In 2015, we distributed 24,815,155 cycles of oral contraceptives (OCs). This prevented 564,951 disability-adjusted life years (DALYs), provided 1,654,344 couple years of protection (CYPs) , and prevented 377,954 unintended pregnancies. We began socially marketing oral contraceptives in Bangladesh in 1976, and currently work with oral contraceptives in 25 countries.
The key to a successful family planning program lies in offering a wide range of contraceptive options to meet the diverse needs and wishes of clients. Oral contraceptives are a popular method among women and couples around the world. They are a highly effective, reversible and safe method of preventing unintended pregnancy.
There are two types of oral contraceptives:
- Combined oral contraceptives contain low doses of two synthetic hormones, estrogen and progestin, which simulate the natural hormones estrogen and progesterone. They work primarily by preventing the release of eggs from the ovaries (ovulation). Combined oral contraceptives are also called “the pill,” low-dose combined pills, oral contraceptive pills (OCPs) and OCs.
- Progestin-only pills contain very low doses of progestin and do not contain estrogen. For this reason, they provide a suitable option for women throughout breastfeeding and can be used by women who cannot use methods with estrogen. They work primarily by thickening cervical mucus (this blocks sperm from meeting an egg) and can prevent ovulation. Progestin-only pills are also called “mini pills” or progestin-only oral contraceptives.
PSI’s marketing strategies for oral contraceptives help inform consumers to create demand by addressing the key barriers that prevent women from using oral contraceptives. We then work with providers in the following ways to meet demand with quality products and services:
- Ensuring that health service providers at all relevant levels are knowledgeable about the full range of contraceptive options and are able to present them within the context of informed choice. Service providers can include doctors, nurses, midwives, community health workers and pharmacists. They are often the first points of contact for clients interested in learning about family planning.
- Training service providers in family planning counseling and method administration, including community-based distribution of oral contraceptives and other short-acting methods as authorized by local health authorities.
- Deploying medical detailers to visit service providers at their workplaces to learn what information and support they need to offer a broad method mix.
Making a Difference
Given the low cost to produce oral contraceptives and the well established market for these products, PSI is exploring opportunities for the development and introduction of more affordable oral contraceptive brands. PSI is currently launching a third generation oral contraceptive called Meuri in countries like Haiti and Angola, among others.
- 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.
- What You Ask and How You Ask It: Results of a Baseline Survey Among Very Young Adolescents (10-14 Years Old) in Honduras
The teenage pregnancy rate in Honduras is among the highest in the region at 22%. Challenges faced by young people are amplified due to low levels of educational attainment, limited economic opportunities, and limited access to AYSRH (adolescent, youth, sexual reproductive health) services. Population Services International (PSI) and PASMO/Honduras are working with young girls aged 10-19 to address harmful gender norms, which contribute to unintended teenage pregnancy.