An assessment of a postpartum family planning intervention in selected areas of Bangladesh

Postpartum family planning (PPFP) focuses on providing family planning (FP) counselling and services to women and couples in the first 12 months after birth. An effective PPFP program helps to improve maternal and child health, through a reduction in short birth intervals.

An effective way of increasing uptake of PPFP is to create demand for PPFP through counseling during ANC and offering FP methods during facility delivery, and soon afterwards. During the prenatal period, WHO recommends the provision of PPFP counselling during facility-based antenatal care (ANC) and community-based pregnancy screening (in cases when women do not go to facilities for ANCs). During the delivery period, 48 hours and six weeks postpartum period, WHO also recommends the provision of PPFP counselling and appropriate services during any contact with women delivering in facilities or at home by skilled birth attendants (SBA).

The Government of Bangladesh has been implementing limited PPFP interventions in Bangladesh since 2002. The DGFP puts high priority on PPFP use as indicated by a DLI (Disbursement linked Indicator) related to the World Bank support to MOHFW.However, despite many efforts, the PPFP initiatives of DGFP, DGHS, and private-sector facilities and providers are weak. PPFP counselling hardly takes place, and methods are rarely offered at facilities during delivery.

MaMoni Maternal and Newborn Care Strengthening Project (MaMoni MNCSP) enables measuring the effect of PPFP counseling on PPFP initiation. This includes providing technical support to MOHFW to strengthen its’ efforts to provide PPFP services through several means. These include training of the service providers on PPFP, PPIUCD, and Maternal Health (MH) package, availability of FP commodities through the e-LMIS & Supply Chain Management Portal (SCMP), providing PPFP counselling job-aid, providing PPFP Method pictorial card job-aid, technical support to relevant GoB staff on recording and reporting to the national platform (MIS3-DGFP, DHIS2-DGHS), monitoring FP compliances, and providing supportive supervision, including Joint supervisory visits (JSV). Additionally, (the) project facilitates to ensure DGHS facility providers like nurses and midwives to receive PPFP training and to ensure coordination between health and FP to increase utilization of FP method at DGHS facilities.

The facilities covered by MaMoni provide “systematic counselling” as well as BCC materials for clients and job aids for providers. In contrast, facilities that are not covered by MaMoni lack in the characteristics mentioned above. Therefore, it is likely that ANC and delivery clients seeking services from MaMoni-supported facilities will have received the required information, counselling, and services on PPFP and thus will have higher use of PPFP than those from non-supported facilities.

The objectives of this study are three folds:

  • To measure the effect of strengthened and systematic PPFP counselling during ANC visits in health facilities and/or offering family planning methods during facility delivery on the acceptance of FP methods during postpartum period.
  • To understand women’s perspective in receiving counselling on PPFP during ANC visits at health facilities and/or during facility delivery, and their decision-making process to use FP methods within respective postpartum period, and
  • To understand the providers’ perspective of PPFP service delivery including the service delivery system.

Intervention area: Feni MCWC, ZU Model Hospital (private), Sonagazi UHC
Comparison area: Cumilla MCWC and Chauddagram UHC


  • Directorate General of Family Planning (DGFP)
  • MaMoni MNCSP
  • Data for Impact (D4I)


December 2023

Dr Quamrun Nahar