Contraceptive implants are small, flexible rods that are inserted under the skin of the woman’s upper arm. The implant is a highly effective long-acting reversible contraceptive (LARC) method that can play an essential role in meeting the large unmet need for family planning throughout the world.
In 2015, PSI inserted 287,994 implants, averting 405,652 disability-adjusted life years (DALYs) from distribution and 636,953 from insertion. This provided 960,515 couple years of protection (CYPs) and prevented 239,116 unintended pregnancies.
The one-rod implant, Implanon NXT, is effective for three years. Two-rod implants, Jadelle or Sino-Implant, are effective for five and four years, respectively. Insertion and removal require minimal equipment, making implants an attractive product offering for providers. Implants can be easily removed by a provider at any time, and women experience a fast return to fertility. Additionally, pelvic exams and vaginal contact are not required for implant insertion, increasing acceptability of the method among those consumers and providers whose discomfort with pelvic exams can be a barrier to use of other methods.
Implants are an essential part of our contraceptive method mix, increasing each consumer’s ability to find a method that best suits their needs, within the context of informed choice.
PSI markets contraceptive implants through social franchises in 23 countries. Working with private sector providers, we assure the quality of insertion and removal of contraceptive implants and informed choice among consumers. We also work with the public sector to provide contraceptive forecasting assistance, provider training and demand creation.
Making a Difference
In Mali, PSI launched an innovative urban outreach model to increase women’s access to long-acting reversible contraception (intrauterine devices and implants), within the context of informed choice.
Under a public-private partnership, PSI/Mali and the Ministry of Health created an outreach model to integrate voluntary family planning education and services with clinic immunization days. Trained midwives discuss LARC methods during group information sessions with women waiting for immunization services for their children and in one-on-one sessions with women who express an interest in a LARC method.
The model employs strong social marketing and behavior change communication to promote LARCs given that the methods are often unknown and underutilized. Trained midwives serve as dedicated LARC providers and travel from clinic to clinic to deliver services. Since 2008, PSI/Mali has provided more than 254,373 women with the LARC of their choice.
- Women’s Limited Choice and Availability of Modern Contraception at Retail Outlets and Public-Sector Facilities in Luanda, Angola, 2012–2015
Despite high rates of unintended pregnancy, access to a wide range of contraceptive methods, especially injectables and long-acting reversible contraceptives (LARCs), is severely limited in both public and private facilities. Knowledge of contraceptive choices is likewise limited, yet a substantial proportion of women are not using their preferred method among the methods they know of.
- Intensive Group Learning and On-Site Services to Improve Sexual and Reproductive Health Among Young Adults in Liberia: A Randomized Evaluation of HealthyActions
Combining intensive group learning and provision of on-site reproductive health services through an
existing alternative basic education program increased use of contraception and HIV testing and
counseling among young out-of-school Liberians.
- Task-Sharing of Implant Insertion to Community Health Workers:The Ethiopia Experience
Task-sharing can be an important strategy in increasing access to long-acting contraceptives at the community level, but commitment from all levels of the MOH is essential. Competency-based training and follow-up mentorship/supervision are critical to quality services with task-sharing, and ensuring adequate implant removal services can be accomplished with multi-pronged strategies.
- La Classe Des Mere, Strategie Efficace Pour La Promotion Du DIU Post Partum Au Mali
The rate of modern contraceptive prevalence in Mali (10%) is among the lowest in the world and unmet need is 29% in the Sikasso region. In 2012, only 3.4% of women 15-49 used the long-term methods. The postpartum IUD is considered as a method used. The low usage is due to rumors about the IUD, socio-cultural barriers and the lack of target information, especially during pregnancy.
- Improving Provider Behavior Change Communication and IPC: Best Practices from the Women’s Health Project
This brief describes the challenges faced, strategies developed, and lessons learned by the Women's Health Project. It also proposes a set of best practices for improving productivity of interpersonal communications (IPC) agents and increasing providers' skills and motivation.
- Increasing LARC Provision in Cambodia through Improved Provider Selection and Motivation Strategies
This brief describes the challenges faced, strategies developed, and lessons learned to improve uptake of long-acting reversible contraception through the Sun Quality Health Network in Cambodia.
- Improving Provider BCC and IPC Productivity & Strengthening the Link between Providers and IPC Agents in Uganda
This brief describes the challenges faced, strategies developed, and lessons learned to improve uptake of long-acting reversible contraception through the ProFam network in Uganda.
- Improving LARC Services through a Provider Reward Scheme and Multiple IPC Channels in Tanzania
This brief describes the challenges faced, strategies developed, and lessons learned to improve uptake of long-acting reversible contraception through the Familia network in Tanzania.
- Increasing LARC Uptake in Kenya through Improved Demand Creation Strategies and Provider Support
This brief describes the challenges faced, strategies developed, and lessons learned to improve uptake of long-acting reversible contraception through the Tunza network of private clinics in Kenya.
- Enabling the Healthy Spacing and Limiting of Pregnancies: Programmatic Approaches to Expand Postpartum IUD Access
Under the Support for International Family Planning Organizations (SIFPO) project funded by USAID, PSI published a technical brief on 'Enabling the Healthy Spacing and Limiting of Pregnancies: Programmatic Approaches to Expand Postpartum IUD Access'. The brief introduces the need for expanded postpartum family planning options, reviews the advantages and disadvantages of the PPIUD, describes the components of successful initiatives to add PPIUD to the range of options for postpartum women, and illustrates three different models for PPIUD service delivery through case studies from the Democratic Republic of the Congo, Guinea, Zambia and Pakistan.