Vol. 7, Issue 2, Part J (2025)

Postpartum Family Planning (PPFP) is crucial for preventing closely spaced pregnancies that pose health risks to mothers and infants. In East Africa, modern contraceptive use remains suboptimal and unmet need is high, particularly in the first year after childbirth. This article synthesizes recent evidence on PPFP uptake, unmet need, and the influence of couple communication in East Africa. Researcher reviewed recent studies examining PPFP outcomes in East African contexts, including multi-country analyses, country-specific surveys, and qualitative research. Key indicators (contraceptive prevalence, unmet need) and determinants (socio-demographic factors, service delivery, spousal involvement) were extracted and compared. PPFP uptake in East Africa has improved in some settings but remains low overall. For example, only about 40% of postpartum women in Tanzania use contraception, and immediate postpartum uptake in facilities can be as low as 4%. Unmet need for contraception among married women ranges from 20% to 33% in several East African countries, with postpartum women experiencing unmet need as high as 81% in the first 6 months after birth. Socio-economic disadvantages (younger age, low education, poverty) are associated with higher unmet need, while adequate counseling and awareness during antenatal/postnatal care favor PPFP uptake. Notably, couple communication and male partner support emerge as pivotal: Women who discuss family planning with their partners are significantly more likely to adopt and continue postpartum contraceptive use. Conversely, lack of spousal approval remains a major barrier (cited by 70% of women not using family planning). Strengthening PPFP in East Africa requires addressing both service delivery gaps and socio-cultural barriers. Integrating contraceptive counseling into maternity care, engaging community health workers, and fostering open spousal communication can substantially increase postpartum contraceptive uptake and reduce unmet need. Policies that involve male partners and tailor interventions to young mothers will be critical to improving PPFP outcomes and accelerating progress toward national and global family planning targets.