studies in Family Planning

View full text Add to dashboard Cite

This article provides programmatic guidance and identifies future research priorities through a review of interventions to improve postpartum contraception. Thirty-five interventions in low- and middle-income countries were identified and classified according to timing and nature of administration: antenatal, postnatal, both ante- and postnatal, and integration with other services. With the exception of single, short antenatal interventions, the evidence of impact is positive but incomplete. A major gap in knowledge concerns demand for, and means of promoting, immediate postpartum family planning services in Asia and Africa. Counseling before discharge is likely to have an impact on subsequent contraceptive uptake. Integration of family planning into immunization and pediatric services is justified, but policy and program obstacles remain. A case for relaxing the strict conditions of the lactational amenorrhea method (LAM) is strong, but qualitative evidence on the perspectives of women on pregnancy risks is required. Despite the gaps in knowledge, the evidence provides useful guidance for strategies to promote postpartum family planning, in ways that take different contexts into account.

show abstract

“…This study is a sub-study of the Healthy Fertility Study (HFS), 2 which was conducted in Sylhet District in northeastern Bangladesh [8]. In Sylhet District, in 2011, almost half (46.5%) of non-first births occurred at short intervals of less than 36 months since the previous birth [9].…”

Section: Introductionmentioning

confidence: 99%

Findings from the use of a narrative story and leaflet to influence shifts along the behavior change continuum toward postpartum contraceptive uptake in Sylhet District, Bangladesh

Cooper¹,

Ahmed

Winch

et al. 2014

Patient Education and Counseling

Self Cite

View full text Add to dashboard Cite

show abstract

Operations research to add postpartum family planning to maternal and neonatal health to improve birth spacing in Sylhet District, Bangladesh

Cited by 39 publications

References 27 publications

Missed opportunities for family planning: an analysis of pregnancy risk and contraceptive method use among postpartum women in 21 low- and middle-income countries

Missed opportunities for family planning: an analysis of pregnancy risk and contraceptive method use among postpartum women in 21 low- and middle-income countries

Interventions to Improve Postpartum Family Planning in Low‐ and Middle‐Income Countries: Program Implications and Research Priorities

Findings from the use of a narrative story and leaflet to influence shifts along the behavior change continuum toward postpartum contraceptive uptake in Sylhet District, Bangladesh

Contact Info

Product

Resources

About