Effect of expanding Standard Days Method services on contraceptive prevalence

Policy makers and program managers contemplating the integration of a new family planning method hope to increase contraceptive prevalence rather than switch users from one method to another. We present a study testing the effect of introducing the Standard Days Method (SDM) at the community level in India (Jharkand), Peru (San Martin), and Rwanda on contraceptive prevalence and method switching.

The SDM is a fertility awareness based method identifying days 8-19 of the menstrual cycle as fertile for women with cycles usually ranging 26-32 days. In recent years the method had been successfully introduced in many countries.

In 2004 method provision was expanded to include all government facilities in selected communities. Service statistics were collected from 280 intervention and control clinics for 27 months, beginning three months before the intervention. Community surveys were conducted prior to and two years after method provision began. About 3500 women and 1750 men were interviewed.

Community survey data from Rwanda show that 5.1% of post-intervention respondents had used the SDM. Two thirds of women and one third of men had heard of it. Survey data from Peru and India will also be presented. Service statistics show that adoption of family planning methods increased in the intervention sites as SDM adoption increased. Most women choosing the method had used no other contraception in the two months prior (Peru 52%; Rwanda 96%). In India 88% had never used a family planning before. We conclude that introducing the SDM into services can strengthen family planning programs.