Family planning for urban slums in lowand middle-income countries: a scoping review of interventions/service delivery models and their impact
Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
International Journal for Equity in Health
Abstract
Background: Although evidence suggest that many slum dwellers in low- and middle-income countries have the
most difficulty accessing family planning (FP) services, there are limited workable interventions/models for reaching
slum communities with FP services. This review aimed to identify existing interventions and service delivery models
for providing FP services in slums, and as well examine potential impact of such interventions and service delivery
models in low- and middle-income settings.
Methods: We searched and retrieved relevant published studies on the topic from 2000 to 2020 from e-journals,
health sources and six electronic databases (MEDLINE, Global Health, EMBASE, CINAHL, PsycINFO and Web of
Science). Grey and relevant unpublished literature (e.g., technical reports) were also included. For inclusion, studies
should have been published in a low- and middle-income country between 2000 and 2020. All study designs were
included. Review articles, protocols or opinion pieces were excluded. Search results were screened for eligible
articles and reports using a pre-defined criterion. Descriptive statistics and narrative syntheses were produced to
summarize and report findings.
Results: The search of the e-journals, health sources and six electronic databases including grey literature and other
unpublished materials produced 1,260 results. Following screening for title relevance, abstract and full text, nine
eligible studies/reports remained. Six different types of FP service delivery models were identified: voucher schemes;
married adolescent girls’ club interventions; Willows home-based counselling and referral programme; static clinic
and satellite clinics; franchised family planning clinics; and urban reproductive health initiatives. The urban
reproductive health initiatives were the most dominant FP service delivery model targeting urban slums. As regards
the impact of the service delivery models identified, the review showed that the identified interventions led to
improved targeting of poor urban populations, improved efficiency in delivery of family planning service, high
uptake or utilization of services, and improved quality of family planning services.
Conclusions: This review provides important insights into existing family planning service delivery models and their
potential impact in improving access to FP services in poor urban slums. Further studies exploring the quality of
care and associated sexual and reproductive health outcomes as a result of the uptake of these service delivery
models are essential. Given that the studies were reported from only 9 countries, further studies are needed to
advance knowledge on this topic in other low-middle income countries where slum populations continue to rise.
Description
Research Article
Keywords
Family planning, Contraception, Reproductive health, Service delivery, Urban slums, Scoping review