CLA Drives Postpartum Family Planning Integration in Egypt's Hospitals

Egypt’s unmet family planning (FP) need remains a significant issue, especially in addressing population growth. To address it, the Egyptian Ministry of Health and Population (MOHP), in collaboration with Strengthening Egypt's Family Planning Program (SEFPP) and with funding from the United States Agency for International Development (USAID), implemented an intervention to expand postpartum family planning (PP-FP) by introducing immediate  postpartum intrauterine device (IUD) insertion during cesarean sections (C-sections). 

The initial phase of the intervention included training of service providers in MOHP hospitals on the PP-IUD service. However, despite training efforts, rates of PP-IUD insertion during C-sections remained low. MOHP and SEFPP applied a collaborating, learning, and adaptation (CLA) approach, including pause and reflect followed by adaptive management methods, continuous learning and improvement, and decision-making methods, that led to a set of actions based on the six World Health Organization (WHO) health systems strengthening building blocks (service provision, workforce, information systems, medical products, financing, and governance) to improve PP-IUD service delivery and uptake.

Through a CLA approach, MOHP and SEFPP strengthened multiple health system components that collectively increased PP-IUD insertions during C-section from 18% to 51%, representing a 33% jump. The results of this intervention are expected to benefit the health and well-being of women in Egypt for future generations to come. This case demonstrates the application of multiple CLA framework components to improve PP-IUD insertion rates among C-section clients following a service provider training, and close collaboration with the Egyptian government to introduce the new intervention in public hospitals across the country.