Healthy Timing and Spacing of Pregnancy (HTSP) is an intervention to help women and families delay or space their pregnancies in order to achieve the healthiest outcomes for women, newborns, infants and children. According to WHO, qualitative studies conducted by USAID in Pakistan, India, Bolivia, and Peru showed that women and couples are interested in the healthiest time to become pregnant
In this way, HTSP differs from previous birth spacing approaches that refer only to the interval after a live birth and when to give birth. HTSP also provides guidance on the healthiest age for the first pregnancy. Thus, HTSP encompasses a broader concept of the reproductive cycle starting from healthiest age for the first pregnancy in adolescents, to spacing subsequent pregnancies following a live birth, still birth, miscarriage or abortion – capturing all pregnancy-related intervals in a woman’s reproductive life.
Multiple studies have shown that adverse maternal and perinatal outcomes are related to closely spaced pregnancies. As shown in the table below, the risks are particularly high for women who become pregnant very soon after a previous pregnancy, miscarriage, or abortion.
Considerable unmet need and demand for spacing still exist in the younger 15-29 age cohorts as well as in postpartum women:
Key HTSP interventions include:
Banner photo: A family carries harvested vegetables in the Philippines. © 2016 Maria Francesca Avila, Courtesy of Photoshare
The HTSP I-Kit is designed to help program managers address the risks of pregnancies among women aged 35 and older (of advanced maternal age, or AMA) and women having five or more births (high-parity, or HP) in their family planning or maternal and child health programs.
By the end of this online course, the student will be able to:
This is USAID's website about the topic of Accelerator Behaviors. These 10 Accelerator Behaviors are identified in the USAID Behavior Change Framework as priority behaviors because they currently have low global uptake and they have the potential
This toolkit was developed to promote USAID/BASICS strategy to utilize maternal and child health entry points to care to introduce messages around healthy timing and spacing and or limiting pregnancies to mothers, couples and care givers that access child health services.
This infographic provides basic information about the value of HTSP for women and their families, along with statistics in support of HTSP implementation.
This web page offers basic information about HTSP, including:
This is a 2-hour online course which is free of charge.
By the end of this course, the student will be able to do the following:
In Burkina Faso, this project promoting HTSP had three components:
The Healthy Timing and Spacing of Pregnancy (HTSP) Counseling Pathways: A Counseling Tool for Health Care Providers can be used to identify a woman who may be at risk of a closely spaced pregnancy or pregnancy at too early an age.
The Nigeria Urban Reproductive Health Initiative is designed to increase contraceptives use in selected urban sites in Nigeria (FCT, Kaduna, Ilorin, Ibadan, Zaria and Benin) with a focus on the urban poor.
Geared towards policy makers and community leaders, this advocacy kit provides detailed information on family planning from a national perspective. Items in the kit provide stakeholders with specific actions to take to show their support of FP/child spacing.
These posters were part of a mass media campaign in Kenya which focused on changing beliefs and behaviors among young men and women ages 25-35 to promote child spacing and informed choice of modern contraceptive methods.
A two page cue card for service providers, showing different methods of family planning and their benefits. The message reads "Modern family planning is safe and easy to use. Help couples to choose a method that fits their lifestyle and needs." The cue cards list each method, its effectiveness, and for whom it is a good option.
A short, illustrated policy brief about the need for family planning in Edo State, Nigeria. Outlines contraceptive prevalence rates and health indices.
A poster describing various modern family planning methods, the facts about the method, and timing issues for each method.
This presentation was used in religious leader orientation by the Christian Health Association of Kenya to introduce the community-based family planning (FP) services of church-based health facilities in the IRH 2011 project.
This poster can be hung in facility waiting or exam rooms to present HTSP/FP information to clients. It asks clients if they want to get pregnant again, and helps them decide what is the best timing for their next pregnancy.
This is a generic type poster that can be used to explain four key messages of HTSP: too young, too old, too close, too soon.
Healthy Timing and Spacing of Pregnancies (HTSP) is an approach to helping couples time their pregnancies to occur during a mother’s healthiest years (ages 18-34) and space pregnancies by 3 to 5 years, improving both maternal and child health.
This video explains the basics of HTSP in a short animated form.
This website is made possible by the support of the American People through the United States Agency for International Development (USAID) under the Breakthrough-ACTION Project, supported by USAID’s Office of Population and Reproductive Health, Bureau for Global Health, under Cooperative Agreement #AID-OAA-A-17-00017 with the Johns Hopkins University.
Breakthrough-ACTION is based at the Johns Hopkins Bloomberg School of Public Health’s Center for Communication Programs (JHU∙CCP). The contents of this website are the sole responsibility of JHU∙CCP. The information provided on this website is not official U.S. Government information and does not necessarily represent the views or positions of USAID, the United States Government, or The Johns Hopkins University.
