Promotion of lactation amenorrhea method intervention trial, Kazakhstan

Meeting the Family Planning Needs of Postpartum Women

“…Their lack of understanding appeared to be unrelated to subsequent pregnancies, however (Kennedy et al 1998). Similar mixed results have been obtained regarding the role of LAM as a gateway to the use of modern methods; some studies find no greater use of contraceptives at 6 or at 12 months among some previous users of LAM than among those who did not use LAM or those who have used other methods (Hardy et al 1998;Alvarado et al 1999;Tazhibayev et al 2004;Bongiovanni et al 2005). In summary, although LAM is an effective clinical method, programs must find more efficacious strategies for training providers and counseling clients regarding the three conditions required to use it appropriately and effectively, and how to use LAM as a bridge to the adoption of modern methods.…”

“…In Kazakhstan, for example, no difference in LAM use was found at six months postpartum between a group of women who were counseled at the hospital about LAM and a group of women who were not counseled but who had also received detailed information about breastfeeding. Moreover, although half the women in intervention hospitals said that they planned to use LAM, significantly fewer knew the three essential elements of the method (Tazhibayev et al 2004). Similarly, in a study in Chile in which exclusive breastfeeding was promoted and LAM was systematically explained to all clients at one clinic but not to those of another, only 2.5 percent of women in the intervention clinic (and no women in the control clinic) used LAM in the postpartum period, whereas 74 percent and 10 percent, respectively, fully breastfed their children at six months (Alvarado et al 1999).…”

Postpartum family planning: current evidence on successful interventions

“…In Kazakhstan, researchers trained maternity staff to provide patient counseling on the benefits of LAM with a 20-hour training and counseling course. 24 The intervention was implemented in four hospitals, two of which were previously certified as baby friendly hospitals (BFHs) according to the WHO/United Nations Children’s Fund standards, and two were not certified BFH, so they were considered ordinary hospitals (OHs). Of the five matched control group hospitals, two were BFHs and three were OHs.…”

Interventions to Improve Postpartum Family Planning in Low‐ and Middle‐Income Countries: Program Implications and Research Priorities

“…One of the surprises of the literature search was the paucity of trials that evaluated the impact of LAM promotion-and the few that were identified gave conflicting results. There is some evidence that LAM can be a popular choice; it may also facilitate adoption of other methods, and certainly breastfeeding practices can be improved (Alvarado et al 1999;Tazhibayev et al 2004;Bongiovanni 2005;Lopez-Martinez, Romero-Gutierrez, and De Leon 2006;Warren et al 2010). However, the evidence from national surveys is not encouraging.…”