Meeting the family planning needs of postpartum women.

T he first days, weeks, and months after a delivery represent a period of substantial information and service needs for both mother and child, including treatment of hemorrhage and infections, breastfeeding infor mation and support, nutritional comple­ ments and micronutrients, immunizations for children and mothers, counseling for managing intimate partner violence and depression, and, most importantly, contracep­ tion. In areas of high HIV prevalence, contraceptives and antiretroviral therapy are especially critical elements of postpartum care. Yet despite its strategic impor­ tance, few organizations have made it a priority to address women's reproductive health and fertility needs during the year following delivery. The situation is compounded by the scarcity of postpar­ tum care in many countries, creating a major public health concern (Fort, Kothari, and Abderrahim 2006). This Program Brief focuses on the degree to which ser­ vice delivery organizations in sub­Saharan Africa, Asia and the Near East, and Latin America and the Caribbean (LAC) meet the contraceptive needs of women in the post­ partum period and the strate­ gies they have tested for doing so. The brief principally relies on reviewing the results and lessons learned from opera­ tions research (OR) projects conducted by the Population Council's Frontiers in Reproductive Health Program (FRONTIERS). n BLOCKINPostpartum contraception offers benefits to women, children, and health systems. n BLOCKINWomen need information and services, including a range of family planning methods, throughout the maternal cycle, including the postpartum period. n BLOCKINResearch has identified many approaches for improving access to postpartum family planning methods. n BLOCKINPostpartum family planning can be integrated into other programs, including programs to prevent and manage HIV. Women need family planning information and services in the postpartum period. Why focus on postpartum contraception? Postpartum contraceptive pro­ grams are strategically important from a public health perspec­ tive, with significant benefits to women and their children. Integrating contraception can benefit health systems as well by increasing women's use of post­ partum, well­baby, family plan­ ning, and other services. Ross and Winfrey (2001) show that in 27 less developed coun­ tries, two­thirds of women within a year of their last deliv­ ery have an unmet need for contraception and that nearly 40 percent plan to use a method but have not done so. Other studies showed that between 25 percent and 40 percent of maternal deaths could be eliminated if unplanned and unwanted pregnancies were pre­ vented (Campbell and Graham 2006), and that 10 …