Health Topics
- Excellent Family Planning Progress in Nigeria Reported by PMA2020
Modern method contraceptive prevalence among married women in Nigeria has jumped to 16.0% in 2016 compared with <10% in 2013.
Notable increases were observed in the South as well as in some Northern states that had strong programming.
Most of the increase was in the uptake of highly effective implants and injectables.
But substantial unmet need for family planning remains, especially among the poorest quintile.
Implants and IUDs are not offered in many facilities and stock-outs are common, suggesting further progress is achievable with improved program effort.
- Youth Voucher Program in Madagascar Increases Access to Voluntary Family Planning and STI Services for Young People
Program accomplishments during the first 18 months:
More than 58,000 free vouchers distributed to young people, of which 74% were redeemed.
79% chose long-acting reversible contraceptives (LARCs) and 51% received STI counseling.
Client profile data snapshot:
69% had never previously used contraception and 96% were 20 or younger.
- Community Health Workers as Social Marketers of Injectable Contraceptives: A Case Study from Ethiopia
Volunteer community health workers (CHWs) administered injectable contraceptives to women in the community for a small fee while providing counseling and referrals for other methods. Over nearly 3 years, more than 600 CHWs provided an estimated 15,410 injections. The model has the potential to improve sustainability of community-based distribution programs by incorporating social marketing principles to partially recover commodity costs and compensate CHWs.
- A Non–Gas-Based Cryotherapy System for the Treatment of Cervical Intraepithelial Neoplasia: A Mixed-Methods Approach for Initial Development and Testing
A non–gas-based treatment device for early cervical cancer treatment, adapted for use in low-resource settings to improve ease of use, portability, and durability, performed similarly to a standard gas-based cryotherapy device in small-scale testing. A large randomized clinical trial is currently underway for further assessment.
- “New Users” Are Confusing Our Counting: Reaching Consensus on How to Measure “Additional Users” of Family Planning
FP2020's overarching goal is framed around the new metric of “additional users.” This measure inherently captures population-level change but has been conflated with other ambiguous metrics, such as “new users.” Therefore, we propose a standard set of terms to provide more consistent measurement. Although commonly used service-level metrics cannot be directly compared to the population-level metric of additional users, we describe 2 modeling approaches that can allow service-level data to inform estimates of additional users.
- Comparing Women's Contraceptive Preferences With Their Choices in 5 Urban Family Planning Clinics in Ghana
Women's method choice largely matched their stated desired duration of effectiveness but not their desires to avoid certain side effects. While most women reported they were counseled about side effects, many fewer reported being specifically counseled about common menstrual side effects with their chosen method, including side effects the women said would cause them to stop using the method.
- Women's Limited Choice and Availability of Modern Contraception at Retail Outlets and Public-Sector Facilities in Luanda, Angola, 2012–2015
Despite high rates of unintended pregnancy, access to a wide range of contraceptive methods, especially injectables and long-acting reversible contraceptives (LARCs), is severely limited in both public and private facilities. Knowledge of contraceptive choices is likewise limited, yet a substantial proportion of women are not using their preferred method among the methods they know of.
- New Ways of Approaching Indoor Residual Spraying for Malaria
Using health extension workers in Ethiopia as supervisors of the spray team reduced operational costs while maintaining quality. But rethinking IRS calls for (1) adapting equipment and procedures to ensure higher-quality spray applications, and (2) empowering decentralized targeting against malaria transmission foci.
- Vasectomy: A Long, Slow Haul to Successful Takeoff
Vasectomy use is plagued by low demand among men. Nevertheless, its compelling advantages make substantial investment worthwhile. On the supply side, a priority is to actively link vasectomy with service delivery approaches for the other highly effective long-acting and permanent clinical methods. Robust demand generation should include messaging specific to vasectomy, but should also draw on broader social and behavior change communication efforts increasingly aimed at engaging men in family planning.