Written by Siti Nurul Qomariyah, Research and Assessment Director, Jhpiego Indonesia and Michael Muthamia, Senior Technician, Jhpiego Kenya
The right of a woman to use family planning throughout her reproductive years should be valued, protected and secured – especially during the time immediately after birth or loss of a baby.
This right is guaranteed in numerous global contexts. For example, the World Health Organization explicitly recognizes The potential of family planning after childbirth to convert individual and family health and prosperity. Yet, majority (61%) of women who want to be perversed or prevent pregnancy within the first year after childbirth do not use family planning. Further, More than half of patients after abortion express interest in using contraception, but 74% abandon the installation without a method.
Health policy -executives, developers and professionals are missing a vital opportunity to ensure that adolescent women and girls can decide when to become pregnant according to their own desires and needs.
After an unprecedented five -year study, we have a very promising path forward to deal with this need for family planning after pregnancy or PPFP based. As technical guides in our respective countries, we are confident that the study has illuminated a strategic plan for accelerating PPFP and saving lives. While our lessons were many, there were two dominant findings: Enhancing our efforts to provide advice is the key and we need to deal more effectively with private installations and providers.
Program of unprecedented study and application
One of the largest studies of this kind, post -pregnancy family planning options (PPFP options) has collected quantitative and qualitative data from healthcare providers, installation managers, community leaders, policy -making managers and more than 9,000 clients in Kenya.
Based on these inputs, this initiative also implemented a number of powerful activities with an ambitious scope. Our teams within the country increased awareness and supported a more supportive environment for health, women and adolescent workers at the level of installation and community level. We provide knowledge and skills to health workers so that they can more effectively advise women and families about their PPFP choices. We have helped to deal with regulatory barriers around the lack of equipment, supplies and business management skills, especially in the private sector. We also convened a quality improvement team to deal with systemic barriers and ensuring continuity at the regional level.
In short, we sought to discover and begin to face a series of complex barriers to access and use PPFP – a scary but deeply rewarding business.
Based on our findings, it is abundant that before rejection counseling is a transformative opportunity. Providing tips – either during prenatal visits or facilities delivery visits – was found to be a key factor in whether a customer ended up using PPFP. This is true in both countries – Kenya and Indonesia each saw a 24% higher reception after birth immediately after delivery to intervention compared to control areas.
However, they remain significant obstacles. The study has enhanced this reluctance to use family planning methods can be greatly influenced by the individual’s cultural and religious background. In Kenya, for example, some women believe that one should cure childbirth before using a family design method. There is also a tendency to underestimate the effectiveness of long -term, reversible contraceptives, while at the same time being state -of -the -art injectable, a perception that can limit the opening of individuals to the PPFP spectrum that suits their life and lifestyle. Adolescents, who have high interruption rates, is another challenge revealed by PPFP options. Consistent, focusing on humans and well -informed counseling can mitigate all these challenges.
New ideas for commitment to private sector
In Kenya, almost 25% of facility deliveries take place in private facilities and in Indonesia this number is close to 73%. This prompted us to focus on the best way to participate in the private sector in providing immediate family planning after childbirth. We have learned that while the use of family planning is increasing overall, it remains low during the post -posting period in private facilities in both countries.
Our findings reveal that customers who choose to have access to private facilities appreciate the personal connection and continuity with the healthcare provider more than the depth and range of services offered by these facilities – a factor that can limit the interest of private providers to extend to PPFP.
But we also encountered deeper, systematic obstacles. Factors involving delayed financial allowances, lack of contraceptive equipment and supplies, and certification processes inhibit all private installations from the provision of family planning after pregnancy.
Expectations and value around PPFP supply should be better articulated and speak directly to what affects the provision of services in the private sector and the interests of women and families who have access to maternal health care in these environments. These facilities must be linked to the supervision of the Government’s Health Service for support to make the case of a stronger continuous care of services that will maintain customers, create confidence between customers and providers, and will continue. Most importantly, we cannot sit down and wait to make PPFP a more common offer, need to be developed, tested and finalized with the goals and challenges of private sector providers.
An invitation for action
Based on these courses and others, health leaders, developers and professionals have necessary new tools for the development of global, national and local PPFP efforts.
Our hope is that every lawyer, professional and policy -maker will have renewed confidence in urgently exploiting their reliable positions and influence to make PPFP available to every woman or girl who wants it and needs it. As the elements are placed, we should not remain inactive. We have the knowledge – it is now imperative to translate and adopt these findings in other contexts as widely as possible.
Photo: JHPIEGO
Keep in mind that blog posts are not evaluated and do not necessarily reflect SRHM’s views as an organization.