Lecture 2.1 Family Planning Methods and Delivery Strategies and Barriers

Family planning
methods, & delivery

strategies
Lecture 2.1
by
Sadat M. (MPH/Rh)
Learning objectives
• Understand different family planning methods
• Identify different FP delivery systems
Family Planning Methods
I. Traditional Family Planning Methods • LAM is very effective (1 - 2
1. Lactational amenorrhoea (LAM) pregnancies per 100 women
during first 6 months) and
2. Abstinence attachment for the new born
3. Coitus Interrupts limitations .
1. Lactational amenorrhoea (LAM)
• It is the use of breastfeeding as a • Is highly effective only until
contraceptive method based on the menses return or up to 6 months.
physiologic effect of suckling to
suppress ovulation
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2. Abstinence
• Its major limitation is that many people ( couples) may not
find it acceptable to go without sex.
3. Coitus Interrupts
• It is not a reliable method because there is often pre -
ejaculation of sperm which can lead to pregnancy.
• Hence, this is not a method to be recommended.
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II. Natural Family Planning Methods
1. The rhythm or calendar method
2. The basal body temperature method (BBT)
3. The cervical mucus method ( Billings method)
4. The sympatothermal method ( Combination of BBT and Billings

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III. Barrier Methods
1. Condom
2. Diaphragm
3. Spermicides
Condom
 Advantage: Protection against STDs can be
used as back up & it don’t interfere with BF
 Limitations : moderate effectiveness ( 2 - 12
pregnancies/100 women/first year)
• 6
IV. Oral Contraceptives (Hormonal methods)
• Mechanism: suppressing ovulation, thickening cervical mucosa, making
implantation less likely and reducing sperm transport in upper genital tract
( Fallopian tubes).
• Combined oral contraceptives (COC) are preparations of synthetic
oestrogen and progesterone
• Benefits: are highly effective (0.1 - 4 pregnancies per 100 women during
the first year of use).
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Injectable Contraceptives
• Limitations: changes in menstrual
• Depo – Provera :is the most common bleeding pattern, some weight gain
type ( 2 kg), and delay in return of fertility.
• It is a progestin only injectable
contraceptive (PICs) given every three
months.
• It can be given up to four weeks early
or four weeks late.
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Contraceptive Implants( Norplant)
• A set of 6 small plastic capsules placed under the skin of a
woman's upper arm.
• Can prevent pregnancy for at least five years.
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Intrauterine (Contraceptive) Devices
Generally there are two types
 Copper releasing and
 Progestin releasing.
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• Advantages:
• Is highly effective ( 0.5 - 1 pregnancies per 100 women during first year use),
• Gives protection for about 10 years, can be provided by trained non - physician
and
• There is an immediate return to fertility upon removal.
• Limitations
• The need for pelvic examination and screening for GTIs,
• Requirement for trained provider for insertion and removal,
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Voluntary Surgical Contraception (VSC) (Vasectomy & Tubal ligation)
• VSC is a procedure for permanent sterilization of men and women.
• VSC is one of the safest, most economical and effective ( 0.2 - 4 pregnancies per 100 women
during first year use) contraceptive methods.
• The limitations include that it is a permanent method ( must be considered not reversible), small
risk of surgical complications, short term discomfort/pain following procedure and requires trained
physician.
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Emergency Contraception
• Is contraception used after unprotected sexual  Are effective only if used within 72
intercourse, if pregnancy is not planned or hours of unprotected intercourse. \
 A second dose must be taken after 12
desired.
hours.
15
Family Planning Delivery Strategies
• FP Service delivery strategies need to be tailored to reach populations in

different locations – urban, rural villages and remote areas.
• The most common service delivery outlets are
Clinics based
Community based distribution (CBD) programs
Commercial retail sales (social marketing) and
Work place program
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1. A clinic based approach

 Is good for clients do not live far from the clinic.
 Able to provide wide range of methods (including IUDs, hormonal
implants, injectables, and VSC).
 Linkage with other services
• Problems are cultural sensitivity convenience and accesses
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2. Community Based Distribution

 Service by village women and men trained to educate about family planning and distribute
certain contraceptives.
 CBD programs usually distribute condoms, pills and spermicides and in some cases they
were trained to provide injectables.
 Because local residents bring family planning services directly to individuals

• They make family planning both accessible, convenient and culturally sensitive 18
3. Commercial Retail Sales

 For people who want to obtain contraceptives from sources outside the health care system i.e
commercial retail sales ( sometimes called social marketing) e.g DKT
 Make contraceptive methods very accessible for certain groups.
 Contraceptives such as oral contraceptive pills, condoms, and spremicides are sold at
reduced, subsidized prices in pharmacies, stores, shops, bars and are advertised on the mass
media..
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•Thank You

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Family planning

methods, & delivery

II. Natural Family Planning Methods

1. The rhythm or calendar method

2. The basal body temperature method (BBT)

3. The cervical mucus method ( Billings method)

4. The sympatothermal method ( Combination of BBT and Billings

• FP Service delivery strategies need to be tailored to reach populations in

1. A clinic based approach

2. Community Based Distribution

 Because local residents bring family planning services directly to individuals

3. Commercial Retail Sales

 Make contraceptive methods very accessible for certain groups.

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