LAM Consultant
University Research Co
Cotabato City, Philippines
3d ago

University Research Co., LLC (URC)

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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 :

  • Review of the LAM study protocol and prepare necessary documents for submission to the Ethics Review Board of Cotabato Regional Medical Center (CRMC) and assist in responding and / or complying with any additional ERB requirements as need be.
  • Conduct of formative research before finalizing the LAM intervention design. The activities for the formative phase are proposed as follows :
  • Map all pregnant women in their third trimester both in intervention and control sites and assess their knowledge on LAM and modern contraceptive methods while also gathering data on household sociodemographic factors, and access to and use of health services.
  • List all women who delivered their babies three months preceding the day of data collection and use a semi-structured interview to know about their breastfeeding status, knowledge on LAM and modern contraceptive methods, and willingness to shift to a modern method.
  • Conduct 3 Key Informational Interviews with the participation of 3-4 key staff (IPHO technical, IPHO health promo officer, health provider of RHU) along with mapping exercises administered among recently delivered women (3) and older women (3) to explore community perceptions about birth spacing, as well as to compile a list of health care providers who offered family planning services.
  • Conduct 15 semi-structured interviews with health care providers and 4 focus group discussions with community opinion leaders, including religious leaders, members of Barangay Administrative Committees, and village leaders, to obtain their opinions on healthy timing and spacing of pregnancies.
  • Work with the COP, PIC / HSQI, and SBC Directors to finalize research design.
  • Coordinate and work with the HSQI Director and SBC Director to train a select group of BHWs on the use of the LAM Job aid
  • Coordinate with BARMMHealth COP, PIC, MOH, and Provincial partners for the implementation / launch of the Research
  • Take the lead on monitoring the interventions and continuous data collections within 6 to 12 months.
  • Provide the COP / PIC-HSQI Director field reports periodically (weekly, monthly, and quarterly) as needed.
  • 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 :

  • Inception plan
  • Results of the formative research / preparation for the research design.
  • Report on the training of data collectors and BHWs in the experimental sites
  • Data collection report and analysis in 6 months
  • Data collection report and analysis in 12 months
  • Narrative consultancy report and PPT
  • 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 :

  • A development professional, with background on education or women’s studies, or with specialization in the field of public health, and / or experience on gender equality in the context of BARMM;
  • Preferably a resident consultant of BARMM, and highly familiar with the culture of the people, social and gender norms and practices, and favorable in reproductive health and rights of individuals;
  • Has extensive knowledge of operations research, population, and development, gender, adolescent youth health and development;
  • Proven track record and extensive experience in training and technical writing;
  • Excellent communications and presentation skills including oral and written communication;
  • Results-oriented with proven ability to work independently or in a teamwork environment; and
  • Excellent computer skills.
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