What is slowing down uptake of contraceptive implants: a review in 10 countries

What is slowing down uptake of contraceptive implants: a review in 10 countries
Pregnant women watch as a HIV nurse counselor demonstrates how to use a female condom at the Princess Christian maternity hospital in Freetown, Sierra Leone in March, 2011. Together,  contraceptive implants, female con UNICEF/Nesbitt

The RMNCH Strategy and Coordination Team (SCT) took part in the fourth International Conference on Family Planning and presented the results of an assessment across ten sub-Saharan African countries looking at the persistent bottlenecks to uptake and utilization of implantable contraceptives. The Conference, which took place in Nusa Dusa, Indonesia, 25-28 February, on the theme ‘Global Commitments, Local Actions’, brought together over 3000 participants to highlight successes that have been achieved in family planning around the world as well as hurdles that still need to be addressed.

The SCT conducted the assessment – the RMNCH Landscape Synthesis – between January 2013 and May 2015 in ten sub-Saharan countries: Cameroon, Ethiopia, Kenya, Nigeria, Senegal, Sierra Leone, Tanzania, Uganda, Mali and Malawi. On average, across the nine countries which

household survey data post-2012, the prevalence of modern contraceptive use was 27.9% for married women, with implantables making up 15.9% of the methods mix, and contributing to just 4.7% of coverage levels.

The RMNCH Landscape Synthesis summarized data for 24 relevant indicators – both systems-related, and specific to implantable contraception.

Results show that despite rapid and impressive gains in the availability and affordability of implantable contraceptives, levels of coverage remain low. Among the main obstacles to utilization are supply chain-related issues, such as the need to refine commodity security strategies, strengthen LMIS systems, and enhance distribution systems to reduce stock outs between national warehouses and points-of-service. In addition, the assessment shows that influx of implantables by donor organizations has sometimes by-passed national systems, as issue that can be avoided if national EMLs were up-to-date and products were registered in-country. Finally, the assessment highlights the need for more efforts to reduce financial access barriers, ensure health workers are trained in insertion and removal, and that basic job-aids and check-lists are made available to enhance the quality of service delivery.

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