Lactational Amenorrhea Method as a Contraceptive Strategy in Niger

Published in: Maternal and Child Health Journal, v. 17, no. 4, May 2013, p. 654-660

Posted on RAND.org on January 01, 2012

by Heather L. Sipsma, Elizabeth Bradley, Peggy G. Chen

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If used properly, the lactational amenorrhea method (LAM) can be a valuable family planning tool, particularly in low-income countries; however, the degree to which LAM is used correctly and characteristics associated with its use have not been well documented. We therefore sought to use nationally representative data from Niger, where fertility rates are high and women may have limited access to alternative contraceptive methods, to describe the proportion of women who use LAM correctly and the characteristics associated with LAM use. We utilized cross-sectional data from the 2006 Niger Demographic Health Survey. Our sample included all sexually active, non-pregnant, breastfeeding women using some form of contraception (N = 673, unweighted). We used weighted frequencies to describe the correct use of LAM and logistic regression models to describe women who chose LAM for contraception. Among our sample, 52 % reported LAM as their primary method of contraception, but only 21 % of the women who reported using LAM used it correctly. Women who reported using LAM were more likely to live in certain regions of the country, to have no formal education, and to have delivered their most recent baby at home. They were also less likely to have discussed family planning at a health facility or with their husband/partner in the past year. Results indicated that few women in Niger who reported using LAM used it correctly. Our findings reinforce the need to address this knowledge gap, especially given Niger's high fertility rate, and may inform efforts to improve family planning in Niger and in other low-income countries.

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