Family planning services in low to middle income countries

As family planning methods continue to remain inaccessible to millions in low to middle income countries (LMICs), University of Adelaide researchers are investigating a way to make it more accessible.

PhD student Farina Gul, Dr Mohammad Mahmood, and Associate Professor Zohra Lassi, all from the University's School of Public Health, and Dr Gizachew A. Tessema from Curtin University are analysing situations across the world to try and find a solution.

Their plan behind the study was published in Sexual and Reproductive Healthcare.

"In LMICs, an estimated 257 million women who wish to avoid pregnancy are not using any form of family planning," said first author Ms Gul.

"Despite advancements in contraception and family planning services in LMICs, significant variations exist across regions.

"Sub-Saharan Africa has a lower contraceptive usage rate (about 30 to 40 per cent) and a higher unmet need of around 20 to 25 per cent while Asia and Latin America demonstrate higher contraceptive prevalence rates (60 to 70 per cent) and a low unmet need (10 to 15 per cent).

"These disparities arise from factors such as inadequate healthcare infrastructure, a lack of trained providers, weak referral mechanism, and insufficient political commitment and funding.

"Addressing these issues is essential for improving family planning access and outcomes."

Ms Gul said the study will explore integrating family planning services with similar health services like antenatal care, postnatal care, post-abortion care, postpartum care, HIV/AIDS services, and immunisation programs.

"A lack of political commitment and inadequate infrastructure, especially for privacy-sensitive services, further hinders integration efforts," she said.

"Additionally, shortages in logistics, equipment, and trained personnel exacerbate these challenges, while increased providers workload often leads to resistance or lack of confidence in offering additional services.

"To effectively combine and streamline health service delivery, a multi-level approach encompassing policy, organisational, and clinical aspects is crucial.

"Integration is a fundamental element for improving accessibility and equity in healthcare, particularly within primary healthcare systems."

A key part of the research exploring examples from low and middle-income countries where the care is already integrated.

"This study will select cases from these countries which will ensure that the experiences offer valuable insights into successful family planning integration strategies, and contribute to a deeper understanding of the challenges and facilitators in these settings," said Ms Gul.