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.