Assessing Acceptability of Biodegradable Contraceptive Implants in Kenya and Senegal

Figures & Tables

Download figure
Open in new tab
Download powerpoint
FIGURE
Descriptions of Biodegradable Implants Presented to Research Participants

TABLE 1.

Topics Covered During In-Depth Interviews and Focus Group Discussions on BDIs, by Participant Group, Kenya and Senegal

Participant Group	Topics Covered
Potential users (Current/previous implant users and never implant users)	Understanding of degradation as a concept Characteristics of BDIs: Size Proposed insertion location Visibility/palpability Duration Possible side effects Removability Any suggested changes
Men	Understanding of degradation as a concept Community beliefs What types of women they would advise to use BDIs Any suggested changes
Community influencers	Understanding of degradation as a concept Community beliefs What types of women they would advise to use BDIs Any suggested changes Best communication channels for future method introduction
FP providers	Experience with current implants Understanding of degradation as a concept Characteristics of BDIs: Size Proposed insertion location Visibility/palpability Duration Possible side effects Removability How they would counsel on BDIs Any concerns about removal process Any suggested changes
Key informants (FP policymakers and FP program staff)	Acceptability among users Feasibility of introduction in the national health system and/or facilities Procurement and stocking concerns

TABLE 2.

Participants in Research Activities in Kenya and Senegal

		Kenya				Senegal
		Nairobi, No.		Meru, No.		Dakar, No.		Thiès, No.
		Activity	Participants	Activity	Participants	Activity	Participants	Activity	Participants
Current/previous implant users	FGD	6	29	3	17	8	33	1	5
	IDI	5	5	8	8	6^a	6	9^a	9
Never implant users	FGD	--	--	1	4	1	3	--	--
	IDI	4	4	1	1	4^a	5	5^a	6
Men	FGD	1	6	1	4	1	2	--	--
	IDI	4	4	4	4	3^a	3	1	1
Community influencers	FGD	2	4	--	--	--	--	1	3
	IDI	1	1	4	4	1	1	3	3
FP providers	FGD	1	5	--	--	1	3	2	8
	IDI	2	2	1	1	2	2	2	2
Key informants	FGD	1	2	--	--	--	--	--	--
	IDI	1	1	--	--	7^a^,^b	7	--	--
Total	FGD	11	46	5	25	11	41	4	16
	IDI	17	17	18	18	23	24	20	21
			63		43		65		37

Abbreviations: FGD, focus group discussion; FP, family planning; IDI, in-depth interview.
↵^a Second round of data collection included IDIs with 2 current/previous implant users, 5 never implant users, 1 man, and 3 key informants in Dakar and 1 current/previous implant user and 2 never implant users in Thiès. Two of the additional IDIs with never implant users had 2 participants each.
↵^b Two key informant IDIs in Senegal emailed their responses to the discussion guide.

TABLE 3.

Preferences for Biodegradable Implant Products Currently in Development

	Likes	Dislikes
Casea S	“Natural” materials (Kenya only) Smaller size (more discreet, may dissolve faster, less painful to insert)	Contains cholesterol (Senegal only) More difficult to palpate due to small size More difficult to insert and remove multiple pellets
Yale	Looks more similar to existing implants (1 rod) Easier to insert and remove if needed Potentially easier to palpate	Larger size (more painful to insert) Perceived brittle nature of material based on prototype “Harder” material could be easier to palpate and/or see by others
Both products	No incision or scars for removal 18 months is not too long or too short (more common in Kenya)	High costs for removal Side effects, especially those that might be caused by degradation Non-hormonal portion remaining in body longer (Kenya only) 18 months not long enough (more common in Senegal) Unable to be removed for entire duration (more common in Senegal)

TABLE 4.

Suggested Changes to Biodegradable Implant Products

Characteristic	Suggested Change
Size	Combine Casea S into 1 pellet Make Yale rod smaller/shorter
Material	Make softer/more flexible Make both products out of “natural” materials (Kenya only) Remove/reduce cholesterol (Senegal only) Ensure non-hormonal portion also dissolves in 18 months or short time after (Kenya only)
Visibility/ palpability	Palpable throughout duration (Senegal only)
Duration	Increase duration to 2–3 years or 3–5 years (more common in Senegal, less in Kenya) Reduce duration to 6 months to 1 year, or provide different options for duration (fewer respondents mentioned)
Removability	Removability for full duration (more common in Senegal, less in Kenya)
Side effects	Reduce side effects, especially menstrual changes