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New WHO Guidance on

Programming Strategies for


Postpartum FamiIy PIanning
Holly Blanchard & Rehana Gubin,
on behalf of the MCHlP FP Team
June 24, 2013
Jhpiego Mini-University
Objectives
!
Provide a primer on key messages for
postpartum family planning (PPFP)
!
ldentify the critical content of the new WHO
Programming Strategies for PPFP guidance
!
Discuss how this guidance can be used to
advocate for country-level programming in
PPFP
Unique Needs of Postpartum Women
Consider:
!
Healthy timing & spacing of pregnancy
!
Return to sexual activity
!
Breastfeeding status
!
Lactational amenorrhea method (LAM) and transition to
another FP method
!
Continue breastfeeding
!
Return to fertility pregnancy risk
!
lntegration: tailoring to fit with timing & service
Pakistan Return to FertiIity and
Pregnancy Risk
Factors infIuencing return to fertiIity
among aII women 0-24 months
postpartum
Risk of pregnancy among sexuaIIy
active women 0-24 months postpartum
Postpartum Women: N = 3,375
Return to Menses: N = 2,304
Sexually Active: N = 2,741
Exclusive Breastfeeding: N = 430
Predominant Breastfeeding: N = 755
Sexually Active: N = 2,741
Using Modern FP: N = 571
Predominant Breastfeeding: N = 456
0-5.9 Months 6-11.9 Months 12-23.9 Months
0%
0%
0%
0%
0%
0%
1%
1%
1%
1%
1%
Predominant BF
Modern FP Use
At Risk of Pregnancy
Composite
not at risk
* see note
Note: the women predominantly breastfeeding from 6-11.9 months have
increasing risk of return to fertility, especially if their menses return
SexuaIIy Active and Not FuIIy
Breastfeeding: Data from 6 Countries
0 20 40 60 80 100 120
Ethiopia-2005
Rwanda-2005
Uganda-2006
Madagascar-2004
Zambia-2007
Malawi-2004
% not fully BF 3-6 months
% sexually active by 3-6 months
Column1
Source: Winfries et al, 2010
Importance of HeaIthy Birth-to-
Pregnancy IntervaIs: Data from Kenya
15
35
22
11
17
>11 months
12-23 months
24-35 months
36-47
48 +
50% of
Kenyan
women
have
BTPIs that
are
too short
(Iess
than 24
months)
FP Options for Every Woman Every Time
TimeIine to WHO Programming
Strategies Guidance
2010 WHO
receive
requests
from
Member
States for
guidance on
PPFP
2010 & 2011
invite USAID
& MCHIP
2011
PPFP Tech
Meeting
Invite COP
on CaII to
Action with
WHO RHR
2011
InternationaI
FP
conference
Dakar WHO
RHR
2012
CoIIective
CaII to
Action on
PPFP
2013 Women
DeIiver
WHO RHR
SmartChart
TM
PrincipIes of Advocacy
Step 1: Program Decisions (Define Objective)
Step 2: Context
Step 3: Strategic Choices (Audience SeIection)
Step 4: Communication Activities (Messages & TooIs)
Step 5: Measurements of Success
Step 6: FinaI ReaIity Check
Summary
The MCHIP FP Team
!
Anne Pfitzer
!
Barbara Deller
!
Holly Blanchard
!
Elaine Charurat
!
Chelsea Cooper
!
Leah Elliott
!
Elizabeth Sasser
!
Devon Mackenzie
!
Rehana Gubin
Thank you!
www.mchip.net

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