The integration of family planning with other health services: a literature review.

CONTEXT

Integrating family planning services with other health services may be an effective way to reduce unmet need. However, greater understanding of the evidence on integration is needed.

METHODS

Studies that evaluated the integration of family planning with any other type of health service were identified by searching five databases. To be included, studies had to have: been published in English between 1994 and 2009; used either a single-group pre- and posttest design or a two-group control or comparison design; and reported a family planning-related behavioral or reproductive health outcome.

RESULTS

Nine studies met the inclusion criteria. The integration interventions ranged from simple referrals between providers of existing services to fully integrated, community-based delivery of education and services. One evaluation used a quasi-experimental design; two used case-control comparison designs; two used combination designs; and the rest used either a single-group pre- and posttest design or a two-group cross-sectional design. Seven studies found improvements in family planning-related outcomes, although not all reported the significance of these changes; another reported mixed results and one found no effect. Of the studies that examined providers', clients' or community members' perspectives of integration, all reported overall satisfaction. No studies provided an economic analysis.

CONCLUSIONS

The evidence supporting the integration of family planning with other health services remains weak, and well-designed evaluation research is still needed. Future research should report outcomes for all health areas being integrated and should investigate in more detail the perspectives of providers, clients and community members and assess the cost-effectiveness of integration.