• family planning services
• Health Services Research

As defined by the WHO, postpartum family planning (PPFP) focuses on the prevention of unintended and closely spaced pregnancies through the first 12 months following childbirth.1 Access to postpartum contraception supports both individual reproductive goals and population health outcomes, and much is known about the safety and efficacy of various contraceptive methods in the postpartum period. In the field of PPFP, as is the case with any field of medicine, clinical innovation and evidence accrue over time, resulting ultimately in the development of best practices and clinical guidelines. Even with best practices in hand, however, we know that moving from evidence to practice can take decades and is always shaped by local context.2 We also know that patient perspectives provide critical insights into the actual needs and real-life barriers within each specific local context.3

In this issue of the Journal, Hofmeyr and colleagues describe a quality improvement initiative in a large public hospital in Botswana, aimed at improving postpartum contraceptive counselling and provision, with specific foci on integrating immediate postpartum intrauterine device services into their practice setting and monitoring patient experience.4 We commend the authors for undertaking this study. This kind of detailed quality improvement work is worth publishing, and elevates accounts of quality improvement and implementation into the emerging knowledge base of implementation science.

Intuitively, we may understand that quality improvement is what it says it is - improving the quality of care. Implementation science is perhaps a next step in the continuum of quality - it is the science (represented by generalisable knowledge, principles, frameworks, …