Integrating family planning with nutrition and other sexual and reproductive health services in low-income and middle-income countries: findings from a scoping review.

INTRODUCTION

Integrating family planning with nutrition could address unmet family planning needs and malnutrition in low-income and middle-income countries (LMICs). Integrating family planning with sexual reproductive health (SRH) services may provide valuable insights as well. This scoping review synthesised evidence from published and grey literature on interventions integrating family planning with nutrition or SRH services in LMICs.

METHODS

We searched MEDLINE, EBSCO and Google Scholar for studies on integrated family planning, nutrition or SRH services, including codelivery or referral-based models. Evidence was analysed using narrative synthesis.

RESULTS

We reviewed 109 articles; most family planning within broader health initiatives, particularly targeting maternal and child health and health system strengthening efforts. Integration strategies varied, generally involving codelivery of services or referral systems linking different service platforms and using diverse health providers. Outcomes were often reported by individual components, concentrating on specific services like family planning use and less so on nutrition or overall maternal and child health, thus limiting a complete understanding of the integrated intervention's impact. Qualitative and process evaluations primarily explored the acceptability and feasibility of integration, highlighting challenges in service delivery, stakeholder engagement and training and supervision gaps.

DISCUSSION: Our findings suggest three evidence-based priorities for improving the integration of family planning, nutrition and SRH services: (1) standardising definitions and frameworks for integration typologies; (2) investing in workforce training and (3) strengthening supply chains. These align with implementation challenges recurrently observed across studies. The review also underscores the necessity for more rigorous research focused on the effectiveness and cost-effectiveness of integrated approaches, providing critical insights for decision-makers aiming to optimise health service delivery in resource-limited settings.