Revitalizing long-acting reversible contraceptives in settings with high unmet need: a multicountry experience matching demand creation and service delivery

Abstract Background Contraception in many developing countries is characterized by high unmet need, irregular access, low utilization and presumed demand for long-acting reversible contraceptives (LARCs). Study Design A 13-country initiative focused on increasing consumer demand and high quality ser...

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Bibliographic Details
Published in:Contraception (Stoneham) 2013-02, Vol.87 (2), p.170-175
Main Authors: Blumenthal, Paul D, Shah, Nirali M, Jain, Kriti, Saunders, Aleen, Clemente, Corina, Lucas, Brad, Jafa, Krishna, Eber, Maxine
Format: Article
Language:English
Subjects:
Adult
Age Factors
Biological and medical sciences
Birth control
Community Health Services
Demand creation
Developing Countries
Educational Status
Family planning
Family Planning Services
Female
Genital system. Reproduction
Gynecology. Andrology. Obstetrics
Humans
Interpersonal communication
Intrauterine device (IUD)
Intrauterine Devices - supply & distribution
Intrauterine Devices - utilization
Long-acting reversible contraceptives
Medical sciences
Medically Underserved Area
Obstetrics and Gynecology
Other methods of contraception. Sterilization
Pharmacology. Drug treatments
Pregnancy
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Summary:Abstract Background Contraception in many developing countries is characterized by high unmet need, irregular access, low utilization and presumed demand for long-acting reversible contraceptives (LARCs). Study Design A 13-country initiative focused on increasing consumer demand and high quality services for intrauterine devices (IUDs) began in 2009. Services were provided through (a) private sector-franchised or affiliated clinics; (b) providers seconded to the public sector and (c) special “event” days. Client intake data are used to compare the profile of IUD acceptors with IUD users from representative national datasets of select countries, as well as examine trends in IUD uptake. Results During 2009–2010, 575,601 IUDs were inserted across the 13 countries. Compared to national IUD users, users in this project were slightly younger and less educated. Among IUD acceptors, 24% used no modern method at the time of IUD initiation, and 28% reported injectable use in the three previous months. Conclusions Convenient, quality, affordable services with demand creation can result in significant uptake of LARCs in settings with low use.
ISSN:0010-7824
1879-0518
DOI:10.1016/j.contraception.2012.10.002