ArticleBMC health services research2020
Integrated delivery of family planning and childhood immunisation services in routine outreach clinics: findings from a realist evaluation in Malawi.
Article in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
8 citing papers in PubMed, 18 citations in OpenAlex.
- Community case management to accelerate access to healthcare in Mali: a realist process evaluation nested within a cluster randomized trial.Health policy and planning · 2024Trial
- Integrating family planning with nutrition and other sexual and reproductive health services in low-income and middle-income countries: findings from a scoping review.BMJ global health · 2025Article
- Integration measurement and its applications in low- and middle-income country health systems: a scoping review.BMC public health · 2023Article
- Uptake of, barriers and enablers to the utilization of postnatal care services in Thyolo, Malawi.BMC pregnancy and childbirth · 2023Article
- Integrated delivery of family planning and childhood immunization services: a qualitative study of factors influencing service responsiveness in Malawi.Health policy and planning · 2022Article
- "It was my own decision": the transformational shift that influences a woman's decision to use contraceptives covertly.BMC women's health · 2022Article
- Integrated delivery of family planning and childhood immunisation services: a mixed methods assessment of service responsiveness.BMC health services research · 2022Article
- Missed opportunities for family planning counselling among postpartum women in eleven counties in Kenya.BMC public health · 2022Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFamily planning (FP) needs among postpartum women in low- and middle-income countries remain largely unmet. Integrating FP with childhood immunisation services could partially reduce this unmet need by creating multiple opportunities for timely contact with FP services during the 12 months following childbirth.
methodsA realist evaluation of an intervention integrating FP and childhood immunisation services in routine outreach clinics in two rural districts of Malawi was conducted. A Context-Mechanism-Outcome (CMO) framework was used to describe the drivers of the intervention. A detailed programme theory was developed based on the analysis of semi-structured interviews and focus group discussions with 50 stakeholders.
resultsA total of 9 core mechanisms were identified, which centred on constructs of access. Findings revealed that on the demand side, women were motivated to attend outreach clinics due to shorter travel distances; they felt confident they could access FP services and use contraceptive methods covertly if needed; and when supported by their husband, they were empowered to take up the use of contraceptive methods. On the supply side, providers were empowered through the training they received to provide integrated services; they were confident in their ability to provide essential services; and they were motivated by teamwork and by the recognition they received for their work. Additionally, some providers were found to be unwilling to walk long distances to reach remote clinics, which was seen to negatively affect the availability of services.
conclusionsThe delivery of integrated FP and childhood immunisation services in the context of routine outreach clinics in rural Malawi was seen to trigger mechanisms of accessibility and to improve the acceptability and availability of FP services. However, further research is needed to understand how the integration of these services in a routine outreach clinic setting may affect other dimensions of accessibility, including the approachability, appropriateness and affordability of services.
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