Transition from the Lactational Amenorrhea Method to other modern family planning methods in rural Bangladesh: Barrier analysis and implications for behavior change communication program intervention design

Kouyaté, Robin Anthony; Ahmed, Salahuddin; Haver, Jaime; McKaig, Catharine; Akter, Nargis; Nash-Mercado, Angela; Baqui, Abdullah H

doi:10.1016/j.evalprogplan.2014.11.008

Cited by 15 publications

(14 citation statements)

References 16 publications

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“…This is despite the fact that prolonged lactation expectedly suppresses the production of certain types of hormones, thereby extending the postpartum anovulatory period. This finding is not consistent with findings of studies in different countries [ 4 , 22 – 24 ]. Although this study did not assess the frequency and intensity of sucking of the infant, it may have been suboptimal in the majority of women studied.…”

Section: Discussioncontrasting

confidence: 99%

Predictors of puerperal menstruation

et al. 2020

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Background Puerperal period is an important and thought-provoking period for puerperal mothers. Surprisingly, reports have indicated that there is increasing number of women resuming menstruation within six weeks of childbirth (puerperal menstruation). To the best of knowledge, there is no prior study on predictors of puerperal menstruation. Objective To determine frequency and predictors of puerperal menstruation. Methods This was a single tertiary health institution cross-sectional study at ESUT Teaching Hospital, Parklane, Enugu, Nigeria that included data from May 2015 to December 2018. Women were interviewed at the end of the first six weeks of their childbirth. Women with HIV positive or had uterine rupture or peripartum hysterectomy were excluded. Bivariate analysis was performed by the chi-squared test and conditional logistic regression analysis was used to determine variables associated with puerperal menstruation. Statistical significance was accepted when P-value is <0.05. Results A total of 371 women met the inclusion criteria. The return of menses within 6 weeks was present in 118(31.8%) women versus 253 (68.2%) women without puerperal menstruation, given a ratio of 1:3. Of the 371 women, 249 (67.1%) were on exclusive breastfeeding. The significant associated risk factors were age (p = 0.009), parity (p<0.001), early use of family planning (p = 0.001), socioeconomic status (p<0.001) and manual removal of placenta (p = 0.007). At conditional logistic regression analysis, early use of family planning (p = 0.001),

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Section: Discussioncontrasting

confidence: 99%

Predictors of puerperal menstruation

et al. 2020

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“…Our findings are consistent with studies in Bangladesh and Kenya, which have also identified barriers to PPFP uptake related to misconceptions around return to fecundity, pregnancy risk, and the role of breastfeeding (Cooper et al, ; Cooper et al, ; Kouyaté et al, ). A study conducted in Morogoro, Tanzania, similarly identified concerns about side effects as a critical reason for nonuse of contraceptives (Chebet et al, ).…”

Section: Discussionsupporting

confidence: 92%

“…Although LAM is a natural contraceptive method that is 98.5% efficacious in protecting against pregnancy when the three conditions for use are met, LAM is often overlooked and not incorporated in country health programmes, including in this region of Tanzania (Labbok et al, ). If women are counselled about the three criteria for LAM use, many women do not adequately adhere to them, and/or do not transition from LAM to another modern method before they are at risk of pregnancy (Türk, Terzioğlu, & Eroğlu, ; Kouyaté et al, ). A recent multicountry DHS analysis found that approximately 75% of women who reported using LAM actually did not meet the three LAM criteria (Fabic & Choi, ).…”

Section: Discussionmentioning

confidence: 99%

Perspectives on maternal, infant, and young child nutrition and family planning: Considerations for rollout of integrated services in Mara and Kagera, Tanzania

Cooper

Kavle

Nyoni

et al. 2019

Maternal & Child Nutrition

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In Lake Zone, Tanzania, low contraceptive prevalence, closely spaced births, and child stunting are common. Synergies exist between postpartum family planning (PPFP) and maternal, infant, and young child nutrition (MIYCN), yet health services are often provided in silos. This qualitative formative research study aimed to identify barriers and facilitating factors for optimal nutrition and PPFP practices in Mara and Kagera, Tanzania. Results informed the program design of an integrated nutrition and family planning (FP) implementation approach. The study involved in‐depth interviews with mothers of infants under 1 year (n = 24), grandmothers (n = 12), health providers (n = 6), and traditional birth attendants (n = 12), and 14 focus group discussions with community health workers, fathers, and community leaders. Findings reveal that breastfeeding initiation was often delayed, and prelacteal feeding was common. Respondents linked insufficient breast milk to inadequate maternal nutrition—in terms of the quality of the diet and small quantities of food consumed by mothers. Breast milk insufficiency was addressed through early introduction of foods and liquids. Mothers believed that breastfeeding prevents pregnancy, regardless of the frequency or duration of breastfeeding, yet were generally not aware of the lactational amenorrhea method (LAM) of FP. Joint decision‐making on FP was viewed as important, and women often discussed it with their partner. Future programming should address misconceptions about return to fecundity knowledge gaps and concerns about FP methods including LAM; and perceptions regarding insufficient breast milk and early introduction of foods which are impediments to optimal MIYCN and FP practices.

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“…In spite of LAM’s effectiveness when practiced correctly, its reported practice in most countries (including Kenya) is extremely low (Moore et al 2015 ). LAM relies on women understanding and following the criteria, however women who report using LAM often do not meet the criteria, remember the criteria, and/or transition to another modern method in a timely manner (Cooper et al 2014 ; Fabic and Choi 2013 ; Kouyate et al 2015 ; Sipsma et al 2013 ). Further exploration of effective approaches for promoting LAM as a contraceptive option are needed.…”

Section: Assessmentmentioning

confidence: 99%

Maximizing Opportunities: Family Planning and Maternal, Infant, and Young Child Nutrition Integration in Bondo Sub-County, Kenya

Cooper¹,

Ogutu²,

Matiri³

et al. 2017

Matern Child Health J

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Purpose This article shares learning from an innovative demonstration program integrating maternal, infant, and young child nutrition (MIYCN) and family planning (FP) services in western Kenya, providing recommendations for future work to expand MIYCN and FP integration. Description Six health facilities reorganized to integrate MIYCN and FP services and community health volunteers (CHVs) promoted MIYCN and FP in adjacent communities in Bondo Sub-County over a 1-year period. At the facility level, each provider was directed to provide both sets of services in a single room during FP, antenatal care, postnatal care, or child consultation visits (a “one stop shop” approach). At community level, CHVs were to conduct household visits equipped with new integrated materials and incorporate MIYCN and FP within community activities. Assessment Although the “one stop shop” approach, where one provider offers all integrated services in one room, was initially proposed for all facilities, this worked most effectively in the dispensary and health centers. The sub-county hospital adapted the approach such that integrated services were offered by more than one provider during a visit, with clients linked from one provider to another through same-day intra-facility referrals. CHVs were generally able to incorporate MIYCN and FP content within household visits and community activities; however some knowledge gaps were noted after initial training, necessitating additional refresher training. Conclusion This demonstration experience revealed that future replication efforts should enable sub-county team leadership, assess facility readiness, streamline data collection, build local buy-in, and prioritize dispensaries and health centers with high client loads.

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Transition from the Lactational Amenorrhea Method to other modern family planning methods in rural Bangladesh: Barrier analysis and implications for behavior change communication program intervention design

Cited by 15 publications

References 16 publications

Predictors of puerperal menstruation

Predictors of puerperal menstruation

Perspectives on maternal, infant, and young child nutrition and family planning: Considerations for rollout of integrated services in Mara and Kagera, Tanzania

Maximizing Opportunities: Family Planning and Maternal, Infant, and Young Child Nutrition Integration in Bondo Sub-County, Kenya

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