1. 1 Healthy Fertility Study Program and Policy Implications from Healthy Fertility Study Findings October 26, 2011

2. Presentation Outline  Summary of program learning  Implications for program and policy  Global applications 2 Community Mobilization Meeting, Sylhet Photo: A. Nash-Mercado

3. HFS 18 month data compared with National and Sylhet, BDHS 2007 3

4. Programmatic Learning  LAM- including EBF criteria  Importance of HH distribution in this setting with this group (mobility, religion)  Pregnancy surveillance as an opportunity for FP  Postpartum women- require messages about pregnancy risk and amenorrhea  Effective integration with MNH- “ “early and new users” 4 When can Asma become pregnant again?

5. Policy Implications  Focusing on extended postpartum extends benefits through second year  Identifable group of women with multiple service contacts and opportunities for FP integration  Evidence that FP integration is a MNH best practice; Addition of FP doesn’t affect delivery/coverage for other interventions  LAM should be advocated based on contraceptive and child survival benefits 5

6. Contribution to Bangladesh and Global Programs  Bangladesh: Mamoni, Mayer Hashi – but opportunities for nutrition, child health  Model application in Afghanistan, Nigeria, Mali, - elements in India  Development of module for addition to UNICEF/WHO newborn care package 6 District Coordination Meeting Photo: S. Ahmed

7. G lobal Interest in HFS at International Fora  ANE Best Practice, 2007  APHA, 2008  APHA, 2009  USAID ANE SOTA,2009  International FP Conf., 2009  ANE Best Practice II, 2010  Global Health, 2010  Women Deliver, 2010  Global Maternal Health, 2010  USAID ANE SOTA, 2010  Global Health 2011 7 International Family Planning Conference 2009 Photo: A. Nash-Mercado

8. Continued Learning  Cost effectiveness analysis  Additional findings  24 month  30 month  36 month  Multiple manuscripts  3,6,12 month findings  LAM and transition  Impact of integration 8 Community Mobilization Meeting Photo: S. Ahmed

9. Further Exploration  Community-based approach- limitations for service delivery  Pregnancy rates- differentiate at six months  Self report  MR  Non-users – intend to get pregnant 9 CHW Household Counseling Session, Sylhet Photo: S. Ahmed

10. HFS Contributions  Landmark study  LAM and EBF  MNH and FP Integration  Early Contraceptive Adoption & Sustained Use  Contraceptive Use and Pregnancy Spacing  Newborn Outcomes 10 CHW Counseling Session, Sylhet Photo: S. Ahmed

11. THANK YOU! 11 CHW Household Visit, Sylhet Photo: S. Ahmed