Latest Articles
- Use of the World Health Organization’s Medical Eligibility Criteria for Contraceptive Use Guidance in sub-Saharan African Countries: A Cross-Sectional Study
The revised 2015 World Health Organization guidance expanded the recommended contraceptive options available to breastfeeding women during the early postpartum period to include progestogen-only pills and implants, but a substantial number of surveyed country representatives indicated that as yet their national policies did not allow such women to use these methods at that time. Countries may benefit from support to incorporate MEC guidance into national service delivery guidelines.
- Postabortion Care: 20 Years of Strong Evidence on Emergency Treatment, Family Planning, and Other Programming Components
Twenty years of postabortion care (PAC) studies yield strong evidence that:
Misoprostol and vacuum aspiration are comparable in safety and effectiveness for treating incomplete abortion.
Misoprostol, which can be provided by trained nurses and midwives, shows substantial promise for extending PAC services to secondary hospitals and primary health posts.
Postabortion family planning uptake generally increases rapidly-and unintended pregnancies and repeat abortions can decline as a result-when a range of free contraceptives, including long-acting methods, are offered at the point of treatment; male involvement in counseling-always with the woman’s concurrence-can increase family planning uptake and support.
- Safety and Acceptability of Community-Based Distribution of Injectable Contraceptives: A Pilot Project in Mozambique
Trained community health workers, including traditional birth attendants (TBAs), safely and effectively administered injectables in northern Mozambique; two-thirds of the women choosing injectables had never used contraception before. Including TBAs in the Ministry of Health’s recent task sharing strategy can improve rural women’s access to injectables and help meet women’s demand for contraception.
- Improving the Quality of Postabortion Care Services in Togo Increased Uptake of Contraception
The quality improvement approach applied at 5 facilities over about 1 year increased family planning counseling to postabortion clients from 31% to 91%. Of those counseled provision of a contraceptive method before discharge increased from 37% to 60%. Oral contraceptives remained the most popular method, but use of injectables and implants increased. The country-driven approach, which tended to use existing resources and minimal external support, has potential for sustainability and scale-up in Togo and application elsewhere.
- 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.
- Effective LARC Providers: Moving Beyond Training
Effective and productive providers are the key to successful provision of long-acting reversible contraceptives (LARCs). But LARCs demand more of providers than short-acting resupply methods. In addition to sound training, key elements to developing highly productive providers of LARCs include a thorough understanding of the service delivery system context; selecting providers with the most potential, especially from mid-level cadres; strong mentoring and supportive supervision; and attention to the supply chain and to demand-side support.
- 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.
- Rapid Contraceptive Uptake and Changing Method Mix With High Use of Long-Acting Reversible Contraceptives in Crisis-Affected Populations in Chad and the Democratic Republic of the Congo
Offering a broad choice of contraceptives can rapidly expand use in crisis-affected settings, particularly when the choice includes long-acting reversible contraceptives (LARCs). Over 5 years, the governments of Chad and the Democratic Republic of the Congo, with support from an NGO, provided nearly 85,000 new clients with contraceptives. LARC users, which included an increasing number of IUD users, accounted for 73%.
- The Mayer Hashi Large-Scale Program to Increase Use of Long-Acting Reversible Contraceptives and Permanent Methods in Bangladesh: Explaining the Disappointing Results. An Outcome and Process Evaluation
The Mayer Hashi program resulted in a modest increase in use of long-acting reversible contraceptives and permanent methods in Bangladesh, but less of an increase than in comparison nonprogram districts, which appears to have been the result of weaknesses in the health system environment in the program districts. Addressing system issues to support providers beyond training might have led to better results.
- 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.