The Quality of Family Planning Services for Breastfeeding Women in Senegal

Abstract

This study examined the management of contraceptive services for lactating women visiting clinics for the first time in Senegal. A situation analysis (SA) was conducted in 1994 among staff at 180 service delivery points for new and family planning (FP) clients. The SA included an inventory of facilities and services at each site observation of service provision exit interviews among first time clients and interviews with providers and program managers. Most staff were midwives. Findings indicate that the mean age of clients was 29 years; parity averaged 3.7 children. Almost all women were Muslim. About 75% were married. 56% of women in exit interviews were breast-feeding. Only 7% of staff said that breast-feeding women would be treated the same when advised about method choice. 66% of providers gave correct information about contraception for lactating women. Almost 40% did not correctly indicate that breast-feeding was a reason not to use combined oral contraceptives. About 25% of providers received training in FP counseling and 66% reported training in clinical FP practice. 75% of those trained considered it inadequate. About 21% of new clients were not asked about their breast-feeding status. Almost 85% of managers indicated that instruction on breast-feeding was provided. Over 33% of breast-feeding women chose combined oral contraceptives. Only 12.5% adopted progestin only pills which were in ample supply. The IUD was the third most common choice but breast-feeding women were less likely to use. Over 75% of clinics had at least one type of IUD in stock.