The Process of Integrating Family Planning Services with Other Reproductive Health Services in Low and Middle-Income Countries: A Scoping Review.

Abstract

Introduction: In low-resource settings, fragmented family planning (FP) services limit contraceptive access, contributing to high unmet needs and unintended pregnancies. Integrating FP with existing reproductive health services can improve access and continuity of care. This review examines the integration strategies in low and middle-income countries (LMICs).

Theory and methods: We conduct a scoping review across five databases for peer-reviewed literature and Google Scholar for grey literature, guided by Joanna Briggs Institute (JBI) and Arksey & O'Malley's frameworks. Data were charted study characteristics and details of integration process. Results were reported following PRISMA-ScR guidelines.

Results: The total of 37 studies from LMICs were included. Only five studies provided explicit definitions of integration. Key strategies involved aligning FP with other services, promoting dual-method use in HIV care, and incorporating long-acting reversible contraception with post-abortion and postpartum care. Training was provided to various health workers to support services integration. Most Models used co-location of services within the same facility. Innovative approaches, such as; the Happy Client Model and private counselling spaces. Integration was influenced by provider skills, workload, communication dynamics, training gaps, and supply constraints.

Conclusion: A review identified diverse methods and factors for integrating family planning services. Clear operational definitions and innovative services delivery models are critical for effective integration. Further research should inform context-adaptable frameworks for implementation in resource-constrained settings. These findings can inform integrated care policy by highlighting the need for coordinated service models, provider training, and context-sensitive strategies to optimise FP access in LMICs.