Assessing the availability and scope of routine data on post-pregnancy family planning: A cross-sectional review of registers and reporting tools in 18 low- and middle-income countries

Abstract

Many low- and middle-income countries (LMICs) include postpartum and postabortion family planning (PPFP/PAFP) in their national family planning (FP) commitments. Understanding what PPFP and PAFP data are available in routine health information systems (HIS) is important, as both county-level and global monitoring increasingly rely on these systems to track service delivery and scale-up, inform program improvements, and support accountability. This paper reviews the availability of PPFP and PAFP data elements in HIS across 18 LMICs. We analyzed 85 facility registers and 31 monthly summary forms covering antenatal care (ANC), labor and delivery (L&D), postnatal care (PNC), FP, and postabortion care (PAC). All 18 countries record PPFP provision in registers and summary forms; 14 also capture PAFP provision in registers, with 10 reporting it in summary forms. Most (15/18) collect immediate PPFP (≤48 hours after childbirth), in alignment with recommendations from the PPFP Community of Practice and High Impact Practices partnership, though 6 need to add this to their summary forms to improve data accessibility. Fourteen countries collect PPFP at multiple time points (e.g., ≤ 48 hours and ≤6 weeks). While all collect client age in registers, only one disaggregates PPFP and two disaggregate PAFP by age in summary forms. There is variation in the contraceptive methods recorded and compiled. Documentation of FP counseling is less consistent: 8 countries record it during ANC (2 in summary forms), 7 before discharge after childbirth (2 in summary forms), and 10 during PNC (2 in summary forms). Differences in timing, disaggregation, and method detail affect cross-country comparability, though several countries collect sufficiently aligned data for meaningful analysis. Country efforts to track PPFP across multiple contact points suggest a commitment to broad integration, which should be matched by expanded global indicator guidance that reflects the full scope of service delivery across the continuum of care.