In Khayelitsha, South Africa, postnatal clubs for breastfeeding women and their HIV-exposed infants are run at a health facility. Groups of three to 15 women and their babies atten the clinic at the same time and meet in a “club room” for clinical services provided by a nurse-midwife. For the mothers, ART refills are provided along with provision of family planning. Services for the exposed infants (such as prophylaxis and immunizations) are provided during the same visit, all by the same nurse-midwife.
In the first six months post-delivery, the mothers and their babies meet monthly. Thereafter, they meet every three months until 18 months after delivery. Presently, most women in this model use injectable contraception. Both the two- and three-monthly injectables are available, and reinjections are aligned to ART refills. Few women use oral contraceptive pills, but for those who do, the duration of pills provided is aligned with the ART refill (up to three months). Long acting, reversible contraceptives (LARCs) are available, but uptake is low.
Eligibility
All women living with HIV who are post-partum.
Building Blocks for contraceptive method
Intra uterine device (IUD)
What
IUD information, counselling, insertion/ removal, management of side effects
When
Offered at week 18 or 22 postpartum; same day as club meeting
Where
Separate clinic room to club
Who
Club nurse
Contraceptive implant
What
Implant information, counselling, insertion/ removal, management of side effects
When
Offered at week 18 or 22 postpartum; same day as club meeting
Where
Separate clinic room to club
Who
Club nurse
Oral pills
What
Combined and progestin only pills, information, counselling, script for pills, management of side effects
When
Every club visit; same duration as ART refill monthly for first 6 months and then 3-monthly
Where
Club room
Who
Club nurse
Sub-cutaneous 3-monthly injectable
What
Not yet available
When
Not yet available
Where
Not yet available
Who
Not yet available
Intra-muscular 3-monthly injectable
What
2- and 3-monthly injectable; injectable information, counselling, giving of injection, management of side effects
When
Every club visit; aim to align with ART refill duration 3 monthly
Where
Separate clinic room to club
Who
Club nurse
Condoms
What
Male and female; information, counselling, dispensing of condoms
When
Every club visit
Where
Club room
Who
Club nurse
Club facilitator
Interested in Leveraging differentiated ART delivery models to strengthen family planning care? Read more here
Learn more about postnatal clubs in South Africa here
Learn about family planning integration within postnatal clubs in Kenya here
