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Member Research & Reports

Member Research & Reports

Johns Hopkins: Integrating Postpartum Family Planning Into Existing Community-Based Health Programs

A new study led by researchers at the Johns Hopkins Bloomberg School of Public Health found that adding postpartum family planning services to existing maternal, antenatal and newborn community health programs significantly decreased the risk of a subsequent birth within two years and reduced the risk of preterm birth. The study also showed community health care workers were able to add family planning to their package of care without undermining the effectiveness of the services they already offered.

The study was published in the July issue of the Journal of Global Health. It was conducted in Sylhet Bangladesh, a rural area where the majority of births occur at home.

The quasi-experimental study was broken into two arms: control and intervention. In the entire study site, community health workers (CHWs) had been providing a platform of maternal, newborn, and child health (MNH) services. Both the control and intervention arms continued receiving these. Women in the intervention arm also received a family planning package of care. CHWs provided family planning information, promoted exclusive breast-feeding for 6 months, distributed short-term contraception, made referrals for long-term contraception, and made two additional home visits in the 6-month postpartum period to provide contraception and check on satisfaction with the method being used.

The study enrolled a total of 4,504 pregnant women. The analysis showed the risk of short birth interval was 19 percent lower in the intervention arm. It also found the risk of preterm births was 21 percent lower in the intervention arm.

A concern related to family planning integration activities is that while adding family planning may improve family planning outcomes, the addition of new tasks and activities may undermine MNH service delivery performance and affect outcomes. Across all measurements, researchers found no significant differences between the two arms of the study.

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