A Process Evaluation of Integrated Family Planning and Routine Child Immunization Services in Benin Público

Abstract

Objective: The integration of routine childhood immunization and family planning (FP) services (FP/EPI) seeks to provide pathways for increased uptake of both services. This evaluation assessed the implementation of a combined service provision model and experiences of postpartum women seeking services at integrated FP/EPI facilities in Benin. 

Methods:We conducted nine focus groups with FP users and non-users in the extended postpartum period. Women were recruited using nurse midwives at seven FP/EPI integrated facilities. We observed FP/EPI sessions at eight representative facilities. We coded focus group discussion data and analyzed them for themes using MAXQDA 12. We analyzed observation data using Microsoft Word and Microsoft Excel.

Results: Thefocus group participants had a median age of 28 years and three children. Most cited withdrawal as a previous FP method, and those currently using a method cited the Jadelle implant most often. Women in both groups shared generally positive experiences with FP sensitization, but felt that the referral process was confusing. Reasons to start a contraceptive method included: to stop worrying about an unplanned pregnancy, to space births, and to recover from a previous birth. Common reasons to not start a contraceptive included: not receiving a husband’s consent, husband not being present at the time the method was offered, and possible contraceptive side effects. Observations revealed that in four out of eight health facilities, FP sensitization did not take place due to staffing shortages. Very few health educators used job aids or referral cards and educational materials were not displayed throughout the health facilities. 

Conclusions:Integrated FP/EPI services are feasible and accepted by postpartum women, but require uniform implementation across health facilities, including adequate staff, adapted referral systems, consistent and continuous training for health workers, and engagement activities targeting men in the community.

Table of Contents

TABLE OF CONTENTS

INTRODUCTION………………………………………………1 – 6

 

LITERATURE REVIEW……………………………………….7 – 20

 

MANUSCRIPT…………………………………………………21 – 41

 

PUBLIC HEALTH IMPLICATIONS………………………….42 – 44

 

APPENDIXES.…………………………………………………45 – 54

 

 

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Obstetrics and Gynecology
Palabra Clave	reproductive, reproduction, postpartum, benin, focus group, patient flow analysis, west africa, public health, family planning, contraception, contraceptive, immunization, vaccination, dtp3, integrated health services
Committee Chair / Thesis Advisor	Rochat, Roger, Emory University
Committee Members	Schroffel, Heidi, CARE USA
Partnering Agencies	International Non-governmental organization (e.g., CARE, Inc.)

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