MULTICENTER STUDY OF THE LACTATIONAL AMENORRHEA METHOD (LAM) .2. ACCEPTABILITY, UTILITY, AND POLICY IMPLICATIONS

A multicenter study of the Lactational Amenorrhea Method (LAM) was car ried out to determine acceptability, satisfaction, and utilization in 20 different populations, and to confirm the efficacy of the method. E fficacy data are presented in a companion paper. A protocol was design ed at the Institute for Reproductive Health (IRH), Department of Obste trics and Gynecology, Georgetown University Medical Center, and review ed and modified in collaboration with the co-sponsors, the World Healt h Organization, the South-to-South Cooperation for Reproductive Health , and the principal investigators from each sire. Data were gathered p rospectively on LAM users at 11 sites, Data were entered and cleaned o n-site, and further cleaned and analyzed at IRH, using country-level a nd pooled data to produce descriptive statistics. The overall satisfac tion with LAM was 83.6%, and continuation with another method of famil y planning was shown to be 67.6% at 9 months postpartum, in most cases exceeding previous use of contraception prior to use of LAM. Knowledg e and understanding of the meshed at discontinuation were high, rangin g from 78.4 to 88.6% for the three criteria. LAM can be used with a hi gh level of satisfaction and success by women in a variety of cultures , health care settings, socio-economic strata, and industrial and deve loping country settings. The results confirm that LAM is acceptable an d ready for widespread use, and should be included in the range of ser vices available in maternal and child health, family planning, and oth er primary health care settings. (C) 1997 Elsevier Science inc. All ri ghts reserved.