Introducing new products provides a key opportunity to not only expand the range of contraceptive options for women and adolescent girls, but also to strengthen family planning delivery systems for all methods.
Expanding access to contraceptive methods through the private sector and community-based sources—which includes task sharing—is an important strategy to help achieve national family planning and development goals and, in particular, aims to reduce barriers to access for youth, lower-income, and other marginalized groups. Private sector pharmacies and drug shops are often the first line of health care in low- and middle-income countries, particularly for many underserved populations and especially in rural areas that have very few private or public clinics. While there are differences between pharmacies and drug shops, there are also common issues around implementation and impact. For both, training and support can improve and expand the range and quality of services they offer and thereby increase access and choice for women.
As part of the Global Health Science and Practice (GHTechX) conference, CHAI, FHI 360, PATH, the Population Council, PSI, and WCG hosted an April 22, 2021 session to synthesize lessons learned across contraceptive introduction of implants, DMPA-SC self-injection, hormonal IUS and other methods. During the session, experts from Kenya, Madagascar, Uganda, and the United States outlined essential steps for the process of contraceptive product introduction, described common challenges, and shared tools and approaches based on experiences with the three methods. Session slides are available below. To watch the recording of this and many other sessions, register for free on the GHTechX website.
This brief outlines existing evidence on DMPA-SC with data grouped into top-line, evidence-based messages, with corresponding data from different countries. This handout can be printed and distributed directly to decision-makers. It contains several one-page spotlight handouts on specific sub-topics, which can be printed and paired with the two-page summary—for distribution to decision-makers—as needed.
This brief summarizes recent evidence from African countries on the costs and cost-effectiveness of DMPA-SC. Key findings include that DMPA-SC may help reduce service delivery costs by catalyzing expansion of channels closest to women and that self-injected DMPA-SC is cost-saving as compared to clinic-administered DMPA-IM when accounting for costs to women and health systems.
This brief offers concise, evidence-based information to help answer common questions and dispel myths about injectable contraception. Myths are not stated directly because repeating a myth may reinforce it in people’s minds.
This customizable slide deck provides a brief description of DMPA-SC and its benefits; an overview of evidence on how the product expands access through multiple delivery channels; and illustrative policy and advocacy gaps and recommendations for country decision-makers.
The World Health Organization (WHO) convened a Guideline Development Group (GDG) meeting from 29 to 31 July 2019 to review global guidance on contraceptive eligibility for women at high risk of HIV acquisition to and determine whether revisions to the fifth edition of the Medical eligibility criteria for contraceptive use (MEC) were needed. The issue was deemed critical, particularly for sub-Saharan Africa, given the high lifetime risk of acquiring HIV alongside the importance of hormonal contraception in offering women and adolescent girls’ choice and in reducing their risk of unintended pregnancy, a common threat to the health, well-being and lives of women and adolescent girls.
The WHO has launched an App for its Medical Eligibility Criteria for Contraceptive Use. This digital tool will facilitate the task of family planning providers in recommending safe, effective and acceptable contraception methods for women with medical conditions or medically-relevant characteristics.
Quality of family planning counseling is likely associated with whether or not women continue to use the same contraceptive method over time. The Method Information Index (MII) is a widely available measure of contraceptive counseling quality but little is known about its association with rates of method continuation. Using data from a prospective cohort study of 1,998 social franchise clients in Pakistan and Uganda, we investigated the relationship between reported baseline MII and the risk of method continuation over 12 months using survival analysis and Cox proportional hazard models. Higher scores on the 3-question Method Information Index (MII)—measuring client-reported receipt of contraceptive information—was associated with continued use of family planning over 12 months. We recommend incorporating use of the MII in routine assessments of family planning service quality.
Drug shops and pharmacies have long been recognized as the first point of contact for health care in developing countries, including family planning (FP) services. Drug shop operators and pharmacists should not be viewed as mere merchants of short-acting contraceptive methods, as this ignores their capacity for increasing uptake of FP services and methods in a systematic and collaborative way with the public sector, social marketing groups and product distributors. We draw on lessons learned from the rich experience of earlier efforts to promote a variety of public health interventions in pharmacies and drug shops. To integrate this setting that provides convenience, confidentiality, access to user-controlled contraceptive methods (i.e., pills, condoms and potentially Sayana Press®) and a gateway to clinic-based FP services, we propose three promising practices that should be encouraged in future interventions to increase access to quality FP services.