Research to Practice to Sustainable Scale-up: Managing the Process with the Standard Days Method(r)

The Standard Days Method (SDM)® is a fertility awareness-based method of family planning developed by Georgetown University Institute for Reproductive Health (IRH) to address unmet need for family planning. As with any family planning method, getting the SDM from initial concept to integration into programs required research, advocacy and partnerships. It also required constant attention to building an evidence base and addressing concerns of key stakeholders. Establishing theoretical efficacy based on data sets from the World Health Organization (WHO), developing and testing provider training and client materials (including CycleBeads®, the visual tool that facilitates understanding and use of the SDM), and conducting an efficacy study in collaboration with ministries of health and private-sector family planning programs were the beginning. Study results showed a high level of efficacy and acceptability by providers and clients. Introduction studies in public and private sector programs followed to test service delivery modes (clinic, community, social marketing), improve training and materials, and address policy-maker's questions, including continuation, impact on contraceptive mix and prevalence, training strategies, and cost. Collaboration with international organizations, including USAID, WHO, and others facilitated acceptance, as did local advocacy efforts. Ten years later, the SDM has been integrated into norms and services in diverse countries around the world and is being offered in pilot programs in several more. Scaling-up efforts are being monitored and evaluated in Asia, Africa and Latin America, using the WHO ExpandNet model. Lessons from these efforts will be presented, and implications for other reproductive health interventions and for sustainability will be considered.