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- Mentoring, Task Sharing, and Community Outreach Through the TutoratPlus Approach: Increasing Use of Long-Acting Reversible Contraceptives in Senegal
Mentoring, task sharing, and community outreach at 100 rural facilities in Senegal led to an 86% increase over 6 months in the number of women choosing long-acting reversible contraceptives (from 1,552 to 2,879). Concurrent improvement of facilities and provider skills, coupled with the application of Senegal’s task-sharing policy, are increasing the range of contraceptive methods available to women throughout the country.
- The Tupange Project in Kenya: A Multifaceted Approach to Increasing Use of Long-Acting Reversible Contraceptives
Use of long-acting reversible contraceptives increased significantly among women in a poor, urban setting through training, mentoring, commodity security, quality improvement, multiple service delivery models, and multiple demand-promotion approaches.
- Applying a Total Market Lens: Increased IUD Service Delivery Through Complementary Public- and Private-Sector Interventions in 4 Countries
Between 2013 and 2014, IUD services provided to women increased more than threefold–from 22,893 to 79,162–in 417 public facilities in Guatemala, Laos, Mali, and Uganda through a Population Services International pilot that engaged the public sector alongside existing private-sector interventions within an informed choice context. Based on family planning market analyses, the country-specific interventions focused on strengthening policy, service delivery, supply chain management, and demand promotion.
- Ugandan Women’s View of the IUD: Generally Favorable but Many Have Misperceptions About Health Risks
Women in Uganda are aware of the IUD and think it is an effective method, but many think it can damage the womb or make a woman infertile. Addressing public misperceptions through interpersonal communication and the mass media, and provider misperceptions through training, can help to build demand for the IUD in Uganda.
- Expanding Access to a New, More Affordable Levonorgestrel Intrauterine System in Kenya: Service Delivery Costs Compared With Other Contraceptive Methods and Perspectives of Key Opinion Leaders
At a public-sector transfer price of US$15 per unit, the direct service delivery cost of Medicines360's levonorgestrel intrauterine system (LNG IUS) per couple-years of protection is comparable with the cost of other contraceptive products commonly procured in Kenya. Interviews with key opinion leaders suggest that introduction of a more affordable LNG IUS could help increase demand for the method.
- Increasing Uptake of Long-Acting Reversible Contraceptives in Cambodia Through a Voucher Program: Evidence From a Difference-in-Differences Analysis
By reducing financial and information barriers, a family planning voucher program in Cambodia significantly increased contraceptive choice and uptake of more effective long-acting reversible contraceptives among poor women and women with the least education. Without vouchers, many of these women would not have used contraception or would not have chosen their preferred method.
- Vouchers in Fragile States: Reducing Barriers to Long-Acting Reversible Contraception in Yemen and Pakistan
Vouchers for family planning in Pakistan and Yemen reduced barriers, such as cost and availability, and encouraged public and private providers to improve skills, leading to an increase in uptake of long-acting reversible contraceptives and permanent methods.
- Strengthening Postabortion Family Planning Services in Ethiopia: Expanding Contraceptive Choice and Improving Access to Long-Acting Reversible Contraception
In Ethiopia, a comprehensive strategy to improve postabortion family planning services has produced overall improvement in the uptake of postabortion family planning and a rise in the choice of more effective long-acting reversible contraceptives to produce a more balanced method mix.
- Bringing Early Infant Male Circumcision Information Home to the Family: Demographic Characteristics and Perspectives of Clients in a Pilot Project in Tanzania
During a pilot project in Tanzania’s Iringa region, more than 2,000 male infants were circumcised in less than 2 years in 8 facilities, representing 16.4% of all male births in those facilities. The age of the infant at circumcision and the time of return for follow-up visits varied significantly between urban and rural dwellers. Early infant male circumcision (EIMC) outreach activities and use of health outposts for follow-up visits should be explored to overcome these geographic barriers. EIMC programs will also require targeted investments in demand creation, especially among fathers, to expand and thrive in traditionally non-circumcising settings such as Iringa.
- Scale-Up of Early Infant Male Circumcision Services for HIV Prevention in Lesotho: A Review of Facilitating Factors and Challenges
Key elements of Lesotho’s phased introduction of early infant male circumcision were strong commitment from the Ministry of Health and donors; adequate training and supervision; integration with maternal, newborn, and child health; and appropriate communication. Challenges around cultural acceptance, the availability of health care providers, and task sharing will need to be addressed.