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The Potential for Integrating Community-Based Nutrition and Postpartum Family Planning: Review of Evidence and Experience in Low-Income Settings


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  • Helle M. Alvesson
  • Menno Mulder-Sibanda
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    The objective of this review was to study where community-based family planning and nutrition programs have been integrated, how this has been accomplished, and what the results have been. Although family planning is a nontraditional intervention in community-based nutrition programs, it can have profound effects on maternal and child health and nutrition. When family planning does not occur, short intervals between pregnancies deplete mothers' reserves of nutrients needed for pregnancy and later for breastfeeding. As a result, short birth intervals are associated with higher maternal and neonatal mortality and malnutrition rates of infants. Family planning, which promotes contraceptive use and the lactational amenorrhea method, can thus improve nutrition outcomes in both mothers and babies. The authors identified a few studies on integrated services in the published literature; thus the main part of the review is built on operational research studies and unpublished smaller scale intervention studies. However, the controlled studies that were identified indicate positive correlation between breastfeeding levels and increased contraception use. Additionally, although the design of the intervention studies did not make it possible to assess the degree to which integration had an impact, the studies did highlight factors that were key to a successful integration process. These are community engagement; multiple and frequent contact points between mothers, community volunteers, and health workers; involvement of husbands; moving implementation decisions closer to the users of the program; and assuring transparency, clarity, and simplicity in the transmission of development objectives to communities.

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    Bibliographic Info

    Paper provided by The World Bank in its series Health, Nutrition and Population (HNP) Discussion Paper Series with number 85743.

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    Length: pages 60 pages
    Date of creation: 01 Nov 2013
    Date of revision:
    Handle: RePEc:wbk:hnpdps:85743

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    Keywords: abortion; access to family planning; access to health care; adolescent girls; adolescent pregnancies; adolescents; age of marriage; Antenatal care; antenatal visits; ... See More + vailability of family planning; babies; baby; BASIC HEALTH CARE; Behavior Change; birth control; breast milk; breastfeeding; care during pregnancy; Child Development; child health; child health services; child marriage; Child Mortality; child mortality rate; child mortality rates; CHILD NUTRITION; CHILD SURVIVAL; childbearing; childbirth; children per woman; clinics; Community health; complementary food; condoms; contraception; contraceptive method; Contraceptive prevalence; contraceptive services; contraceptive use; counselors; declines in fertility; delivery care; demographic targets; development objectives; diabetes; diseases; Early childbearing; economic growth; economic status; emergency obstetric care; exchange of information; existing family planning; families; Family Health; Family Health International; FAMILY PLANNING; family planning methods; FAMILY PLANNING PROGRAMS; family planning services; family size; fertility; fertility rate; fertility rates; fewer pregnancies; first pregnancy; forms of contraception; gender issues; global policy; HEALTH CARE; health care providers; health care services; health centers; HEALTH EDUCATION; health facilities; health indicators; health interventions; health messages; health outcomes; health promotion; Health sector; health system; health systems; health workers; high child mortality; HIV; home visits; hospital; hospitals; household surveys; Human Development; Human Immunodeficiency Virus; husbands; hygiene; ill-health; Illness; immunization; Immunizations; Immunodeficiency; individual women; Infant; infant feeding; Infant mortality; Infant mortality rate; infant mortality rates; infant nutrition; INTEGRATING FAMILY PLANNING; international organizations; intervention; iodine deficiency; iron; IUD; IUDs; lactational amenorrhea; lactational amenorrhea method; LAM; large families; laws; live births; local community; longitudinal research; Low-Income Settings; male involvement; malnourished children; maternal care; maternal deaths; maternal health; MATERNAL MORTALITY; Maternal mortality rate; maternal mortality rates; Maternal mortality ratio; maternal nutrition; maternity services; medical facilities; midwife; midwifery; midwives; Millennium Development Goals; Ministry of Health; modern contraceptives; morbidity; mortality; mortality among infants; MORTALITY REDUCTIONS; mother; national Drug; national level; National Population; National Population Policy; neonatal mortality; newborns; number of children; number of women; nurses; NUTRITION; nutrition education; nutritional status; oral contraceptives; outreach workers; peer groups; pill; population control; population growth; postabortion; postabortion care; postnatal care; postpartum period; practitioners; pregnancies; pregnancy; pregnant women; preventive health care; Primary Health Care; progress; promotion of family planning; provision of family planning; puberty; public debate; Public Health; public health services; quality of services; radio; religious leaders; reproductive age; reproductive health; reproductive health services; risk of death; role models; rural areas; safe motherhood; sanitation; scientific evidence; screening; service delivery; sexually active; siblings; skilled personnel; small families; smaller families; social services; stillbirth; surgery; teenage girls; teenage pregnancies; teenagers; UNFPA; United Nations Population Fund; unmarried adolescent; unmarried women; use of family planning; use of family planning methods; vaccination; village chiefs; voluntary family planning; woman; workers; World Health Organization; Young Child; young children;

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    1. Anoshua Chaudhuri, 2008. "Revisiting the Impact of a Reproductive Health Intervention on Children’s Height-for-Age with Evidence from Rural Bangladesh," Economic Development and Cultural Change, University of Chicago Press, vol. 56, pages 619-656.
    2. Leach, Melissa A. & Fairhead, James R. & Millimouno, Dominique & Diallo, Alpha Ahmadou, 2008. "New therapeutic landscapes in Africa: Parental categories and practices in seeking infant health in the Republic of Guinea," Social Science & Medicine, Elsevier, vol. 66(10), pages 2157-2167, May.
    3. Horton, S. & Ross, J., 2003. "The economics of iron deficiency," Food Policy, Elsevier, vol. 28(1), pages 51-75, February.
    4. Amin, Ruhul & St. Pierre, Maurice & Ahmed, Ashraf & Haq, Runa, 2001. "Integration of an Essential Services Package (ESP) in Child and Reproductive Health and Family Planning with a Micro-credit Program for Poor Women: Experience from a Pilot Project in Rural Bangladesh," World Development, Elsevier, vol. 29(9), pages 1611-1621, September.
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