Family Planning and Reproductive Health
- Systems approach to monitoring and evaluation guides scale up of the Standard Days Method of family planning in Rwanda
Scaling-up lessons included: (1) simplifying provider training and client materials; (2) ensuring core aspects of the intervention, for example, that the CycleBeads client tool was integrated into the supply chain system; (3) addressing provider-generated medical barriers; and (4) managing threats from changing political and policy environments. A focus on systems, the use of multiple M&E data sources, maintaining fidelity of the innovation, and ongoing environmental scans facilitated scale-up success.
- Informed push distribution of contraceptives in Senegal reduces stockouts and improves quality of family planning services
Dedicated logisticians restocked contraceptives monthly at facilities to maintain defined minimum stock levels, freeing up clinic staff. High stockout rates were virtually eliminated. Also, quality and timely data on contraceptives distributed allowed for better program management.
- A bright future for IUD use in Africa?
High uptake of IUDs under the mobile outreach service delivery model in Kenya bodes well for IUDs in sub-Saharan Africa, if delivered with good access and quality.
- It's about time: WHO and partners release programming strategies for postpartum family planning
The postpartum period is a critical time to address high unmet family planning need and to reduce the risks of closely spaced pregnancies. Practical tools are included in the new resource for integrating postpartum family planning at points when women have frequent health system contact, including during antenatal care, labor and delivery, postnatal care, immunization, and child health care.
- Introduction of the levonorgestrel intrauterine system in Kenya through mobile outreach: review of service statistics and provider perspectives
Limited introduction of the LNG IUS through mobile outreach in Kenya, without any special promotion, resulted in good uptake. And providers viewed it positively, particularly because of its noncontraceptive benefits. Increased provision of the LNG IUS can improve options for women needing highly effective reversible contraception.
- Scaling up delivery of contraceptive implants in sub-Saharan Africa: operational experiences of Marie Stopes International
Between 2008 and 2012, Marie Stopes International (MSI) provided 1.7 million contraceptive implants in sub-Saharan Africa as part of a comprehensive method mix, primarily through mobile outreach using dedicated MSI providers and also through social franchising and MSI-run clinics. Large-scale access, quality, and informed choice were key elements of MSI's strategy.
- Injectable contraception provided by community-based health workers: one important step toward meeting unmet need
Community-based provision of injectable contraception continues to advance and is gaining wider acceptance—a major step toward meeting unmet need. However, fully addressing family planning need will require access to a much wider range of methods, including long-acting reversible contraception and permanent methods.
- “A cup of tea with our CBD agent … ”: community provision of injectable contraceptives in Kenya is safe and feasible
Community health workers can safely provide the injectable DMPA when appropriately trained and supervised. We also found a fivefold increase in contraceptive uptake—a finding that builds on evidence from other countries for supportive policy change.
- Building on safety, feasibility, and acceptability: the impact and cost of community health worker provision of injectable contraception
This project in Zambia contributes to our understanding of the impact of community-based provision of injectables on method choice and uptake and of the costs of adding DMPA to an established community-based family planning program. The project also illustrates the importance of involving stakeholders from the outset, analyzing costs relevant to scale up, and engaging in policy change dialogue not at the end, but rather throughout project implementation.
- Early pregnancy detection by female community health volunteers in Nepal facilitated referral for appropriate reproductive health services
Trained female community health volunteers provided low-cost urine pregnancy tests in their communities, leading to counseling and appropriate referrals for antenatal care, family planning, or comprehensive abortion care.