The Integration of Family Planning and Childhood Immunization Services in Togo

Abstract

Improvements in the constellation of services in the African context are largely addressed through attaining better measures of service integration, which can be achieved through improved referral across categories of health programs. The use of an unobtrusive referral message that linked family planning and the Expanded Program of Immunizations (EPI) services was tested in an operations research study in Togo. The introduction of the referral message was accompanied by an 18-percent increase in awareness of available family planning services and an increase in the average monthly number of new family planning clients of 54 percent. These positive results indicate that the use of referral can have a significant and dramatic impact on family planning services in a relatively short time. In Togo, no evidence existed of a negative impact on EPI services, and a majority of the EPI providers reported satisfaction with the effect of the referral message at the close of the study.

Relationships between structure, process and outcome to assess quality of integrated chronic disease management in a rural South African setting: applying a structural equation model

“…Similar to a Togolese study in which the majority of service providers positively viewed the impact of integrating family planning services to the routine expanded programme on immunisation [36], the operational managers in this study reported being satisfied with 16 of the 17 dimensions of quality of care in the ICDM model. However, this was less so for the patients who reported satisfaction with 14 of these dimensions of care.…”

Outreach and integration programs to promote family planning in the extended postpartum period

“…Interventions varied considerably in character and counseling intensity, and were not described consistently. Four studies conducted interventions at infant vaccination visits: 2 studies [20,23] involved family-planning counseling and referral to a family-planning clinic, 1 study [24] provided education on breastfeeding and family planning, and another study [25] included multidisciplinary care with a social worker, pediatrician, and nurse practitioner. Other studies tested multiple additional visits outside of routine infant care.…”

“…Of the 3 mother–infant care integration studies that reported positive results [23–25], 1 study [25] was of fair quality and 2 studies [23,24] were of poor quality. In a randomized controlled trial of postpartum adolescents [25], the intervention group that received an integrated multidisciplinary mother–infant care program had a significantly decreased repeat pregnancy rate at 18 months compared with a control group that received routine well-infant care (12% versus 28%; P =0.003).…”

“…The limitations of the identified studies on mother–infant integration programs included unclear time and method of outcome measurement [24,25] and significant loss to follow-up limiting the ability to measure outcomes [21,22]. In addition, the study by Huntington et al [23] was a combination of a time series survey and a retrospective review of service statistics, both of which have a high susceptibility to confounding and bias. Research on mother–infant care integration is sparse and varied in quality, although some research [23–25] has shown that these interventions improve contraceptive use and pregnancy spacing.…”

Quasi-experimental Study of Systematic Screening for Family Planning Services among Postpartum Women Attending Village Health and Nutrition Days in Jharkhand, India

“…Postpartum women may not seek health services to space their next pregnancy, but are likely to seek routine immunization services for their children [89]. Women bringing their children to facilities according to the routine vaccination schedule have multiple contacts with health providers over the course of their first year postpartum, providing opportunity to introduce integrated messaging on a number of critical health issues, including family planning [210].…”