Integration of family planning into maternal and child health and other services at Harare Central Hospital

To increase the accessibility, availability, and acceptance of family planning methods and counseling, family planning services were integrated with maternal and child health care services at Harare Central Hospital in Zimbabwe. The Family Planning Project was implemented with hopes that mothers would seek contraceptive methods and counseling concurrent with their or their children's hospital admission, thereby making facility and service inaccessibility a thing of the past. Ante-natal, post-natal, and postabortal women were targeted for project outreach at the facility, along with patients suffering chronic medical and psychiatric problems, and mothers of malnourished children. Weaknesses of family planning provision at the hospital prior to the project are presented in the component parts of pharmacy, emergency gynecology unit, outpatient department, ante-natal clinic, post-partum care, post-natal clinic, and the general hospital. 2 full-time nurse- midwives and 2 part-time gynecologists counsel and provide services for the Family Planning Project. Other programmatic changes and improvements are described. There were 3,822 new acceptors and 5,423 return visits during the 1st project year, with the nurse-midwives providing 3,114 couple-years of protection, equal to 5.1% of the total provided by all 35 national family planning council clinics. Additional results, plans for the future, and problem areas are further discussed. The project, undertaken with few resources and high motivation, yielded high family planning acceptance rates with markedly less inconvenience for acceptors.