Family Planning and Reproductive Health
- Successful Proof of Concept of Family Planning and Immunization Integration in Liberia
Mobilizing vaccinators to provide mothers key family planning information and referrals to co-located, same-day family planning services was feasible in resource-limited areas of Liberia, leading to substantial increases in contraceptive use. Conversely, impact on immunization rates was less clear, but at a minimum there was no decrease in doses administered.
- Breaking new ground in family planning communication
The Urban Reproductive Health Initiative has shown impact on contraceptive use from its communication components even within a few years, as described in 2 GHSP articles. One specifically addressed “ideation” about family planning in detail and was able to show both changes in ideation due to program exposure and correlated changes in contraceptive use. The other used a sophisticated analytical technique that indicated the observed changes in contraceptive use resulted from exposure to the communication efforts, and not just because people more prone to adopt family planning were also more likely to recall exposure to the communication messages.
- A better future for injectable contraception?
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Provision of injectables though drug shops appears practicable and can contribute a marked share of family planning services.
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A potential longer-acting injectable providing at least 6 months of protection appeals to programmatic professionals.
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Subcutaneous administration of DMPA offers major injectable improvements over the current intramuscular approach.
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Ironically, while injectable use will inevitably grow, better choice and wider availability of other methods—especially of long-acting and permanent methods—will reduce injectables′ overall share.
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- Demand generation activities and modern contraceptive use in urban areas of four countries: a longitudinal evaluation
Demand generation activities that were significantly associated with increased use of modern contraception in India (Uttar Pradesh), Kenya, Nigeria, and Senegal included: (1) community outreach activities, such as home visits and group discussions about family planning; (2) local radio programs; and (3) branded slogans and print materials circulated widely across the city. Television programming was also significant in India and Nigeria. Exposure to more activities may increase women's likelihood of using contraception.
- Using behavior change communication to lead a comprehensive family planning program: the Nigerian Urban Reproductive Health Initiative
Greater exposure to a comprehensive family planning program in urban Nigeria that emphasized demand generation and communication theory was associated with improved ideation among women (their beliefs, ideas, and feelings about family planning), and more positive ideation was associated with greater contraceptive use, especially among the poor. Improving providers' knowledge, attitudes, and skills was also key. By the end of the observation period, outreach through mobile service delivery contributed nearly one-half of the project clinics' family planning services.
- Policy and programmatic considerations for introducing a longer-acting injectable contraceptive: perspectives of stakeholders from Kenya and Rwanda
Unique attributes of a longer-acting injectable would likely appeal to both existing injectable users and new clients, both for spacing and for limiting births, and allow health systems to operate more efficiently. Considerations for enhancing successful introduction of this potential new method include keeping the cost low, expanding access through community-based distribution, and training providers to improve practices about injectables in general.
- Getting closer to people: family planning provision by drug shops in Uganda
Private drug shops can effectively provide contraceptive methods, especially injectables, complementing government services. Most drug shop clients in 4 peri-urban areas of Uganda were continuing users of DMPA; had switched from other providers, mainly government clinics, because the drug shops had fewer stock-outs and were more convenient (closer location, shorter waiting time, more flexible hours); and were satisfied with the quality of services. The drug shops provided a substantial part of the total market share for family planning services in their areas.
- Getting family planning and population back on track
After a generation of partial neglect, renewed attention is being paid to population and voluntary family planning. Realistic access to family planning is a prerequisite for women's autonomy. For the individual, family, society, and our fragile planet, family planning has great power.
- Preferences for a potential longer-acting injectable contraceptive: perspectives from women, providers, and policy makers in Kenya and Rwanda
High effectiveness, predictable return to fertility, and a single, prepackaged, disposable delivery system ranked high. Side effects were generally acceptable to women if they did not last long or disrupt daily activities. Cost was considered important for providers but not so much for most potential users.
- Medical barriers to emergency contraception: a cross-sectional survey of doctors in North India
Emergency contraceptive pills (ECPs) are extremely safe and do not interfere with implantation. Yet many surveyed physicians in India did not know that there are no contraindications to using ECPs, and many had negative attitudes about ECP users. Most were against having ECPs available over-the-counter and wanted to impose age restrictions. Efforts are needed to address such misconceptions that might lead to limiting ECP availability.