Family Planning and Reproductive Health
- Time to Evolve Beyond Prototypical Community-Based Distribution (CBD) of Contraception?
CBD efforts have a definite role in a variety of country programming contexts. However, contemporary efforts need to strive for an expanded method mix, strong support and motivation of CBD agents, and robust integration with existing health systems.
- Regaining Momentum in Family Planning
Since the launch of the Family Planning 2020 initiative 5 years ago, 46 million more clients in the 69 poorest countries are using modern contraception—a tremendous accomplishment, albeit behind schedule to reach the 2020 global goal of 120 million. Family planning continues to be innovative, and as reflected in the recent 2018 International Conference on Family Planning in Rwanda, there is a newfound momentum behind the movement and a new generation of young leaders with powerful ideas, creativity, and passion who are stepping up to help propel family planning onward.
- Evolution of a Large-Scale Community-Based Contraceptive Distribution Program in Kinshasa, DRC Based on Process Evaluation
Midterm process evaluation results indicated that design and implementation failures hindered the program's success, notably: (1) the short-acting methods provided by community-based distributors (CBDs) offered limited choice; (2) the nominal revenue retained from selling the methods provided limited motivation for the volunteer CBDs; and (3) the model was poorly coordinated with the existing clinical service system, partly because of challenging systems issues. In the revised model, the CBDs will also provide subcutaneous injectables and emergency contraceptive pills, retain more revenue from contraceptive sales, and have better interaction with the existing system including conducting monthly mini-campaigns to increase visibility and attract more clients.
- Introduction of Subcutaneous Depot Medroxyprogesterone Acetate (DMPA-SC) Injectable Contraception at Facility and Community Levels: Pilot Results From 4 Districts of Uganda
Over 1 year, the NGO-led project provided more than 14,000 units of DMPA-SC, mostly in community settings and to a substantial proportion (43%) of young women. The share of injectables increased significantly, as did the volume of all methods provided, including short-acting, long-acting, and permanent methods.
- The Net Promoter Score (NPS) for Insight Into Client Experiences in Sexual and Reproductive Health Clinics
The NPS measures a customer's likeliness to recommend a company to a friend or colleague on a 0-to-10 scale. Pilot testing in 4 countries suggests the NPS can also be successfully used in nonprofit clinics and among low-literacy populations. Combining the NPS with client demographic and service-use data can provide a powerful tool for identifying populations for whom the client experience can be improved.
- Client Perceptions of Quality and Choice at Static, Mobile Outreach, and Special Family Planning Day Services in 3 African Countries
In all 3 countries, nearly all women obtained their method of choice, with more mobile outreach and special family planning day clients having a preexisting preference for implants than static service clients. Clients of all service modalities in all countries reported experiencing most elements of full, free, and informed choice, but there is room for improvement with some aspects, such as counseling about potential side effects and giving clients the opportunity to ask questions.
- Quality and Cost Interventions During the Extended Perinatal Period to Increase Family Planning Use in Kinshasa, DRC: Results From an Initial Study
The combined intervention of free contraceptives plus a set of quality inputs for family planning during the extended perinatal period, including provision of long-acting methods immediately postpartum, had the strongest effect on use of modern contraceptives, especially long-acting methods.
- Assessment of Family Planning Service Availability and Readiness in 10 African Countries
In the 10 countries surveyed, the availability of oral contraceptives, injectables, and condoms varied greatly, and the availability of basic items indicating service readiness, such as guidelines, trained staff, equipment, and certain commodities, was low.
- Role of Religious Leaders in Promoting Contraceptive Use in Nigeria: Evidence From the Nigerian Urban Reproductive Health Initiative
Exposure to family planning messages from religious leaders was significantly associated with higher modern contraceptive use, after accounting for background characteristics and other variables such as myths and misconceptions. Engaging religious leaders to support positive social norms is an important strategy to improving voluntary contraceptive use in Nigeria.
- Adaptation of the Training Resource Package to Strengthen Preservice Family Planning Training for Nurses and Midwives in Tanzania and Uganda
Lessons learned when adapting the evidence-based global family planning training resource package included the need to: (1) engage key nursing and midwifery educators for buy-in; (2) update the technical skills of educators in contraceptive technology and competency-based training methods; and (3) adapt to the local context including condensing the global content for the time-limited preservice education context.