RESEARCH SUMMARY

December 2003

Family Planning and PMTCT Services: Examining Interrelationships,
Strengthening Linkages

Preventing unintended pregnancy among HIV-positive women through family planning services is one of the four cornerstones of a comprehensive program for prevention of mother-to-child HIV transmission (PMTCT).¹ According to the World Health Organization (WHO 2002), a moderate reduction in the number of pregnancies among HIV-infected women would yield a reduction equivalent to the number of infections averted among infants of HIV-positive pregnant women, given that so few of these women receive the full package of PMTCT interventions (from HIV counseling and testing to support for safer infant feeding practices).

Reducing unintended pregnancies among HIV-positive women through family planning also reduces the number of children potentially orphaned when parents die of AIDS-related illnesses. It also reduces HIV-positive women's vulnerability to morbidity and mortality related to pregnancy and lactation. In addition, family planning for both HIV-positive and -negative women safeguards their health by enabling them to space births.

This summary focuses on findings from Horizons studies on the extent to which voluntary counseling and testing (VCT) and PMTCT programs address family planning, and vice versa. In Kenya and Zambia, the Horizons Program collaborated with NARESA and the MTCT Working Group, respectively, and UNICEF to document the acceptability, operational barriers, costs, and impact of pilot PMTCT services. The major research activities in each country included tracking the utilization of various services, including VCT and family planning; following a cohort of clinic users for 12 to 18 months to determine the effect of PMTCT service utilization on knowledge, practices, and rates of mother-to-child HIV transmission; observation of the quality of care delivered by providers; and an economic analysis of the PMTCT program.

This summary also draws on data from a Horizons study in Uganda that tested a strategy for the integration of HIV counseling into health services, including family planning, and from a recent evaluation of United Nations-supported pilot PMTCT projects in 11 countries.² In the Uganda study, researchers used a combination of methods to determine the extent to which providers assessed client needs, discussed HIV-related issues, and made referrals for such related services as VCT. In the UN study, UNICEF and Horizons employed a mix of qualitative and quantitative methodologies, including a rapid assessment of services at pilot sites in Rwanda and Zambia, to identify strengths as well as gaps in service delivery (see Rutenberg et al. 2003a).

¹ The other three cornerstones are primary prevention of HIV infection in women, reducing transmission from HIV-infected pregnant and lactating women to their children, and care and support of women, infants, and families infected and affected by HIV/AIDS.

² These were the original 11 countries that began PMTCT interventions in 1999-2000. They include Botswana, Burundi, Honduras, India, Ivory Coast, Kenya, Rwanda, Tanzania, Uganda, Zambia, and Zimbabwe.

• Key Findings
• Program Implications
• References
• PDF format of summary (100 KB)

Study Investigators

Study investigators include Margaret Siwale and Chipepo Kankasa of the MTCT Working Group in Zambia; Ruth Nduati, Dorothy Mbori Ngacha, and Jennifer Oyieke of NARESA in Kenya; Naomi Rutenberg and Scott Geibel of Horizons/Population Council; and Sam Kalibala of the International AIDS Vaccine Initiative (formerly of Horizons).

Suggested citation: Rutenberg, N. et al. 2003. "Family Planning and PMTCT Services: Examining Interrelationships, Strengthening Linkages," Horizons Research Summary. Population Council: Washington DC.

About Horizons

Horizons conducts global operations research to improve prevention, care, and support program. Horizons is implemented by the Population Council under a cooperative agreement with the U.S. Agency for International Development. Horizons is implemented by the Population Council in partnership with the International Center for Research on Women (ICRW), the Program for Appropriate Technology in Health (PATH), the International HIV/AIDS Alliance, Tulane University, Family Health International (FHI), and Johns Hopkins University.

Copyright © 2003, The Population Council

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See Also

• Population Council – Gender, Family, and Development Program
• Population Council – HIV/AIDS
• Robert H. Ebert Program on Critical Issues in Reproductive Health

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For additional information please contact: 
Horizons 
Population Council 
4301 Connecticut Ave. NW, Suite 280 
Washington, DC 20008
Telephone: +1 202 237 9400 
Facsimile: +1 202 237 8410 
E-mail: horizons@popcouncil.org 

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This page updated
19 October 2007