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Context-specific, evidence-based planning for scale-up of family planning services to increase progress to MDG 5: health systems research
BACKGROUND: Unmet need for family planning is responsible for 7.4 million disability-adjusted life years and 30% of the maternity-related disease burden. An estimated 35% of births are unintended and some 200 million couples state a desire to delay pregnancy or cease fertility but are not using cont...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3563623/ https://www.ncbi.nlm.nih.gov/pubmed/23140196 http://dx.doi.org/10.1186/1742-4755-9-27 |
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author | Byrne, Abbey Morgan, Alison Soto, Eliana Jimenez Dettrick, Zoe |
author_facet | Byrne, Abbey Morgan, Alison Soto, Eliana Jimenez Dettrick, Zoe |
author_sort | Byrne, Abbey |
collection | PubMed |
description | BACKGROUND: Unmet need for family planning is responsible for 7.4 million disability-adjusted life years and 30% of the maternity-related disease burden. An estimated 35% of births are unintended and some 200 million couples state a desire to delay pregnancy or cease fertility but are not using contraception. Unmet need is higher among the poorest, lesser educated, rural residents and women under 19 years. The barriers to, and successful strategies for, satisfying all demand for modern contraceptives are heavily influenced by context. Successfully overcoming this to increase the uptake of family planning is estimated to reduce the risk of maternal death by up to 58% as well as contribute to poverty reduction, women’s empowerment and educational, social and economic participation, national development and environmental protection. METHODS: To strengthen health systems for delivery of context-specific, equity-focused reproductive, maternal, newborn and child health services (RMNCH), the Investment Case study was applied in the Asia-Pacific region. Staff of local and central government and non-government organisations analysed data indicative of health service delivery through a supply–demand oriented framework to identify constraints to RMNCH scale-up. Planners developed contextualised strategies and the projected coverage increases were modelled for estimates of marginal impact on maternal mortality and costs over a five year period. RESULTS: In Indonesia, Philippines and Nepal the constraints behind incomplete coverage of family planning services included: weaknesses in commodities logistic management; geographical inaccessibility; limitations in health worker skills and numbers; legislation; and religious and cultural ideologies. Planned activities included: streamlining supply systems; establishment of Community Health Teams for integrated RMNCH services; local recruitment of staff and refresher training; task-shifting; and follow-up cards. Modelling showed varying marginal impact and costs for each setting with potential for significant reductions in the maternal mortality rate; up to 28% (25.1-30.7) over five years, costing up to a marginal USD 1.34 (1.32-1.35) per capita in the first year. CONCLUSION: Local health planners are in a prime position to devise feasible context-specific activities to overcome constraints and increase met need for family planning to accelerate progress towards MDG 5. |
format | Online Article Text |
id | pubmed-3563623 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-35636232013-02-08 Context-specific, evidence-based planning for scale-up of family planning services to increase progress to MDG 5: health systems research Byrne, Abbey Morgan, Alison Soto, Eliana Jimenez Dettrick, Zoe Reprod Health Research BACKGROUND: Unmet need for family planning is responsible for 7.4 million disability-adjusted life years and 30% of the maternity-related disease burden. An estimated 35% of births are unintended and some 200 million couples state a desire to delay pregnancy or cease fertility but are not using contraception. Unmet need is higher among the poorest, lesser educated, rural residents and women under 19 years. The barriers to, and successful strategies for, satisfying all demand for modern contraceptives are heavily influenced by context. Successfully overcoming this to increase the uptake of family planning is estimated to reduce the risk of maternal death by up to 58% as well as contribute to poverty reduction, women’s empowerment and educational, social and economic participation, national development and environmental protection. METHODS: To strengthen health systems for delivery of context-specific, equity-focused reproductive, maternal, newborn and child health services (RMNCH), the Investment Case study was applied in the Asia-Pacific region. Staff of local and central government and non-government organisations analysed data indicative of health service delivery through a supply–demand oriented framework to identify constraints to RMNCH scale-up. Planners developed contextualised strategies and the projected coverage increases were modelled for estimates of marginal impact on maternal mortality and costs over a five year period. RESULTS: In Indonesia, Philippines and Nepal the constraints behind incomplete coverage of family planning services included: weaknesses in commodities logistic management; geographical inaccessibility; limitations in health worker skills and numbers; legislation; and religious and cultural ideologies. Planned activities included: streamlining supply systems; establishment of Community Health Teams for integrated RMNCH services; local recruitment of staff and refresher training; task-shifting; and follow-up cards. Modelling showed varying marginal impact and costs for each setting with potential for significant reductions in the maternal mortality rate; up to 28% (25.1-30.7) over five years, costing up to a marginal USD 1.34 (1.32-1.35) per capita in the first year. CONCLUSION: Local health planners are in a prime position to devise feasible context-specific activities to overcome constraints and increase met need for family planning to accelerate progress towards MDG 5. BioMed Central 2012-11-12 /pmc/articles/PMC3563623/ /pubmed/23140196 http://dx.doi.org/10.1186/1742-4755-9-27 Text en Copyright ©2012 Byrne et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Byrne, Abbey Morgan, Alison Soto, Eliana Jimenez Dettrick, Zoe Context-specific, evidence-based planning for scale-up of family planning services to increase progress to MDG 5: health systems research |
title | Context-specific, evidence-based planning for scale-up of family planning services to increase progress to MDG 5: health systems research |
title_full | Context-specific, evidence-based planning for scale-up of family planning services to increase progress to MDG 5: health systems research |
title_fullStr | Context-specific, evidence-based planning for scale-up of family planning services to increase progress to MDG 5: health systems research |
title_full_unstemmed | Context-specific, evidence-based planning for scale-up of family planning services to increase progress to MDG 5: health systems research |
title_short | Context-specific, evidence-based planning for scale-up of family planning services to increase progress to MDG 5: health systems research |
title_sort | context-specific, evidence-based planning for scale-up of family planning services to increase progress to mdg 5: health systems research |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3563623/ https://www.ncbi.nlm.nih.gov/pubmed/23140196 http://dx.doi.org/10.1186/1742-4755-9-27 |
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