Family Planning and Reproductive Health
- Vouchers: A Hot Ticket for Reaching the Poor and Other Special Groups With Voluntary Family Planning Services
Vouchers can be a highly effective tool to increase access to and use of family planning and reproductive health services, especially for special populations including the poor, youth, and postpartum women. Voucher programs need to include social and behavior change communication with clients and quality assurance for providers, whether in the private or public sector. In the longer term, voucher programs can strengthen health systems capacity and provide a pathway to strategic purchasing such as insurance or contracting.
- Successful Implementation of a Multicountry Clinical Surveillance and Data Collection System for Ebola Virus Disease in West Africa: Findings and Lessons Learned
Despite resource and logistical constraints, International Medical Corps cared for thousands at 5 Ebola treatment units in Liberia and Sierra Leone between 2014 and 2015 while collecting hundreds of data points on each patient. To facilitate data collection and global reporting in future humanitarian responses, standardized data forms and databases, with clear definitions of clinical and epidemiological variables, should be developed and adopted by the international community.
- Safety and Acceptability of Community-Based Distribution of Injectable Contraceptives: A Pilot Project in Mozambique
Trained community health workers, including traditional birth attendants (TBAs), safely and effectively administered injectables in northern Mozambique; two-thirds of the women choosing injectables had never used contraception before. Including TBAs in the Ministry of Health’s recent task sharing strategy can improve rural women’s access to injectables and help meet women’s demand for contraception.
- Intensive Group Learning and On-Site Services to Improve Sexual and Reproductive Health Among Young Adults in Liberia: A Randomized Evaluation of HealthyActions
Combining intensive group learning and provision of on-site reproductive health services through an existing alternative basic education program increased use of contraception and HIV testing and counseling among young out-of-school Liberians.
- Improving the Quality of Postabortion Care Services in Togo Increased Uptake of Contraception
The quality improvement approach applied at 5 facilities over about 1 year increased family planning counseling to postabortion clients from 31% to 91%. Of those counseled provision of a contraceptive method before discharge increased from 37% to 60%. Oral contraceptives remained the most popular method, but use of injectables and implants increased. The country-driven approach, which tended to use existing resources and minimal external support, has potential for sustainability and scale-up in Togo and application elsewhere.
- Use of the World Health Organization’s Medical Eligibility Criteria for Contraceptive Use Guidance in sub-Saharan African Countries: A Cross-Sectional Study
The revised 2015 World Health Organization guidance expanded the recommended contraceptive options available to breastfeeding women during the early postpartum period to include progestogen-only pills and implants, but a substantial number of surveyed country representatives indicated that as yet their national policies did not allow such women to use these methods at that time. Countries may benefit from support to incorporate MEC guidance into national service delivery guidelines.
- Increasing Uptake of Long-Acting Reversible Contraceptives in Cambodia Through a Voucher Program: Evidence From a Difference-in-Differences Analysis
By reducing financial and information barriers, a family planning voucher program in Cambodia significantly increased contraceptive choice and uptake of more effective long-acting reversible contraceptives among poor women and women with the least education. Without vouchers, many of these women would not have used contraception or would not have chosen their preferred method.
- The Mayer Hashi Large-Scale Program to Increase Use of Long-Acting Reversible Contraceptives and Permanent Methods in Bangladesh: Explaining the Disappointing Results. An Outcome and Process Evaluation
The Mayer Hashi program resulted in a modest increase in use of long-acting reversible contraceptives and permanent methods in Bangladesh, but less of an increase than in comparison nonprogram districts, which appears to have been the result of weaknesses in the health system environment in the program districts. Addressing system issues to support providers beyond training might have led to better results.
- Increasing Use of Postpartum Family Planning and the Postpartum IUD: Early Experiences in West and Central Africa
Competency-based training in postpartum family planning and postpartum IUD (PPIUD) service delivery of antenatal, maternity, and postnatal care providers from 5 francophone African countries generated an enthusiastic response from the providers and led to government and donor support for expansion of the approach. More than 2,000 women chose and received the PPIUD between 2014 and 2015. This model of South–South cooperation, when coupled with demand promotion, supportive supervision, and reliable collection of service outcome data, can help to expand PPIUD services in other regions as well.