Impact of integrating family planning with maternal and child health on uptake of contraception: A quasi-experimental study in rural, Sindh, Pakistan.

This study aimed to evaluate the impact of integrating family planning with maternal and child health (FP-MCH) on the uptake of modern contraceptive methods (MCMs) and related health outcomes in two rural districts of Sindh, Pakistan using a quasi-experimental control before-after study design. Inte...

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Main Authors: Zahid Memon, Wardah Ahmed, Shah Muhammad, Fatima Haider, Talib Hussain Lashari, Muhammad Jawwad, Sophie Reale, Rachael Spencer, Zulfiqar Bhutta, Hora Soltani
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLOS Global Public Health
Online Access:https://doi.org/10.1371/journal.pgph.0004872
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author Zahid Memon
Wardah Ahmed
Shah Muhammad
Fatima Haider
Talib Hussain Lashari
Muhammad Jawwad
Sophie Reale
Rachael Spencer
Zulfiqar Bhutta
Hora Soltani
author_facet Zahid Memon
Wardah Ahmed
Shah Muhammad
Fatima Haider
Talib Hussain Lashari
Muhammad Jawwad
Sophie Reale
Rachael Spencer
Zulfiqar Bhutta
Hora Soltani
author_sort Zahid Memon
collection DOAJ
description This study aimed to evaluate the impact of integrating family planning with maternal and child health (FP-MCH) on the uptake of modern contraceptive methods (MCMs) and related health outcomes in two rural districts of Sindh, Pakistan using a quasi-experimental control before-after study design. Intervention package integrated FP with MCH in the existing public sector at facility and community levels. This included capacity building of health care providers, ensuring sustained supplies of family planning commodities, and community engagement activities through Lady Health Workers (LHW). Data was collected through household surveys at baseline (1st October- 31st December 2020) and endline (1st October- 31st December 2022). Sample size was calculated as 880 married women of reproductive age (MWRA) in each district. The Difference-in-Differences (DiD) analytical method was used to assess the impact of intervention. There was an increase of 11.7% in current use of MCMs in the intervention group compared to the control group (p-value <0.003), with increases observed in uptake of injections, implants, and condoms. Furthermore, family planning counseling during ANC (DiD 9.1%, p-value 0.162), LHW visits during pregnancy (DiD 15.4%, p-value 0.018), postnatal care (PNC) visits for mothers (DiD 24.0%, p-value <0.001), LHW visits after delivery (DiD 20.6%, p-value <0.001), and counseling by LHW about family planning at PNC visit (DiD 15.3%, p-value 0.027). The study concludes that integrating FP with MCH services proved impactful in increasing contraception uptake and minimizing missed opportunities. It underscores the necessity for cohesive efforts by the government and local stakeholders to design local, regional, and national policy frameworks pertaining to health and population planning for sustainable mother and child health improvements.
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spelling doaj-art-78dad963f76042daaef67f360cc851762025-08-20T03:17:51ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752025-01-0157e000487210.1371/journal.pgph.0004872Impact of integrating family planning with maternal and child health on uptake of contraception: A quasi-experimental study in rural, Sindh, Pakistan.Zahid MemonWardah AhmedShah MuhammadFatima HaiderTalib Hussain LashariMuhammad JawwadSophie RealeRachael SpencerZulfiqar BhuttaHora SoltaniThis study aimed to evaluate the impact of integrating family planning with maternal and child health (FP-MCH) on the uptake of modern contraceptive methods (MCMs) and related health outcomes in two rural districts of Sindh, Pakistan using a quasi-experimental control before-after study design. Intervention package integrated FP with MCH in the existing public sector at facility and community levels. This included capacity building of health care providers, ensuring sustained supplies of family planning commodities, and community engagement activities through Lady Health Workers (LHW). Data was collected through household surveys at baseline (1st October- 31st December 2020) and endline (1st October- 31st December 2022). Sample size was calculated as 880 married women of reproductive age (MWRA) in each district. The Difference-in-Differences (DiD) analytical method was used to assess the impact of intervention. There was an increase of 11.7% in current use of MCMs in the intervention group compared to the control group (p-value <0.003), with increases observed in uptake of injections, implants, and condoms. Furthermore, family planning counseling during ANC (DiD 9.1%, p-value 0.162), LHW visits during pregnancy (DiD 15.4%, p-value 0.018), postnatal care (PNC) visits for mothers (DiD 24.0%, p-value <0.001), LHW visits after delivery (DiD 20.6%, p-value <0.001), and counseling by LHW about family planning at PNC visit (DiD 15.3%, p-value 0.027). The study concludes that integrating FP with MCH services proved impactful in increasing contraception uptake and minimizing missed opportunities. It underscores the necessity for cohesive efforts by the government and local stakeholders to design local, regional, and national policy frameworks pertaining to health and population planning for sustainable mother and child health improvements.https://doi.org/10.1371/journal.pgph.0004872
spellingShingle Zahid Memon
Wardah Ahmed
Shah Muhammad
Fatima Haider
Talib Hussain Lashari
Muhammad Jawwad
Sophie Reale
Rachael Spencer
Zulfiqar Bhutta
Hora Soltani
Impact of integrating family planning with maternal and child health on uptake of contraception: A quasi-experimental study in rural, Sindh, Pakistan.
PLOS Global Public Health
title Impact of integrating family planning with maternal and child health on uptake of contraception: A quasi-experimental study in rural, Sindh, Pakistan.
title_full Impact of integrating family planning with maternal and child health on uptake of contraception: A quasi-experimental study in rural, Sindh, Pakistan.
title_fullStr Impact of integrating family planning with maternal and child health on uptake of contraception: A quasi-experimental study in rural, Sindh, Pakistan.
title_full_unstemmed Impact of integrating family planning with maternal and child health on uptake of contraception: A quasi-experimental study in rural, Sindh, Pakistan.
title_short Impact of integrating family planning with maternal and child health on uptake of contraception: A quasi-experimental study in rural, Sindh, Pakistan.
title_sort impact of integrating family planning with maternal and child health on uptake of contraception a quasi experimental study in rural sindh pakistan
url https://doi.org/10.1371/journal.pgph.0004872
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