AN ASSESSMENT OF THE 9-MONTH LACTATIONAL AMENORRHEA METHOD (MAMA-9) IN RWANDA

This report presents a secondary data analysis based on prospectively collected records gathered during a field assessment that was carried out in Rwanda in August 1993. The assessment used service statistics a nd follow-up interviews to evaluate the efficacy of a modified lactati onal amenorrhea method (LAM) as a nine-month introductory postpartum n atural family planning method. The program, carried out by Action Fami liale Rwandaise (AFR), reflects high efficacy of the method in a compl iant sample that sought this method followed by another form of family planning. These results are promising and provide guidance for the ex tended use of LAM past six months. Programmatic findings suggest that studies be conducted for the contribution of extended LAM to improved weaning practices, the high efficacy of continued reliance on substant ial lactation and amenorrhea beyond nine months, and male involvement in LAM and breastfeeding.