A model of integration: Extending family planning through community based maternal and newborn services

Background

In Bangladesh, neonatal mortality remains high, and 17% of births occur at intervals less than 24 months. We describe an innovative intervention strategy for an area of rural Bangladesh where over 90% of births occur at home, and demonstrate how postpartum family planning and promotion of birth spacing can be effectively integrated into this package.

Intervention

The intervention consists of (i) system and capacity strengthening by training of the health providers and, (ii) community-based advocacy and behavior change communication that is targeting postpartum women and their families. Female Community Health Workers (CHW), one per 4000 population, conduct antenatal and postpartum home visits during which they counsel families on newborn care, the lactational amenorrhea method (LAM), transitional methods and Healthy Timing and Spacing of Pregnancy (HTSP). Community Mobilizers (CM) organize advocacy and community meetings with community and religious leaders, influential persons, their wives and with pregnant and postpartum women, their mothers-in-law and husbands; and identify people to serve as role models on LAM (“LAM Ambassadors”).

Evaluation Design

The study has a quasi-experimental design. It follows 1330 women longitudinally from the antenatal period to 12 months postpartum in four unions of Zakiganj sub-district of Sylhet district, Bangladesh

Conclusion

Expected outcomes are neonatal mortality will be decreased, knowledge about LAM and use of balanced method mix will be increased during extended postpartum period.

The results of data collected during the first six months will be presented. These results will describe findings in knowledge and contraceptive use between the experimental and control groups for the initial study period.