Original research articleBeing strategic about contraceptive introduction: the experience of the Standard Days Method®
Introduction
Successful introduction of a new family planning method must be done in a systematic and strategic way. According to the World Health Organization (WHO), the introduction of contraceptive methods should focus not on a technology-driven approach, but rather on how a new method responds to peoples' needs and rights, as well as on how it enhances overall quality of care and broadens the options available to clients [1]. The WHO strategic approach uses a client-centered systems framework to examine the acceptability and sustainability of innovations — such as a new family planning method — as a function of three elements: (1) people and services, (2) technologies and (3) policies and institutional capacities [2]. This article uses elements of the client-centered systems framework to describe the Standard Days Method® (SDM) pilot studies, which assessed the feasibility and acceptability of introducing the method into different service delivery settings. These studies represent the first systematic introduction of the SDM into service delivery settings outside the context of the clinical trial.
Section snippets
The SDM
Many national and institutional family planning policies explicitly include fertility awareness-based (FAB) methods among the method options that should be made available.1 Yet, programs rarely fully implement those
Results
The WHO client-centered systems framework focuses on critical issues related to (1) people, services and technologies, (2) policy and (3) institutional capacities, and how these three elements affect the acceptability and sustainability of a new family planning method. The following discussion focuses on the elements of people and services.
Discussion
The experience and results of these introduction studies provide insight into the feasibility and acceptability of the SDM in diverse service delivery settings and offer guidance for SDM expansion. Implications for the integration process, provider training and supervision, and service delivery protocols are discussed below.
Data on user characteristics from the 14 studies indicate that the SDM reached a group of women with unmet need but who did not want to use any kind of contraceptive
Acknowledgment
This research was funded by the United States Agency for International Development under Cooperative Agreement #HRN-A-00-97-11100-00 with the Institute for Reproductive Health, Department of Obstetrics and Gynecology at Georgetown University, Washington, DC. The authors would like to acknowledge the commitment to innovation and service demonstrated by the organizations and principal investigators that participated in the first introduction of the SDM: ABFP (Mamatou Djossou, Lahanatou Biomama);
References (10)
- et al.
A fixed formula to define the fertile window of the menstrual cycle as the basis of a simple method of natural family planning
Contraception
(1999) - et al.
Efficacy of a new method of family planning: the standard days method
Contraception
(2002) - et al.
The strategic approach to contraceptive introduction
Stud Fam Plann
(1997) - et al.
Helping public sector health systems innovate: the strategic approach to strengthening reproductive health policies and program
Am J Public Health
(2006) Medical eligibility criteria for contraceptive use
WHO/RHR/FCH
(2000)
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