Family Planning and Immunization Integration: Updated Impact Data
|Table 1a. Percentage of Women attending routine childhood immunization service who leave the Facility With a Modern Contraceptive Method, before and after family planning was systematically offered as part of routine immunization care. (updated March 5, 2018)|
|% of women attending an IMZ clinic who received a modern method (n (%))||Difference in difference1||Change in IMZ services||Full citation|
|Ghana||Intervention||646 (22%)a||482 (24%)a||1 pp||Not reported||Vance et al.,2013|
|Control||833 (21%)a||801 (22%)a|
|Liberia||Intervention only||NA||1224 (8-41%)b||NA||No negative effects||Cooper et al.,2015|
|Nepal||Intervention only||NA||2349 (37%)||NA||No negative effects||NHSSP,2013|
|Philippines||Intervention||191 (27%)c||275 (38%^)c||8 pp||Not reported||Herrin et al.,2012|
|Control||301 (35%)c||331 (38%^)c|
|Rwanda||Intervention||403 (49%*)d||426 (57%*^)d||15 pp||No negative effects||Dulli et al.,2016|
|Control||403 (58%)d||422 (51%^)d|
|Zambia||Intervention||1506 (41%)a||962 (49%)a||4 pp||Not reported||Vance et al.,2013|
|Control||2659 (32%)a||1092 (36%)a|
1. Difference in Difference is the change in contraceptive use in the intervention group minus the change in contraceptive use in the control. This is the estimate percentage point change in contraceptive use that is attributal to the intervention.
* statistically significant difference between baseline and endline, p<.05
^ statistically significant difference between intervention and control groups, p<.05
(a) Use of a non-condom modern FP method for women 9-12 months postpartum, unclear if method received on site or already using a method
(b) 1224 is the total number of referral acceptors from EPI who accepted an FP method that day across both counties. 8-41% is the range across sites of average monthly % of mothers bringing children for immunization who accept an FP method that day.
(c) % of women attending an IMZ clinic, who have an unmet need and received a modern method
(d) % of women 6-12 months postpartum attending an IMZ clinic, unclear if method received on site or already using a method
Table 1a reports on the percentage of women attending childhood immunization services before and after family planning was systematically offered as part of routine immunization care. In most cases we are unable to determine what percentage of women received a modern method at the facility or if they were using a method prior to seeking care. However, all four of the studies that collect baseline and endline results reported increased contraceptive use at endline and difference in difference calculation indicate that integrated care contributed to increased contraceptive use. Three of the six studies also collected data on the effects on immunization services. All found no negative effects.
Cooper CM; Fields R; Mazzeo CI; Taylor N; Pfitzer A. Successful proof of concept of family planning and immunization integration in Liberia. Global Health: Science and Practice. 2015 Mar 1;3(1):71-84.
Dulli LS; Eichleay M; Rademacher K; Sortijas S; Nsengiyumva T. Meeting postpartum women’s family planning needs through integrated family planning and immunization services: results of a cluster-randomized controlled trial in Rwanda. Global Health: Science and Practice. 2016 Mar 1;4(1):73-86.
Herrin AN, Benabaye RS, Escalada LDP, et al. FP-EPI integration as an approach to reduce unmet need for modern family planning. Unpublished report; November 2012.
Nepal Health Sector Support Programme (NHSSP). Case Study 5 Integration of Expanded Programme on Immunisation and Family Planning Clinics: Value for Money Study. Kalikot Operational Research Pilot 2012-13. August 2013.
Vance G, Janowitz J, Chen M, Boyer B, Kasonde P, Asare G, Kafulubiti B, Stanback J. Integrating Family Planning Messages into Immunization Services: A Cluster-Randomized Trial in Ghana and Zambia. Health Policy and Planning; 2013 Apr 9.