Expanding Access to Family Planning in Non-Traditional Settings: Offering the Standard Days Method in Small Shops (“Boutiques”) in Rural Mali

Lack of availability and limited access to health services, contraceptive commodities and/or health providers can be a deterrent to utilizing family planning (FP) services. In rural areas of Mali, small stores or “boutiques” provide families access to household supplies and can also be a source of contraceptives. This two-phase study examines the provision of CycleBeads®, the visual tool used with Standard Days Method® (SDM) to communities through boutiques. The objectives of Phase I were to: 1) revise the package insert explaining how to use SDM without provider assistance and 2) assess potential users' understanding of the insert. We randomly selected men and women attending local markets in Koulikoro and Segou districts (N=100) for four rounds of insert testing in Phase 1. The pictorial side (images only) of the insert was eliminated, as participants better understood the messages accompanied by explanations. Recruitment was restricted to men and women with at least primary level education for Rounds 2-4. Over the course of insert testing with adaptations to text/images, our findings revealed increases in comprehension scores of the following concepts: “who can use CycleBeads,” “what to do the first day of the menstrual period,” “what to do when a woman forgets to move the ring,” and “when to see a provider.” Future direct-to-consumer approaches should target men and women with basic literacy skills, as it is critical that users are able to read and understand the text that is used to explain how to use the SDM/CycleBeads.