PT - JOURNAL ARTICLE AU - Mamadou Kandji AU - Hawa Talla AU - René Jean Firmin Nakoulma AU - Sujata Naik Bijou AU - Cheikh Ibrahima Diop AU - Josephat Avoce AU - Fatoumata Bamba AU - Fatimata Sow TI - Increasing Contraceptive Use Through Free Family Planning Special Days in Poor Urban Areas in Francophone West Africa AID - 10.9745/GHSP-D-22-00227 DP - 2023 Feb 13 TA - Global Health: Science and Practice 4099 - http://www.ghspjournal.org/content/early/2023/03/14/GHSP-D-22-00227.short 4100 - http://www.ghspjournal.org/content/early/2023/03/14/GHSP-D-22-00227.full AB - Key FindingsFamily Planning Special Days (FPSDs) reach new contraceptive users, particularly adolescents and youth, through a combination of free services, proximity, convenience, and awareness raising.During our study period, FPSDs in francophone West Africa provided free long-acting contraceptive methods to a majority of the women of reproductive age who chose a method.Municipalities paid for 35% of the total cost of FPSDs held during the study period.Key ImplicationsMunicipalities must allocate more financial resources to the health system to ensure the sustainability of conducting FPSDs.Other challenges to the sustainability of FPSDs include contraceptive stock-outs and continuity of family planning services during system shocks such as the COVID-19 pandemic.Introduction:In francophone West Africa (FWA), contraceptive uptake remains limited, often due to geographic, economic, and social barriers. With technical support from The Challenge Initiative (TCI), municipalities and health systems implemented Family Planning Special Days (FPSDs) to improve family planning (FP) uptake and reduce high unmet need. The FPSD intervention consisted of organizing free FP services on a monthly or quarterly basis over 2 to 5 consecutive days within health facilities or sites close to the population. These events helped to educate, inform, and mobilize the community around FP and improve geographic and financial access to FP services. We describe the process of implementing FPSDs in FWA countries and analyze the results.Methods:We used several techniques and data sources in our descriptive analysis, including document review of activity reports, analysis of health management information system data, and retrospective data collection on the profile of FPSD users and implementation costs.Results:Between July 2020 and June 2021, municipalities and health systems collaborated to hold 1,046 FPSDs in 452 health facilities in 10 FWA cities. This collaboration was made possible through the establishment of city-level management and coordination units composed of municipal, health system, and TCI focal points. In the 10 FWA cities, 181,792 people were made aware of the FPSDs and 71,669 contraceptive users were served. The overall cost of organizing the FPSDs was about 145382501 Central African CFA francs (US$252839), 35% of which came from the municipalities’ local financial contribution.Discussion:Results from our analysis showed that, with appropriate financial support from municipalities, the health system could offer high-quality free FP services. Nonetheless, there are still challenges to the sustainability of conducting FPSDs, including the availability of contraceptive products and continued financing of the strategy during system shocks such as the COVID-19 pandemic.