From efficacy to effectiveness: selecting indicators for a community-based lactational amenorrhoea method promotion...

Area of Science:

• Reproductive Health
• Family Planning
• Maternal and Child Health

Background:

• Lactational amenorrhoea (LAM) is a natural method of birth spacing following childbirth.
• Its effectiveness as a contraceptive method is well-documented in clinical trials.
• Community-based studies highlight the need for appropriate effectiveness indicators.

Purpose of the Study:

• To review clinical trials and community studies on lactational amenorrhoea as a contraceptive.
• To compare indicators used in efficacy trials and effectiveness interventions.
• To recommend a set of effectiveness indicators for community-based LAM programs.

Main Methods:

• Review of existing literature on lactational amenorrhoea (LAM).
• Comparison of indicator sets from efficacy trials and effectiveness interventions.
• Application of a five-tiered ecological framework for indicator selection.

Main Results:

• Existing indicators may not fully capture community-level LAM program effectiveness.
• A tiered ecological framework aids in selecting relevant indicators across different levels.
• Specific indicator sets are proposed for community-based LAM interventions.

Conclusions:

• Effective evaluation of LAM programs requires tailored indicators.
• The proposed framework supports health practitioners in designing and assessing LAM interventions.
• Focusing on appropriate indicators can enhance LAM program reach and impact in target communities.