our work

What we do and the evidence behind it

What we do

We connect women with family planning options in the postpartum (post-birth) period – a uniquely impactful juncture. Contraceptive access in the year after birth prevents short-spaced pregnancies, a significant cause of maternal and neonatal mortality. Pregnancies that occur less than two years apart are associated with a 32% higher rate of maternal mortality and 18% higher rate of infant mortality (Conde-Agudelo 2007; Kozuki 2013). Despite these risks, contraceptive use in Ghana drops by two-thirds in the early postpartum period.

Our work focuses on Ghana, West Africa’s second-most populous country. In collaboration with our local partners and the Ghana Health Service, we train midwives and nurses in the integration of two new models of family planning counselling developed by MHI into the standard check-ups mothers and their children receive in the months after giving birth.

How we do it

Our training provides healthcare workers with a specific approach to counselling based on extensive research and collaboration with experts in the field. This approach maximises the quality of counselling provided while ensuring convenient access to family planning commodities is integrated into counselling sessions.

By targeting existing postnatal and child welfare sessions that women attend, we ensure that high-quality information and access to family planning services is seamlessly integrated into existing systems of care.

We are continually refining our training to deliver further increases to provider knowledge and their confidence in delivering high-quality information to the women they serve. By empowering healthcare workers, we can ensure that local staff embedded in the communities we work in have the tools and skills they need to transform the healthcare women recieve.

Why is this a good solution?

Post-birth care is one of the few times many women in lower-income countries interact with formal healthcare services. Integrating family planning services into this care is a highly cost-effective, scalable, and evidence-based approach to increasing contraceptive uptake and reducing maternal mortality.

Integrating high-quality counselling into routine care addresses multiple barriers to contraceptive uptake. First, mothers do not need to travel to a facility specifically for family planning. This means that they can receive confidential information and that they are spared the costs – both in time and money – of a separate visit.

Second, many women express significant concerns around side effects and health consequences from family planning. High-quality counselling ensures women receive counselling on multiple methods – helping to find a method that avoids the side effects they may be concerned about – while addressing myths and misconceptions that can drive opposition to the use of methods.

Postpartum family planning is recommended as a High Impact Practice by USAID and the Gates Foundation for its demonstrated ability to transform access to family planning services.

It is essential that improvements to healthcare systems are designed around the lived experiences and culture of the places where they are implemented. Our focus on the quality of counselling ensures that women recieve information that is tailored to their specific circumstances, greatly increasing the value and impact of the counselling that is given.

Why Ghana?

One of our first decisions was where to work first. Our research suggested that women across Sub-Saharan Africa would benefit from improved family planning care. We selected Ghana as the starting point for our work due to its high unmet family planning needs, high birth rate, and robust healthcare system with which we could build a sustainable programme.

Women interact with the Ghana healthcare system at a few key points when having children. We identified postnatal care (PNC) and child welfare clinics (CWC) as two key touchpoints that women attended at high rates and occurred at times when women were able to take up most family planning methods, making these the focus of our work.

The effectiveness of postpartum family planning has been demonstrated by a number of high-quality randomised control trials (RCTs).

The evidence is clear: postpartum family planning increases contraceptive uptake and improves health outcomes for women.

Support our work

We would love your support in achieving our mission, whether by following our work, contributing to our funding, or offering your time to help guide our efforts.

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