Demography, Population, and Ecology Commons^™

Introducing Contraceptive Methods In Low-Resource Settings: New Opportunities In Kenya, Population Council

Reproductive Health

This factsheet outlines the Delivering Contraceptive Vaginal Rings project, awarded by USAID to the Population Council in October 2013 to foster the introduction of two contraceptive methods. The objectives of this project are to: 1) improve availability and affordability of a three-month Progesterone Vaginal Ring for postpartum breastfeeding women, and 2) facilitate regulatory approval and introduction of a one-year contraceptive vaginal ring containing Nestorone® and ethinyl estradiol—a long-acting method for non-breastfeeding women that is in the late stages of development. The factsheet identifies milestones achieved and new opportunities in Kenya to implement activities in the year ahead.

Introducing Contraceptive Methods In Low-Resource Settings: New Opportunities In Nigeria, Population Council

Reproductive Health

This factsheet outlines the Delivering Contraceptive Vaginal Rings project, awarded by USAID to the Population Council in October 2013 to foster the introduction of two contraceptive methods. The objectives of this project are to: 1) improve availability and affordability of a three-month Progesterone Vaginal Ring for postpartum breastfeeding women, and 2) facilitate regulatory approval and introduction of a one-year contraceptive vaginal ring containing Nestorone® and ethinyl estradiol—a long-acting method for non-breastfeeding women that is in the late stages of development. The factsheet identifies milestones achieved and new opportunities in Nigeria to implement activities in the year ahead.

Introducing Contraceptive Methods In Low-Resource Settings: New Opportunities In Senegal, Population Council

Reproductive Health

This factsheet outlines the Delivering Contraceptive Vaginal Rings project, awarded by USAID to the Population Council in October 2013 to foster the introduction of two contraceptive methods. The objectives of this project are to: 1) improve availability and affordability of a three-month Progesterone Vaginal Ring for postpartum breastfeeding women, and 2) facilitate regulatory approval and introduction of a one-year contraceptive vaginal ring containing Nestorone® and ethinyl estradiol—a long-acting method for non-breastfeeding women that is in the late stages of development. The factsheet identifies milestones achieved and new opportunities in Senegal to implement activities in the year ahead.

Delivering Contraceptive Vaginal Rings To Breastfeeding Women, Population Council

Reproductive Health

The Progesterone Vaginal Ring (PVR) is a user-controlled contraceptive that helps breastfeeding women safely and effectively space, delay, or limit their next pregnancy. The Population Council and partners developed the PVR to help address the unmet need for contraception among breastfeeding women. The ring provides a convenient option that adds choices for new mothers and promotes optimal infant nutrition and health. This two-page brief provides fast facts for advancing nutrition and infant health with the PVR.

Distribution D'Anneaux Vaginaux Contraceptifs, Population Council

Reproductive Health

Dans le cadre de son projet “Distribution d’anneaux vaginaux contraceptifs”, le Population Council a conclu un accord de coopération avec l’USAID pour introduire deux nouvelles méthodes contraceptives modernes sur les marchés en développement: l’anneau vaginal contraceptif à progestérone, un anneau contraceptif d’une durée d’action de trois mois spécifiquement conçu pour espacer les grossesses durant l’allaitement; et un anneau vaginal contraceptif expérimental d’une durée d’utilisation d’un an—l’anneau vaginal contraceptif Nestorone®/ethinyl estradiol—qui peut être utilisé par les femmes sexuellement actives en âge de reproduction (15 à 49 ans) pour retarder ou espacer les grossesses. Le Population Council vise à élargir le choix …

Willingness To Pay For Contraceptive Vaginal Rings In Senegal, Babacar Mane, Fatou Mbow, Deepa Rajamani, Nafissatou Diop, Saumya Ramarao

Reproductive Health

Contraceptive vaginal rings are an innovative category of products that have not been introduced into any sub-Saharan African country. As a result, there is little experience to guide the introductory pricing for the PVR and the one-year NES/EE CVR when it becomes available. The evidence generated by this consumer willingness to pay, and provider/procurer study has shed light on critical aspects of PVR introduction in Senegal. In general, the results generated here complement and reinforce findings from an acceptability study of the PVR and stakeholder discussions that have been occurring over the past three years. Results confirm that contraceptive vaginal …

Delivering Contraceptive Vaginal Rings—Task Sharing In The Delivery Of Family Planning Programs: Experiences From Senegal, Babacar Mane, Nafissatou Diop, Saumya Ramarao

Reproductive Health

The Population Council is conducting activities to facilitate the introduction of vaginal rings in sub-Saharan Africa. This report notes that the first ring to be introduced will be the Council’s Progesterone Contraceptive Vaginal Ring (PCVR), which is relevant in contexts where women practice prolonged lactation. The PCVR will also address the high unmet need for family planning (FP), especially for postpartum women. The Council aims to expand the availability and affordability of vaginal rings in Kenya, Nigeria, and Senegal. One of the challenges is the lack of skilled providers. To design plans for involving mid- and lower-level health workers in …

An Innovative Financing Model For The Progesterone Contraceptive Vaginal Ring Through Voucher Programs, Ishita Chattopadhyay, John Townsend, Saumya Ramarao

Reproductive Health

This technical report introduces the theoretical framework for the demand generation and supply chain mechanisms for an effective reproductive health voucher system. The key roles and functions of an effective voucher system are described. A methodology for implementation of a voucher system for the Population Council’s Progesterone Contraceptive Vaginal Ring (PCVR), also referred to as the PCVR Voucher Based Care (VBC) program, has been designed to introduce the PCVR in the context of choice, equity in price, and range of outlets, ensuring quality of care and consistent availability of services. The model provides a framework and guidelines on how the …

Progesterone Vaginal Ring: A Call-To-Action To Fill Critical Gaps In Post-Partum Family Planning, Population Council

Reproductive Health

The progesterone vaginal ring (PVR) is a safe and effective method of contraception for lactating women. It is a priority medicine on the WHO’s Essential Medicines List and is included in the Medical Eligibility Criteria for family planning providers. Developed by the Population Council, the PVR is an intravaginal ring that provides women who breastfeed at least four times a day with a contraceptive option as early as four weeks after giving birth. The PVR provides a new option to reduce unmet need among new mothers, allow women to safely space their pregnancies, and improve the health of women and …

Progesterone Vaginal Ring: Results Of A Three-Country Acceptability Study, Saumya Ramarao, Heather Clark, Deepa Rajamani, Salisu Mohammed Ishaku, Babacar Mane, Francis Obare, Harriet Birungi, Nafissatou Diop, Wilson Liambila, Fatou Mbow, Chi-Chi Undie, Godwin Unumeri, John Townsend

Reproductive Health

Global and national policies have refocused attention on postpartum family planning as an important component of ensuring healthy outcomes for women and babies. The progesterone vaginal ring (PVR) is used to extend the contraceptive effectiveness of lactational amenorrhea among breastfeeding women. Clinical trials have proven the PVR to be safe and effective; it is currently registered in eight Latin American countries. There is a need to assess acceptability prior to introduction into country programs, and the Population Council conducted PVR acceptability studies in Kenya, Nigeria, and Senegal. This report represents the results from a pooled analysis of data from the …

Anneau Vaginal À Progestérone: Évite Les Grossesses, Population Council

Reproductive Health

Cette fiche de renseignements fournit des informations sur l’utilisation de l’anneau contraceptif vaginal à la progestérone pour prévenir la grossesse. L'anneau vaginal à progestérone (AVP) offre une nouvelle manière de fournir un moyen de contraception. Il a été prouvé qu'il s'agit d'une méthode contraceptive sûre et efficace pour les femmes qui allaitent. Utilisé par ces femmes, l'AVP évite les grossesses en inhibant la croissance folliculaire et, par conséquent, empêchant l'ovulation; renforçant les effets inhibiteurs de l'allaitement maternel sur l'ovulation; étendant l'aménorrhée post-partum; et épaississant la glaire cervicale, et donc en empêchant les spermatozoïdes d'atteindre l'ovule. L'AVP donc étend la gamme …

Progesterone Vaginal Ring: Results Of An Acceptability Study In Nigeria, Salisu Mohammed Ishaku, Afolabi Kayode, Godwin Unumeri, Ayodeji Oginni, Adekunle Adeyemi, Deepa Rajamani, Heather Clark, Naomi Rijo, Saumya Ramarao

Reproductive Health

The progesterone vaginal ring (PVR) is used to extend the contraceptive effectiveness of lactational amenorrhea among breastfeeding women. The PVR was first registered in Chile and Peru in 1998 for use by postpartum women and has since been expanded to other Latin American countries. Previous studies have shown that contraceptive vaginal rings are safe, effective, and well accepted in varied cultural settings. However, the extent to which the ring is acceptable in the sub-Saharan African context is unknown. This study examined the acceptability of the PVR in Nigeria as part of a larger project that was also conducted in Kenya …

Anneau Vaginal À Progestérone: Aussi Sûr Pour Maman Que Pour Bébé, Population Council

Reproductive Health

Cette fiche d'information fournit des informations de base sur l'innocuité et l'efficacité de l'anneau contraceptif vaginal à la progestérone (AVP). Son effet contraceptif fonctionne en renforçant les effets inhibiteurs de l'allaitement maternel sur l'ovulation, et en étendant l'aménorrhée post-partum. L'AVP est un contraceptif sûr et efficace pour les mamans, leurs bébés et leurs partenaires sexuels. Cette méthode étend largement le gamme de contraceptifs à la disposition des femmes qui allaitent.

---

This fact sheet provides basic information on the safety and effectiveness of the progesterone vaginal contraceptive ring. It works as a contraceptive by reinforcing the inhibitory effect of breastfeeding …

Progesterone Vaginal Ring: Results Of An Acceptability Study In Kenya, Francis Obare, Wilson Liambila, Chi-Chi Undie, Harriet Birungi, Shiphrah Kuria, Heather Clark, Deepa Rajamani, Saumya Ramarao

Reproductive Health

The progesterone vaginal ring (PVR) is used to extend the contraceptive effectiveness of lactational amenorrhea among breastfeeding women. Previous studies have shown that contraceptive vaginal rings are safe, effective, and well accepted in varied cultural settings. However, the extent to which the ring is acceptable in the sub-Saharan African context is unknown. This study examined the acceptability of the PVR in Kenya as part of a larger project that was also conducted in Nigeria and Senegal. The specific objectives of the study were to assess the factors influencing the acceptability of the method among clients, their spouses, providers, community members, …

Progesterone Vaginal Ring: Prevents Pregnancy, Population Council

Reproductive Health

This fact sheet provides information about how the progesterone vaginal contraceptive ring works to prevent pregnancy. The progesterone vaginal ring (PVR) offers a novel way of delivering safe and effective contraceptives for lactating women. When used by such women it prevents pregnancy by inhibiting follicular growth, hence preventing ovulation; reinforcing the inhibitory effect of breastfeeding on ovulation; extending postpartum amenorrhea; and thickening the cervical mucus, thus inhibiting sperm from meeting the egg. The PVR expands the range of contraceptives available to lactating women and has the potential to contribute to improving maternal and infant health.

Progesterone Vaginal Ring: Safe For Mothers And Babies, Population Council

Reproductive Health

This fact sheet provides basic information on the safety and effectiveness of the progesterone vaginal contraceptive ring. It works as a contraceptive by reinforcing the inhibitory effect of breastfeeding on ovulation and extending postpartum amenorrhea. The PVR is an effective and safe contraceptive for mothers, their babies, and their sexual partners. This method vastly expands the range of contraceptive choices available for nursing women.

L’Anneau Vaginal À Progestérone: Résultats De L’Étude D’Acceptabilité Au Sénégal, Babacar Mane, Papa Chimere Diaw, Nafissatou Diop, Fatou Mbow, Heather Clark, Saumya Ramarao, Deepa Rajamani

Reproductive Health

Le Gouvernement du Sénégal s’est engagé dans une politique volontariste de repositionnement de la planification familiale à travers l’adoption d’un Plan d’Action National de Planification Familiale. Pour mieux adresser les besoins de contraception des femmes et réduire les taux d’abandon, le Population Council a initié le développement d’une gamme d’anneaux vaginaux; le premier produit développé était l’anneau vaginal à progestérone ou AVP, conçu pour les femmes qui allaitent en vue de prolonger la période d’aménorrhée lactationnelle et ainsi promouvoir l’espacement des naissances. Avec l’appui de la Fondation Bill & Melinda Gates, le Population Council a entrepris des activités de pré-introduction …

Delivering Contraceptive Vaginal Rings, Population Council

Reproductive Health

To bolster sustainable contraceptive delivery and use, USAID recently proposed a renewed focus, articulating five key areas to address unmet need for family planning: Method Choice, Total Market Approach, Family Planning Workforce, Social and Behavior Communication Change, and Strengthened Supply Systems. In its Delivering Contraceptive Vaginal Rings project, the Population Council has entered into a cooperative agreement with USAID to introduce two new modern contraceptive methods in developing markets: the progesterone contraceptive vaginal ring (PCVR), a three-month ring designed specifically for spacing while breastfeeding, and an investigational one-year contraceptive vaginal ring—the Nestorone®/EthinylEstradiol contraceptive vaginal ring (NES/EE CVR)—that can be used …

Willingness To Pay For Contraceptive Vaginal Rings In Kenya, Wilson Liambila, Deepa Rajamani, Francis Obare, Saumya Ramarao, Harriet Birungi, Heather Clark

Reproductive Health

Despite progress made in reducing fertility and increasing the contraceptive prevalence rate in Kenya, many women still experience high unmet need for contraception. Part of the challenge in addressing current levels of unmet need is the limited use of contraception by women during the first 12 months postpartum. New methods are needed that offer greater ease of use, are women-initiated, and do not require significant medical provider involvement for service delivery. One such method is the Progesterone Vaginal Ring (PVR), a reversible contraceptive that according to clinical trial data is safe and effective for breastfeeding women. New product introduction strategies …

Willingness To Pay For Contraceptive Vaginal Rings In Nigeria, Salisu Mohammed Ishaku, Ayodeji Oginni, Godwin Unumeri, Deepa Rajamani

Reproductive Health

During the last two decades, Nigeria’s contraceptive prevalence rate (CPR) for modern methods remained at 10 percent, one of the lowest rates in sub-Saharan Africa. Following the renewed global commitments culminating in the 2012 London Summit on Family Planning with promises to reach an additional 120 million new users of modern contraceptives worldwide, Nigeria’s Federal Ministry of Health set a new target of raising Nigeria’s CPR to 36 percent by 2018. One way to accomplish this is by meeting the contraceptive needs of women in the immediate postpartum period and beyond. Attention is being focused on making proven contraceptive methods …

Utilizing Social Marketing And Social Franchising Models To Expand Access To The Progesterone Contraceptive Vaginal Ring, Ishita Chattopadhyay, John Townsend, Saumya Ramarao

Reproductive Health

The Population Council’s Progesterone Contraceptive Vaginal Ring (PCVR) is an effective, user-initiated contraceptive option that helps meet the need for postpartum family planning (PPFP). It is exclusively designed for postpartum breastfeeding women who want to space or delay pregnancies the first year following childbirth. This technical report describes a social marketing and social franchising model that will be adopted for the introduction and scale-up of the PCVR. A methodology for implementation of this model, also referred to as the PCVR–Social Marketing and Social Franchising (PCVR-SM/SF) Model, has been designed to introduce the PCVR in the context of choice among other …

Offering Progesterone Contraceptive Vaginal Rings For Postpartum Women Through Integrated Family Planning And Immunization Services, Ishita Chattopadhyay, John Townsend, Saumya Ramarao

Reproductive Health

This technical report describes a model for providing the Population Council’s Progesterone Contraceptive Vaginal Ring (PCVR) through integrated FP/Immunization (FP/I) services, the core components of the model, the types of inputs required, and the steps for introduction and scale-up. It describes how the PCVR can be offered to breastfeeding women in the first year following childbirth. A methodology for implementation of the PCVR-Family Planning/Immunization model (also referred to as PCVR-FP/I) has been designed to introduce the PCVR in the context of accessibility, choice, equity, and, quality. A proposed structure to introduce and integrate the PCVR has been outlined and described …

Anneau Vaginal À La Progesterone: Appel A L'Action Pour Combler Les Ecarts Importants Dans La Planification Familiale Postnatal, Population Council

Reproductive Health

L’anneau vaginal à la progestérone (AVP) est une méthode efficace et sûre de contraception pour les femmes qui allaitent. C’est une médecine prioritaire de la liste des produits médicaux essentiels de l’OMS et elle est inclue parmi les critères médicaux éligibles pour les personnels de la planification familiale. Développé par le Population Council, l’AVP est un anneau intra-vaginal qui donne une option contraceptive aux femmes qui allaitent au moins quatre fois par jour dès la quatrième semaine après l’accouchement. L’AVP apporte une nouvelle option pour réduire les besoins non-satisfaits des nouvelles mères, permet aux femmes d’espacer leurs grossesses sans problème, …

Progesterone Vaginal Ring: Beneficial Role In Birth Spacing, Population Council

Reproductive Health

As a result of growing urbanization and changing social norms concerning the role of women in developing countries, the duration of exclusive breastfeeding and its impact as a contraceptive strategy has been reduced. This has given rise to the need for a contraceptive method that can extend the infertile period following delivery, especially in countries where access to other contraceptives is limited and where longer duration of breastfeeding is a social norm and a major benefit to infant health. This project brief provides information on the progesterone vaginal ring (PVR), which can enhance the effect of breastfeeding on birth spacing. …

Delivering Contraceptive Vaginal Rings—Task Shifting And Task Sharing In The Delivery Of Family Planning Services: Experiences From Kenya, Wilson Liambila, Saumya Ramarao, Heather Clark

Reproductive Health

This report describes the task-shifting and task-sharing policies and experiences relevant to the provision of family planning (FP) services in Kenya and the potential place for contraceptive vaginal rings. The feasibility, effectiveness, and acceptability of mid- and lower-level providers in the provision of FP services is documented. The report highlights how the provision of integrated RH/FP/HIV services could be delivered by various levels in the national health care system through task-sharing. Opportunities for facilitating delivery of the Population Council’s Progesterone Contraceptive Vaginal Ring (PCVR) within the national health care system in Kenya are also described. Kenya has in place policies …

L’Offre Des Anneux Vaginaux Contraceptifs— La Planification Familiale Postpartum: Experience Du Sénégal, Fatou Mbow, Babacar Mane, Saumya Ramarao

Reproductive Health

Le Gouvernement du Sénégal, à travers l’adoption du Plan National d’Action pour la Planification Familiale, s’est résolument engagé dans une politique de repositionnement de la planification familiale (PF) qui s’est fixé comme objectif d’augmenter le taux de prévalence contraceptive. L’introduction de l’anneau vaginal à progestérone (AVP) dans la gamme des méthodes contraceptives devra apporter une perspective intéressante pour la promotion de la planification familiale post-partum (PFPP). Pour faciliter cette introduction, il demeure important de bien comprendre le contexte dans lequel évolue le programme national de PF en général et celui de la PFPP en particulier. Grâce à un financement de …

Delivering Contraceptive Vaginal Rings—Task Sharing Policies And Practices In The Delivery Of Family Planning Services: Experiences From Nigeria, Godwin Unumeri, Salisu Mohammed Ishaku

Reproductive Health

Despite tremendous progress over the past decades in family planning and fertility reduction, more than 220 million women have unmet need for contraception globally. The government of Nigeria pledged over $11 million to procure contraceptive commodities for distribution in the public sector from 2011–2015, to increase the contraceptive prevalence rate (CPR) that had stalled at 10 percent for almost two decades. The Population Council is facilitating the registration, introduction, and scale-up of the Progesterone Contraceptive Vaginal Ring (PCVR), designed particularly for breastfeeding women, in the sub-Saharan African countries of Kenya, Nigeria, and Senegal. In Nigeria, restrictive policies regarding matching health …

Assessing The Potential Market For A Progesterone Contraceptive Vaginal Ring (Pcvr) As A New Contraceptive Option In Sub-Saharan Africa Using Needs-Based Market Segmentation, Francis Obare, Deepa Rajamani, Saumya Ramarao

Reproductive Health

Developing countries, especially in sub-Saharan Africa, have disproportionately high unmet contraceptive needs compared to other regions, and especially high levels of unmet need for spacing pregnancies. To address some of sub-Saharan Africa’s barriers to effective contraception, there is renewed focus on new methods that offer greater ease of use. New methods under investigation would not require daily action, their use would be controlled by women themselves, and they would require no medical providers or significant health-system infrastructure for service delivery. Contraceptive vaginal rings hold great potential by offering not only ease of use but a safe and effective FP solution. …

Policy And Programme Considerations For Arv-Based Prevention For Women: Insights From Key Opinion Leaders In Zimbabwe About Tenofovir Gel, Samukeliso Dube, Barbara Friedland, Saiqa Mullick, Martha Brady, C. Elizabeth Mcgrory

HIV and AIDS

Zimbabwe has seen a tremendous shift in the HIV landscape in the last decade, particularly regarding prevalence. Yet many people, especially women, are still at high risk and efforts to identify and implement additional HIV-prevention options remain critical. After nearly 20 years of microbicides research, 1 percent tenofovir gel is the first vaginal microbicide to show promise. Since 2011, Zimbabwe has been scaling up use of tenofovir-based regimens as first-line therapy for adults infected with HIV. A randomized, placebo-controlled, double-blind trial demonstrated that women assigned to use 1 percent tenofovir gel had a 39 percent lower risk of HIV infection …

Program And Policy Considerations For Tenofovir Gel In India: An Overview, Population Council

HIV and AIDS

The 2011 National Sentinel Surveillance estimated that 1.9 million people in India aged 15 and older were living with HIV. An estimated 39 percent are women. Given the urgent need for HIV-prevention options for women, a number of efforts are underway to prepare for introduction of tenofovir gel should it be shown to be effective. One of these is a guide to assist policymakers and program managers in identifying the most strategic opportunities for introducing tenofovir gel. The guide includes three related components: a landscape analysis, a discussion guide for key opinion leader interviews, and a program planning tool. The …