PMID- 25276580
OWN - NLM
STAT- MEDLINE
DCOM- 20150611
LR  - 20220330
IS  - 2169-575X (Print)
IS  - 2169-575X (Electronic)
IS  - 2169-575X (Linking)
VI  - 2
IP  - 2
DP  - 2014 May
TI  - Integrating family planning into postpartum care through modern quality 
      improvement: experience from Afghanistan.
PG  - 226-33
LID - 10.9745/GHSP-D-13-00166 [doi]
AB  - To address low contraceptive use in Afghanistan, we supported 2 large public 
      maternity hospitals and 3 private hospitals in Kabul to use modern quality 
      improvement (QI) methods to integrate family planning into postpartum care. In 
      2012, QI teams comprising hospital staff applied root cause analysis to identify 
      barriers to integrated postpartum family planning (PPFP) services and to develop 
      solutions for how to integrate services. Changes made to service provision to 
      address identified barriers included creating a private counseling space near the 
      postpartum ward, providing PPFP counseling training and job aids to staff, and 
      involving husbands and mothers-in-law in counseling in person or via mobile 
      phones. After 10 months, the proportion of postpartum women who received family 
      planning counseling before discharge in the 5 hospitals increased from 36% to 
      55%, and the proportion of women who received family planning counseling with 
      their husbands rose from 18% to 90%. In addition, the proportion of postpartum 
      women who agreed to use family planning and left the hospital with their 
      preferred method increased from 12% to 95%. Follow-up telephone surveys with a 
      random sample of women who had received PPFP services in the 2 public hospitals 
      and a control group of postpartum women who had received routine hospital 
      services found significant differences in the proportion of women with 
      self-reported pregnancies: 3% vs. 15%, respectively, 6 months after discharge; 6% 
      vs. 22% at 12 months; and 14% vs. 35% at 18 months (P < .001). Applying QI 
      methods helped providers recognize and overcome barriers to integration of family 
      planning and postpartum services by testing changes they deemed feasible.
FAU - Tawfik, Youssef
AU  - Tawfik Y
AD  - University Research Co., LLC, Bethesda, MD, USA. Now with Jhpiego , Dhaka , 
      Bangladesh.
FAU - Rahimzai, Mirwais
AU  - Rahimzai M
AD  - University Research Co., LLC, Kabul, Afghanistan. Now in Delhi , India.
FAU - Ahmadzai, Malalah
AU  - Ahmadzai M
AD  - University Research Co., LLC, Kabul, Afghanistan. Now with the Ministry of Public 
      Health [Afghanistan] , Kabul , Afghanistan.
FAU - Clark, Phyllis Annie
AU  - Clark PA
AD  - University Research Co., LLC, Bethesda, MD, USA. Now in Quepos , Costa Rica.
FAU - Kamgang, Evelyn
AU  - Kamgang E
AD  - University Research Co., LLC , Bethesda, MD , USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140415
PL  - United States
TA  - Glob Health Sci Pract
JT  - Global health, science and practice
JID - 101624414
SB  - IM
MH  - Afghanistan
MH  - *Contraception
MH  - Counseling
MH  - Family
MH  - *Family Planning Services
MH  - Female
MH  - Humans
MH  - Postnatal Care/*standards
MH  - *Postpartum Period
MH  - Pregnancy
MH  - *Quality Improvement
PMC - PMC4168614
COIS- Competing Interests: None declared.
EDAT- 2014/10/03 06:00
MHDA- 2014/10/03 06:01
PMCR- 2014/04/15
CRDT- 2014/10/03 06:00
PHST- 2013/11/10 00:00 [received]
PHST- 2014/02/06 00:00 [accepted]
PHST- 2014/10/03 06:00 [entrez]
PHST- 2014/10/03 06:00 [pubmed]
PHST- 2014/10/03 06:01 [medline]
PHST- 2014/04/15 00:00 [pmc-release]
AID - GHSP-D-13-00166 [pii]
AID - 10.9745/GHSP-D-13-00166 [doi]
PST - epublish
SO  - Glob Health Sci Pract. 2014 Apr 15;2(2):226-33. doi: 10.9745/GHSP-D-13-00166. 
      eCollection 2014 May.