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Division & Project Overview : During the first year of BARMMHealth project implementation, it has been realized through data review and stakeholder consultations that women who delivered babies recently have limited access to information on modern contraceptive methods hence, delay transition from LAM to modern contraceptives which results in unplanned or unintended pregnancy.
It was also observed that a lot of postpartum women were identified to be LAM users. Notedly, drop-out rates for the said method are high and would account for potential unmet needs.
Initially, BARMMHealth plans to conduct operational research to closely examine the practice of LAM and to generate evidence of missed opportunities to help women of the region to successfully transition from LAM to modern methods.
In 2017, BARMM’s modern Contraceptive Prevalence Rate (mCPR) was at 18.7% compared to 41.13% nationally. Despite the wide gap, BARMM’s rate of increase in mCPR was 1-percentage point from NDHS 2013-2017.
On the other hand, at the national level, the rate of increase in CPR is 0.6-percentage point. It underscores that BARMM has made great strides but remains one of the weakest regions in terms of the use of modern family planning method.
LAM is a World Health Organization (WHO) recommended method of modern family planning. Islam recognizes the health importance of exclusive breastfeeding for the first six months for the health benefits and well-being of the infant and the mother being an obligatory duty of parents as embodied in the Qur’an that says, The mother shall suckle their children for two whole years for those who wish to complete the period of suckling.
Suratul-Baqarah, 2 : 233). LAM accounts for less than 1% of contraceptive use (NDHS, 2017) nationally and in BARMM. However, the Field Health Service and Information System (FHSIS, 2018) shows that country-wide, LAM accounts for 10.
86% of all methods, whereas, it is nearly double in BARMM at 20.75%. In BARMM, LAM ranks as the third-highest used method next to pills (33.
02%) and injectable (33.15%). For new acceptors, about 49.57% are LAM users (FHSIS, 2018), accounting for half of the Family Planning (FP) methods and outranking Oral Contraceptive Pills (OCP) and injectable.
A study to evaluate LAM compliance found that at three months postpartum, 97% of women either met LAM criteria or had shifted to a non-LAM modern family planning method.
In the 6th month, 87% of women no longer met LAM criteria and of these, only 31% had shifted to an alternative modern family planning method.
This means that at six-month postpartum, 56% of the women were not protected against pregnancy through any modern family planning method.
There are no existing studies on LAM in BARMM, particularly whether the LAM users meet the criteria, the extent of unmet need post-LAM, or whether they shift to a more intermediate or long-acting FP method.
In BARMM, provincial service statistics reported that nearly half of new acceptors are using LAM but users also drop out at a higher rate too.
As a regular practice among health workers in the region, LAM is reported as themethod in use of any woman who deliver her baby in a health facility was then initiated into breastfeeding .
Towards the end of the 2020 FY, BARMMHealth will launch the LAM operational research in Maguindanao and Sulu identified research sites based on representativenes, a commitment of DOH to support the implementation within 18 months.
Deliverables BARMMHealth project is being implemented to improve maternal and child health status by making high-quality family planning services available.
As part of the project, the LAM research is conducted to understand how to support lactating women to choose and accept an appropriate method of family planning for her if she chooses to do so.
This STTA consultant will assist in the following LAM activities :
This consultancy will be for the period starting on August 17, 2020, to March 31, 2021, for a maximum of 63 days. Expected Outputs Outputs of this TA include contact / meeting reports following the phases of engagement, such as :
Minimum Qualifications : In line with the specified scope of work detailed above and expected outputs, the STTA provider should preferably possess the following essential specialization, skills, and competencies :