FROM EFFICACY TO EFFECTIVENESS - SELECTING INDICATORS FOR A COMMUNITY-BASED LACTATIONAL AMENORRHEA METHOD PROMOTION PROGRAM

This paper reviews the results of clinical trials and community studie s of lactational amenorrhoea and its role as a contraceptive method (L AM). Indicators which are used in efficacy trials and effectiveness in terventions are compared and sets of indicators of effectiveness appro priate to community-based LAM programmes are recommended. A five-tiere d ecological framework is used to facilitate selection of indicators w hich range from individual to policy level outcomes. The indicator fra mework is intended as a tool for health practitioners in family planni ng and maternal and child health service delivery settings who are int erested in designing programmatic interventions for the promotion of L AM, particularly among less well-educated women of lower socioeconomic communities.