Assessing the Feasibility of Integrating Family Planning Services into Postpartum and Post Abortion Care in Togo, West Africa Público
Maher,Katherine (Summer 2023)
Abstract
Background: Western Africa has one of the highest rates of maternal mortality in the world. One initiative to decrease this high rate of maternal mortality, is the integration of family planning (FP) into postpartum and post abortion care. In 2014, Togo made a commitment to establish family planning integration as an essential element of their health care plans. However, there is a need to understand the barriers within the healthcare system that may impede effective integration of family planning into postpartum and abortion care.
Objective: This study explores key stakeholders’ perspectives on the feasibility of integrating family planning into Togo’s postpartum and post abortion care and to identify if there are areas that require capacity building for successful FP integration.
Methods: To gain diversity of perspectives from Togo’s health care system, 41 stakeholders from academic, government and private organizations were interviewed. Data was analyzed using thematic analysis through five cyclical steps: identifying core issues to develop a codebook, coding data using MAXQDA software, conducting inter-coder agreement, descriptive analysis, and categorizing major themes found in the data.
Results: Four major areas of capacity building for patient and provider levels were identified: lack of knowledge amongst patients and providers surrounding FP; the need for a standardized process for providers that includes FP in postpartum and post abortion care; the need for integrated infrastructure that allows for seamless counseling and provision of FP methods in health facilities; and, the need for sufficient supplies and equipment to successfully provide FP. Potential capacity building strategies for these areas included: multi-pronged education campaigns; education outreach initiatives, and comprehensive FP continued education.
Discussion: These results indicate that while challenges for integrating family planning into postpartum and post abortion care are well known, it is important that government, non-government organizations, health facilities, providers and community health workers must work together in order for integration of FP to be successful in Togo. Future steps for integration include gathering patient perspectives of their perceived barriers to integration FP, the role of men in FP decisions and what challenges urban health facilities face for integrating FP.
Table of Contents
Introduction 1
Family Planning 3
Postpartum Family Planning 5
Post Abortion Care Family Planning 9
Overview of Togo 11
Family Planning, Postpartum and Post abortion Family Planning in Togo 12
Study Objectives 13
Methods 14
Results 17
Capacity Building Needs 18
Strategies for Capacity Building for Successful Integration of FP 25
Discussion 28
Limitations 31
Conclusion 31
Public Health Implications 32
Further Suggestions for Research 34
References 36
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