Integrating Immunization and Family Planning Services in the Philippines: The Polomolok Experience

Background - The national average for fully immunized children is high, but improvements in FP lag. Partnering with Polomolok Municipality and South Cotabato Province, an integrated intervention that presented three FP referral messages to mothers bringing in their children for first-year immunizations was implemented March–December 2009. Methods - Polomolok had fully immunized child coverage of 98% and contraceptive prevalence of 49% (the national target is 60%). After pre-testing to determine appropriateness, midwives administering immunizations delivered three messages to mothers: one encouraging spacing/delaying subsequent pregnancy and two promoting FP counseling services. To measure impact, data on new acceptors, method mix and CPR were collected and compared during the same months of 2008 and 2009. Baseline and end-line surveys were administered to determine changes in client knowledge, attitudes, and practices (KAP). Results - New FP acceptors increased by 38% (1,405 in 2008 versus 1,943 in 2009); CPR increased from 49% to 55%. KAP survey results showed a shift from LAM and withdrawal to injectables and IUDs; pill use remained unchanged. Health centers as the primary source of FP information among users increased from 47% to 87%. One health station outperformed others as the midwife provided written FP messages to clients and posted them on the wall. Conclusions - Our small study indicates some promising results, suggesting that FP service referrals provided during immunizations may lead to increased service delivery performance (new FP acceptors). Although a definitive link cannot be established, more study at additional sites with more scientific rigor is warranted.