Data on integration of provision of postpartum FP services with MCH services by the types of service. A comprehensive facility survey instrument called the Service Provision Assessment (SPA) has been developed by USAID and Macro International Inc. to be used with nationally representative samples of health facilities to provide information on the characteristics of health services, including availability of FP methods as part of labor and delivery, postpartum, and/or child health care (MEASURE DHS, 2011). The data can be further disaggregated by the type of facility or program (public, private, non-governmental, community-based, etc.), by the specific types of methods available, and by other relevant factors such as districts, urban/rural location, and target populations.

Data Source(s):

Facility registers on services provided; surveys, such as SPA; WHO’s Service Availability and Readiness Assessment (SARA); and information management systems.

Purpose:

This indicator can be used to compare and track trends in the level of integration of FP with MCH services and can serve as a proxy for women’s access to postpartum FP services.  When subset by type of service, the indicator can help policy and program planners identify where scaling up of integrated FP and MCH services is taking place and where there are gaps. Optimally, MCH programs and services can provide a range of methods to meet the needs of postpartum woman for limiting and spacing pregnancies. FP use during the first year postpartum has the potential to significantly reduce the number of unplanned pregnancies leading to fewer closely spaced pregnancy intervals and decreases in maternal and child morbidity and mortality. The integration of the range of contraceptive methods for postpartum women with MCH programs and services provides opportunities to streamline and improve care at the most favorable and critical times for maximizing women’s reproductive health and the health of their children. Multiple contacts with MCH services during the antenatal and the postpartum periods have been shown to increase women’s use of FP methods by six months postpartum and decrease unmet need for FP (USAID/ACCESS-FP/ Frontiers, 2008). The benefits associated with combining FP and MCH services are directly related to achieving Millennium Development Goals #4 reduce child mortality and #5 improve maternal health.

Issue(s):

This indicator measures integration of and increased access to postpartum FP through MCH services, but the overall access to, distribution of, and quality of services can best be measured using a range of indicators that provide data on method procurement, storage, affordability, travel time to facilities, staffing, delivery of method services and follow-up, and client utilization and satisfaction (WHO, 2010).

References:

MEASURE DHS. 2011, Service Provision Assessments (SPA) Survey Overview, DHS Website. http://www.measuredhs.com/What-We-Do/Survey-Types/SPA.cfm