Contraceptive implants offer immense potential to meet the need for family planning. More than 220 million women in developing countries currently have an unmet need for modern contraception, mainly in South Asia and sub-Saharan Africa.1 Many other women are using less effective “resupply” methods—short-acting methods that require users to continually replenish their supplies of the contraceptive—because highly effective, more convenient methods such as implants are not easily accessible. In all countries, access is lower among poorer, less educated, rural, and younger women.1-2 From January 1, 2009, to December 31, 2012, more than 9 million implants valued at over US$190 million have been shipped to developing countries—87% to sub-Saharan Africa.3 The magnitude of commodity provision is likely to increase markedly, due to major price reductions.
What are implants? Why do they offer so much promise? What challenges must programs address to make them even more widely accessible and used?
THE PROMISE OF IMPLANTS
What Women Like About Implants
Implants are a long-acting, reversible form of progestin-only contraception that release an ultra-low amount of progestin continuously into the bloodstream. Currently, 3 implants are available: Implanon®, Jadelle®, and Sino-implant II® (see Table). Women who use implants find them to be very convenient—they are effective immediately and offer up to 3 to 5 years of extremely reliable contraceptive protection upon one client action. Only a brief, very minor surgical procedure under local anesthesia is needed to place 1 or 2 matchstick-sized plastic rods beneath the skin of the inner upper arm.4-5 Some women also like …