Family Planning and Reproductive Health
- Increasing Contraceptive Access for Hard-to-Reach Populations With Vouchers and Social Franchising in Uganda
Between 2011 and 2014, the program provided more than 330,000 family planning services, mostly to rural women in the informal sector with little or no education. 70% of the voucher clients chose an implant and 25% an intrauterine device.
- Migration Experiences and Reported Sexual Behavior Among Young, Unmarried Female Migrants in Changzhou, China
30% reported being sexually experienced, but only 38% reported using contraception at first sex and 58% consistently over the past year, leading to many unintended pregnancies and abortions. These findings document an unmet need for reproductive health education and services for young, unmarried female migrants in urban China.
- Availability and Quality of Family Planning Services in the Democratic Republic of the Congo: High Potential for Improvement
A few facilities provided good access to and quality of family planning services, particularly urban, private, and higher-level facilities. Yet only one-third offered family planning services at all, and only 20% of these facilities met a basic measure of quality. Condoms, oral contraceptives, and injectables were most available, whereas long-acting, permanent methods, and emergency contraception were least available. Responding to the DRC's high unmet need for family planning calls for substantial expansion of services.
- Increasing Access to Family Planning Choices Through Public-Sector Social Franchising: The Experience of Marie Stopes International in Mali
While social franchising has been highly successful with private-sector providers, in Mali the approach was expanded to public-sector community health clinics. From 2012 to 2015, these clinics served >120,000 family planning clients, 78% of whom chose long-acting reversible methods. Many clients were young, poor, and had not been using a method during the 3 months prior to their visit.
- 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.