Use of Diffusion Innovation Theory to Identify Challenges and Next Steps in for Potential Scale-Up: The Case of the Standard Days Method in the Philippines

In 2001, a new family planning innovation, the Standard Days Method (SDM), was introduced in two areas of the Philippines via a pilot efficacy study that resulted in 220 users. In 2003, a reduction of donor funding reduced programming efforts in the Philippines. Despite this setback, SDM expanded to 8 areas, and contributed to 0.1-0.3% of the contraceptive prevalence rate. Research was conducted to elucidate how spontaneous diffusion occurred within this context. In June-July 2008, an assessment of the status of the SDM was conducted in the Philippines. We used diffusion of innovations theory to investigate scale-up and interpret findings. Data was collected through in-depth stakeholder interviews, focus group discussions, health facility assessments, health provider and community health worker interviews. Despite widespread knowledge of the innovation and perceived ease of use, many challenges were identified. The cost and lack of availability of CycleBeads resulted in the re-invention of the SDM to locally-made “vertical beads” to meet client demand. The divisive political situation between the government and church and withdrawal of contraceptives by international donors has stalled the scale-up process. Some church groups, opposed to the SDM, negatively labeled the innovation as a pretext to promote contraception. Diffusion of innovations theory aided in identification of challenges, re-invention of the innovation, and building change agents and networks. Next steps are to address the cost of the innovation, strengthen existing homophilous church networks, and to support the continued re-invention of the innovation.