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.