Background: The global unmet need for postpartum family planning remains high, while immunization services are among the most widely utilized health services. Most women in the extended postpartum period want to delay or avoid future pregnancies but many are not using a modern contraceptive method. Establishing a systematic screening, counseling and referral systems from different contact points particularly from EPI units may improve family planning uptake in the extended postnatal period. This study was aimed to assess the effect of counseling for family planning at infant immunization units on contraceptive uptake during the extended post-partum period.

Methods: A before-and-after quasi-experimental design was conducted in 10 purposively selected health centers in Sidama region south Ethiopia. All mothers coming to the selected health centers for infant immunization services were screened, counseled and referred for family planning. Structured interviewer-administered questionnaire was used to collect quantitative data from a total of 1,422 randomly selected mothers (718 for the pre intervention and 704 for the post intervention phases) presented to the selected health centers. Data  were  checked,  coded  and  entered  to  EpiData version  3.1 and  exported  to  SPSS  version 22  for  analysis. The effect of the intervention was assessed using multivariable logistic regression adjusting for the effects of potential confounders. P value < 0.05 was considered as statistically significant.

Results: Contraceptive utilization rate among mothers presented to health centers for infant immunization before the intervention was 72.7%. It was 91.9% after the intervention. Utilization of contraceptive pills increased from 4.3% to 6.9%, injectables from 52.4% to 57.5%, implants from 12.75% to 22.9% and IUCD from 3.2% to 5.0% after the intervention was initiated. After adjusting for the effect of possible confounding variables, screening, counseling and referring mothers for family planning at infant immunization units significantly increases contraceptive utilization rate among mothers presented for infant immunization services, AOR (95% CI) = 5.83(4.02, 8.46) and P< 0.01.

Conclusion and recommendation: screening, counseling and referring mothers for family planning services at infant immunization units significantly increases contraceptive uptake. Integrating family planning messages with infant immunization services was recommended.