Shinde Sachin, Yelverton Cara, Ali Nazia Binte, Partap Uttara, Ouédraogo Moussa, Yusufu Innocent, Shah Iqbal, Fawzi Wafaie
Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA.
BMJ Glob Health. 2025 May 30;10(Suppl 1):e017482. doi: 10.1136/bmjgh-2024-017482.
Integrating family planning with nutrition could address unmet family planning needs and malnutrition in low-income and middle-income countries (LMICs). Integrating family planning with sexual reproductive health (SRH) services may provide valuable insights as well. This scoping review synthesised evidence from published and grey literature on interventions integrating family planning with nutrition or SRH services in LMICs.
We searched MEDLINE, EBSCO and Google Scholar for studies on integrated family planning, nutrition or SRH services, including codelivery or referral-based models. Evidence was analysed using narrative synthesis.
We reviewed 109 articles; most family planning within broader health initiatives, particularly targeting maternal and child health and health system strengthening efforts. Integration strategies varied, generally involving codelivery of services or referral systems linking different service platforms and using diverse health providers. Outcomes were often reported by individual components, concentrating on specific services like family planning use and less so on nutrition or overall maternal and child health, thus limiting a complete understanding of the integrated intervention's impact. Qualitative and process evaluations primarily explored the acceptability and feasibility of integration, highlighting challenges in service delivery, stakeholder engagement and training and supervision gaps.
Our findings suggest three evidence-based priorities for improving the integration of family planning, nutrition and SRH services: (1) standardising definitions and frameworks for integration typologies; (2) investing in workforce training and (3) strengthening supply chains. These align with implementation challenges recurrently observed across studies. The review also underscores the necessity for more rigorous research focused on the effectiveness and cost-effectiveness of integrated approaches, providing critical insights for decision-makers aiming to optimise health service delivery in resource-limited settings.
将计划生育与营养相结合可以满足低收入和中等收入国家（LMICs）未得到满足的计划生育需求并解决营养不良问题。将计划生育与性健康和生殖健康（SRH）服务相结合也可能提供有价值的见解。本范围综述综合了已发表文献和灰色文献中关于低收入和中等收入国家将计划生育与营养或性健康和生殖健康服务相结合的干预措施的证据。
我们在MEDLINE、EBSCO和谷歌学术上搜索了关于综合计划生育、营养或性健康和生殖健康服务的研究，包括联合提供或基于转诊的模式。使用叙述性综合分析证据。
我们审查了109篇文章；大多数计划生育是在更广泛的卫生倡议中进行的，特别是针对孕产妇和儿童健康以及加强卫生系统的努力。整合策略各不相同，通常涉及联合提供服务或连接不同服务平台并使用不同卫生服务提供者的转诊系统。结果往往按各个组成部分报告，主要集中在计划生育使用等特定服务上，而对营养或整体孕产妇和儿童健康的关注较少，因此限制了对综合干预措施影响的全面理解。定性和过程评估主要探讨了整合的可接受性和可行性，突出了服务提供、利益相关者参与以及培训和监督差距方面的挑战。
我们的研究结果提出了改善计划生育、营养和性健康和生殖健康服务整合的三个基于证据的优先事项：（1）标准化整合类型的定义和框架；（2）投资于劳动力培训；（3）加强供应链。这些与各项研究中反复观察到的实施挑战相一致。该综述还强调了有必要进行更严格的研究，关注综合方法的有效性和成本效益，为旨在优化资源有限环境中卫生服务提供的决策者提供关键见解。
