expanding access to postpartum family planning with dedicated providers in mali and zambia maxine...

Expanding Access to Postpartum Family Planning with Dedicated Providers

in Mali and Zambia

Maxine EberSIFPO-PSI Deputy Director

September 18, 2015

Short birth intervals increase risk of

adverse maternal and child health outcomes

65% women have unmet need for

contraception in 12 months following

delivery

The Problem

Low awareness among providers and couples:

-Health consequences of short birth intervals

-Pregnancy risk in post-partum period

-Method choices for lactating women

Cultural taboos around post-partum sexual activity Disconnect between ANC, Delivery, and PNC Service Access

Barriers to PPFP

Where do women access health services?

Delivery

Immunization

Bring services closer to the client

PSI midwives seconded to strategically selected public clinics to reach women with unmet need for FP

FP provided during regular immunization days

Interactive education sessions Private counseling and eligibility

screening Co-located, same day services

Dedicated FP Providers

Mali: Adding LARC to the Method Mix

2006 (DHS)

2009 2010 2011 2012 2013 (June)

0

5000

10000

15000

20000

25000

2 Midwives

5 Midwives

15 Midwives

SERVICES PROVIDED

Measurable Impact

page 7

Questions of sustainability: Dedicated providers external to clinic health teams

Challenges

Group 1: no support Group 2: partial support

Looking Forward: An Evolving Model

0

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

31% de-crease in service

provision

Jan-14 Feb-14 Mar-14 Apr-14 May-14 Jun-14 Jul-14 Aug-14 Sep-14 Oct-14 Nov-14 Dec-140

500

1000

1500

2000

2500

3000Données mensuelles 2014

Méthodes choisies Pilplan-d Méthodes choisies Confiance Méthodes choisies DIU Méthodes choisies Implant

New Opportunities

• Revised WHO MEC expands range of methods available to breast feeding women post-delivery

• PP Implant!• Dedicated IUD inserter facilitates delivery-room provision

Thank you.