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Evaluating The Inclusion Of Family Planning Within The National Health Insurance Benefits Package In Ghana, Kamil Fuseini, Augustine Ankomah
Evaluating The Inclusion Of Family Planning Within The National Health Insurance Benefits Package In Ghana, Kamil Fuseini, Augustine Ankomah
Reproductive Health
Contraceptive use in Ghana has remained low despite annual increases since 2012. Having a high unmet need for family planning (FP) suggests that there may be barriers to access and uptake. Over time, several policies, including Ghana’s Costed Implementation Plan from 2015–20, have suggested FP initiatives to improve contraceptive use yet they have not been entirely implemented. Further, although FP was included in the health insurance act passed in 2003, amended in 2008, and revised in 2012, which indicated that health-care benefits include FP, people continue to pay out of pocket for services at National Health Insurance Authority facilities because …
Modeling The Impact Of Inclusion Of Family Planning Services In Ghana's National Health Insurance Scheme, Justin Archer, Gillian Eva, Augustine Ankomah, Saumya Ramarao, Kamil Fuseini, Anne Coolen, Stephen Duku, Benjamin Bellows
Modeling The Impact Of Inclusion Of Family Planning Services In Ghana's National Health Insurance Scheme, Justin Archer, Gillian Eva, Augustine Ankomah, Saumya Ramarao, Kamil Fuseini, Anne Coolen, Stephen Duku, Benjamin Bellows
Reproductive Health
While access to and uptake of modern family planning (FP) in Ghana has steadily risen over the last decade, the modern Contraceptive Prevalence Rate (mCPR) among all women reached only 22% in 2019 with 30% of women still reporting unmet need. To increase FP uptake via mitigation of cost barriers among women with unmet need, the Government of Ghana is seeking to integrate claims-based FP services into the National Health Insurance Scheme benefits package. The impact of these activities has the potential to be significant with the proportion of women accessing modern FP shifting dramatically to public facilities over the …
Contraceptive Use Dynamics In India: A Prospective Cohort Study Of Modern Reversible Contraceptive Users, Arupendra Mozumdar, Elizabeth Tobey, Kumudha Aruldas, Rajib Acharya, Aparna Jain
Contraceptive Use Dynamics In India: A Prospective Cohort Study Of Modern Reversible Contraceptive Users, Arupendra Mozumdar, Elizabeth Tobey, Kumudha Aruldas, Rajib Acharya, Aparna Jain
Reproductive Health
This report highlights the contraceptive use dynamics among 2,699 married women in India who began using one of four reversible contraceptive methods over one year. Women aged 15-49 were enrolled into the study from Odisha and Haryana states within one month of starting their reversible method—interval intrauterine device (IUD), postpartum IUD (PPIUD), injectable contraceptive, or oral contraceptive pill (OCP)—and were interviewed at four time points: at enrollment into the study, and three, six, and 12 months after enrollment. Study findings include the quality of care received at the time of method adoption, experience and management of side effects, reasons for …
Dynamics Of Injectable Contraceptive Use In India, The Evidence Project
Dynamics Of Injectable Contraceptive Use In India, The Evidence Project
Reproductive Health
This brief describes a research study by the Population Council, with support from USAID/India, whose purpose is to provide evidence that can be used to strengthen the family planning program and meet the needs of reversible contraceptive users who want to prevent pregnancy in India. Understanding the experiences of the small but growing population of women choosing the injectable is important as the Government of India continues to roll out injectable contraceptive methods in the public sector. The report’s key recommendations include: disseminating messaging about potential side effects of the injectable, institutionalizing quality of care in pre-service trainings for all …
Dynamics Of Oral Contraceptive Pill Use In India, The Evidence Project
Dynamics Of Oral Contraceptive Pill Use In India, The Evidence Project
Reproductive Health
The purpose of this brief is to provide evidence that can be used to strengthen the family planning program in India, particularly for community-based and facility-based distribution of oral contraceptive pills (OCPs), use of which remains low despite their availability. Understanding women’s interactions with frontline health workers while obtaining the method and during follow-up counseling can help the Government of India improve its National Family Planning Program. Based on its findings, the report recommends that all providers, especially frontline health workers, receive training focusing on four domains of quality of care: 1) respectful care, 2) counseling to enable appropriate method …
Contribution Of Contraceptive Discontinuation To Unintended Births In 36 Developing Countries, Population Council
Contribution Of Contraceptive Discontinuation To Unintended Births In 36 Developing Countries, Population Council
Reproductive Health
High contraceptive discontinuation results in millions of women having an unmet need for contraception. This Population Council study using data from 36 Demographic and Health Surveys shows that contraceptive discontinuation also results in millions of unintended pregnancies and births. This brief recommends attention to issues related to quality of care, such as counseling, to ensure that each woman has the method she needs/wants and uses it correctly. This will help women avoid contraceptive discontinuation and associated unmet need and unintended fertility right from the beginning. As programs become more successful, quality of care will become key to expanding contraceptive use …
Strengthening The Role Of Patent And Proprietary Medicine Vendors In The Provision Of Injectable Contraception In Nigeria, Salisu Mohammed Ishaku
Strengthening The Role Of Patent And Proprietary Medicine Vendors In The Provision Of Injectable Contraception In Nigeria, Salisu Mohammed Ishaku
Reproductive Health
In Nigeria, overall modern contraceptive use is very low, however 60 percent of modern contraceptive services are obtained from private providers, including Patent and Proprietary Medicine (PPM) shops, which provide more than half of these private-sector services. PPM shops are owned by Patent and Proprietary Medicine Vendors (PPMVs) licensed to sell patent or proprietary drugs. Current regulations do not permit PPMVs to sell or administer injectable contraceptives, though, because they are not regarded as sufficiently trained. Given this, it is an opportune time to generate evidence that can drive policy action to formally engage and train PPMVs in the provision …
Ensuring Contraceptive Security Through Effective Supply Chains, Moazzam Ali
Ensuring Contraceptive Security Through Effective Supply Chains, Moazzam Ali
Reproductive Health
Establishing and maintaining well-functioning supply chains that meet the needs of public and private sectors, as well as health professionals at all levels in family planning programs, will play a critical role in reducing unmet need for modern contraception in low and middle income countries. This evidence brief identifies two evidence-based solutions to address the challenges faced by these countries: increasing the visibility of product flows and user demand, and leveraging the expertise of the private and public sector to ensure a total market approach to supply-chain management. Strengthening the capacity of public and private-sector family planning providers and managers …
Women's Perceptions And Experiences Of Family Planning By Contraceptive Methods In Kenya And Bangladesh: Preliminary Results, Kazuyo Machiyama, Joyce Mumah, Caroline W. Kabiru, George Odwe, Francis Obare, Fauzia Akhter Huda, John C. Cleland, John B. Casterline
Women's Perceptions And Experiences Of Family Planning By Contraceptive Methods In Kenya And Bangladesh: Preliminary Results, Kazuyo Machiyama, Joyce Mumah, Caroline W. Kabiru, George Odwe, Francis Obare, Fauzia Akhter Huda, John C. Cleland, John B. Casterline
Reproductive Health
No abstract provided.
What Do Users Really Want?, Saumya Ramarao, John Townsend, James Sailer
What Do Users Really Want?, Saumya Ramarao, John Townsend, James Sailer
Reproductive Health
No abstract provided.
Method-Specific Attributes That Influence Choice Of Future Contraception Among Married Women In Nairobi’S Informal Settlements, Joyce Mumah, John B. Casterline, Kazuyo Machiyama, Marylene Wamukoya, Caroline W. Kabiru, John C. Cleland
Method-Specific Attributes That Influence Choice Of Future Contraception Among Married Women In Nairobi’S Informal Settlements, Joyce Mumah, John B. Casterline, Kazuyo Machiyama, Marylene Wamukoya, Caroline W. Kabiru, John C. Cleland
Reproductive Health
No abstract provided.
Understanding Adolescent And Youth Sexual And Reproductive Health-Seeking Behaviors In Ethiopia: Implications For Youth Friendly Service Programming, Aparna Jain, Hussein Ismail, Elizabeth Tobey, Annabel Erulkar
Understanding Adolescent And Youth Sexual And Reproductive Health-Seeking Behaviors In Ethiopia: Implications For Youth Friendly Service Programming, Aparna Jain, Hussein Ismail, Elizabeth Tobey, Annabel Erulkar
Reproductive Health
To meet the unique sexual and reproductive health needs of its large adolescent and youth population, Ethiopia’s government has expanded and institutionalized youth-friendly services (YFS) at all levels of the health system. To help inform and improve these efforts, the Evidence Project, in collaboration with USAID/Ethiopia and the Ethiopian Federal Ministry of Health, conducted a study on adolescents’ and young people’s use of and opinions on YFS. Results showed that young people were satisfied overall with the health services they received, regardless of whether it was basic health services or YFS. Awareness and use of YFS was low, but many …
The Need For Improved Information Exchange Between Family Planning Providers And Clients, Population Council
The Need For Improved Information Exchange Between Family Planning Providers And Clients, Population Council
Reproductive Health
The information exchanged during a contraceptive visit is important because providers need to understand clients’ reproductive intentions and clients need to receive adequate information about the method options and possible method-related side effects and problems. Little is known about how information exchange has changed over time and across countries, so FP2020 identified 17 core indicators to track progress made by FP programs, including the method information index (MII). The purpose of this study is to address the following issues: how the MII varies among countries, how it changes between two surveys in the same country, how it varies by type …
Uganda Retail Audit: Analysis And Report, The Evidence Project
Uganda Retail Audit: Analysis And Report, The Evidence Project
Reproductive Health
This brief presents results of a retail audit, carried out in January 2016, that was commissioned as part of PATH’s work under the USAID-funded Evidence Project to conduct a landscape assessment of the feasibility of a Total Market Approach (TMA) in Uganda. This project also involved key informant interviews with stakeholders on their attitudes toward TMA principles and the collection of a Uganda Market Research Summary of existing family planning knowledge. The approach is based on an understanding that equitably meeting the diverse needs of different population segments requires increased coordination across sectors, including the public, private for-profit, and not-for-profit …
Introducing Contraceptive Methods In Low-Resource Settings: New Opportunities In Kenya, Population Council
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.
Contraceptive Use Dynamics In India: Cohort Study Of Modern Spacing Contraceptive Users, Population Council
Contraceptive Use Dynamics In India: Cohort Study Of Modern Spacing Contraceptive Users, Population Council
Reproductive Health
This two-page activity brief provides an overview of the Evidence Project’s Contraceptive Use Dynamics in India activity. Modern contraceptive use in India has steadily increased, but remains heavily skewed toward female sterilization. Use of modern spacing methods such as injectables, the pill, and the IUCD is low, and discontinuation rates are high. Achieving the goal of expanding the method mix by increasing reliance on modern spacing methods, as laid out in India’s FP2020 commitment, requires understanding and addressing the reasons for discontinuation and for method switching (or non-switching), from both the users’ and the providers’ perspective.
Scaling Up Family Planning In Zambia—Part 2: The Cost Of Scaling Up Family Planning Services, David Collins, Colin Gilmartin
Scaling Up Family Planning In Zambia—Part 2: The Cost Of Scaling Up Family Planning Services, David Collins, Colin Gilmartin
Reproductive Health
This costing study is Part 2 of a broader implementation research study designed to establish the feasibility of integrating successful interventions and lessons from the Scaling Up Family Planning (SUFP) project into Zambia’s health system at the conclusion of the project, and to contribute to the global learning on scaling up family planning services. The main contribution of the costing study was to examine the cost implications in determining the scope and pace of scale up. Challenges experienced during the project reportedly included lack of equipment and limited space in some facilities, government staff shortages, and irregular access to supplies …
Introducing Contraceptive Methods In Low-Resource Settings: New Opportunities In Senegal, Population Council
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.
Men As Contraceptive Users: Programs, Outcomes And Recommendations, Karen Hardee, Melanie Croce-Galis, Jill Gay
Men As Contraceptive Users: Programs, Outcomes And Recommendations, Karen Hardee, Melanie Croce-Galis, Jill Gay
Reproductive Health
Knowledge about reaching men as clients of family planning services in today’s programming environment is still limited. This report reviews 47 current activities, programs, and evidence that affect men’s use of contraceptive methods. The review includes three methods that men use directly, namely condoms, vasectomy, and withdrawal, and one that requires their direct cooperation, namely the Standard Days Method. Evidence comes from: a review of published and grey literature documentation of interventions focused on men as users of contraception in low- and middle-income countries; and interviews with organizations and institutions that are conducting programming and research in the area of …
Delivering Contraceptive Vaginal Rings To Breastfeeding Women, Population Council
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.
Introducing Contraceptive Methods In Low-Resource Settings: New Opportunities In Nigeria, Population Council
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.
Scaling Up Family Planning In Zambia—Part 1: Assessment And Feasibility Of Maintaining An Innovative Program, Benjamin Bellows, Mary Nambao, Luigi Jaramillo, Roz Fanaiayan, Mardieh Dennis, Karen Hardee
Scaling Up Family Planning In Zambia—Part 1: Assessment And Feasibility Of Maintaining An Innovative Program, Benjamin Bellows, Mary Nambao, Luigi Jaramillo, Roz Fanaiayan, Mardieh Dennis, Karen Hardee
Reproductive Health
To support the Government of Zambia in addressing its reproductive health challenges and in meeting its goals for 2020, the United Kingdom Department for International Development funded a four-year effort to support public sector contraceptive expansion under the Scaling Up Family Planning (SUFP) Project, led by Abt Associates. Launched in 2012, and with a focus on hard-to-reach areas and youth and expanding access to long-acting reversible contraceptives, SUFP was a technical assistance program designed to strengthen the ability of the public sector to provide services to meet the country’s FP2020 goals. SUFP focused on capacity building, infrastructure strengthening, behavior change …
Distribution D'Anneaux Vaginaux Contraceptifs, Population Council
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
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 …
Contraceptive Use And Fertility Intentions Among Women Living With Hiv In Kenya And Swaziland, Integra Initiative
Contraceptive Use And Fertility Intentions Among Women Living With Hiv In Kenya And Swaziland, Integra Initiative
Reproductive Health
At the end of 2013, an estimated 35 million people were living with HIV, and sub-Saharan Africa was disproportionately affected. With major efforts directed at expanding access to life-saving antiretroviral therapy in sub-Saharan Africa, many people are living longer with HIV, leading productive and sexually active lives. Unintended pregnancies and the potential of vertical transmission are some of the challenges faced by women living with HIV. Understanding the fertility preferences and reproductive decisions of these women is vital for informing efforts to enable them to achieve these desires effectively and safely. The “Steps to Integration” series provides a guide on …
Delivering Contraceptive Vaginal Rings—Task Sharing In The Delivery Of Family Planning Programs: Experiences From Senegal, Babacar Mane, Nafissatou Diop, Saumya Ramarao
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
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 …
Family Planning Vouchers To Improve Delivery And Uptake Of Contraception In Low And Middle Income Countries: A Systematic Review, Benjamin Bellows, Ashish Bajracharya, Carol Bulaya, Sophie Inambwae
Family Planning Vouchers To Improve Delivery And Uptake Of Contraception In Low And Middle Income Countries: A Systematic Review, Benjamin Bellows, Ashish Bajracharya, Carol Bulaya, Sophie Inambwae
Reproductive Health
Family planning vouchers have provided accessible and quality reproductive health services to the poor and have been critical to countries in making progress in achieving Millennium Development Goal 5. Increased utilization of contraception allows for birth spacing, decreases unintended pregnancy, and results in healthier mothers and families. Strategies to improve utilization through targeted subsidies in low- and middle income countries (LMICs) have not been fully documented in a systematic review of the literature. This study report summarizes the effect of voucher systems for contraceptive services on socioeconomic and demographic indicators in LMICs. A systematic review of unpublished reports and published …
Progesterone Vaginal Ring: A Call-To-Action To Fill Critical Gaps In Post-Partum Family Planning, Population Council
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 An Acceptability Study In Kenya, Francis Obare, Wilson Liambila, Chi-Chi Undie, Harriet Birungi, Shiphrah Kuria, Heather Clark, Deepa Rajamani, Saumya Ramarao
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, …