Child Spacing in MCH Programs

1
Child Spacing in MCH Programs

• Harriet Stanley, PhD
• Hstanley_at_path.org

2
Overview

• Impact of child spacing on the health of women
  and children
• FP services in development countries what weve
  learned
• Womens choices
• Looking Ahead

3
Child Spacing

• Close spacing and high fertility are a
  significant determinant of poor health of mothers
  and infants and impacts the health and
  socio-economic well being of families

4
Mothers

• Avoid unsafe abortion
• Limit health risks of pregnancy and childbirth
• Limit births to healthiest ages
• Limit number of births.

5
Children

• Spacing increases chances of survival
  significantly
• Healthier birth weights, healthier babies
• Assures babies are adequately breastfed.

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Reducing Excess Fertility

• Family planning
• Delayed marriage
• Prolonged breastfeeding
• Abortion

7
Traditional Approaches to Child Spacing

• There are many examples of traditional practices
  that promoted birth spacing
• Women lives with own family
• Polygamy
• Importance of breastfeeding period.

8
Changing Trends

• In surveys, women report lower desired than
  actual fertility or that their last birth was
  unwanted. Even more report that they want no
  more children. If they do, they want to wait a
  significant period of time.

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Trends

• Last 30 years, couples using contraception from
  10 to 50
• Fertility dropped from average of 6 to 4 children
  per woman
• FP and socio-economic development both play role
  to some degree

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Family Planning Programs what weve learned

• At service delivery level demand, access,
  choice of methods, client-centered quality,
  communication.
• At program Admin level leadership, RD.
• At govt policy level political commitment,
  financial resources.

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Meeting peoples Needs

• Setting targets for contraceptive acceptors is
  not the road to family planning success. Rather,
  if people are given the opportunity, they choose
  family planning when it meets their needs.

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Field Programs focus on availability, access
and quality

• Availability

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Field Programs contd

• Access understanding the barriers
• Distance, time and cost
• Gender, caste and class
• Economic
• Cultural

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Field Programs contd

• Quality
• Skilled providers at all levels
• Safe clinical practices
• Effective counseling

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Challenges

• Meeting remaining unmet need
• Reaching young, unmarried women
• Increasing mens involvement
• Linking to broader RH services