309746
Policy and Programmatic Considerations for Introduction of a Longer-Acting Injectable Contraceptive: Perspectives from International Opinion Leaders and Providers, Program Implementers, and Policymakers in Kenya and Rwanda
Contraceptive discontinuation is common for the current injectable, despite its popularity, and FHI 360 is spearheading efforts to develop a longer acting injectable (LAI) to address some of the causes of discontinuation. Contraceptive discontinuation can be affected by policy decisions, logistical problems, and other systems-level issues. Thus, the impact of a new LAI will rely not only on its acceptability by users, but its fit within current healthcare systems.
Methods:
We conducted qualitative case studies in Kenya and Rwanda. In-depth interviews were conducted with 27 service providers and 19 policymakers and program implementers focused on systems-level barriers and facilitators to contraceptive delivery services, for both medroxyprogesterone acetate and for a potential LAI. We also surveyed 28 international contraception leaders.
Results:
The regulatory process for drug registration was seen as cumbersome by policymakers; similarly, they saw manufacturing and procurement processes as potentially costly and time-consuming with limited funding available to cover the cost of a new product. Providers saw an LAI filling a need by providing a longer-term method that would appeal to women wanting to limit and space births. Respondents emphasized a well-planned introduction as essential in securing access and ensuring uptake of an LAI.
Conclusions:
An LAI could be integrated into existing contraceptive commodity policy-making, program planning, and distribution activities. However, to better ensure access to such a product, systems-level considerations and opportunities should be examined. Early involvement of all policy and healthcare cadres and communities will be important for introducing an affordable and accessible product.
Learning Areas:
Implementation of health education strategies, interventions and programsPlanning of health education strategies, interventions, and programs
Public health or related research
Learning Objectives:
Describe key barriers and opportunities for introduction of a new longer-acting injectable contraceptive as perceived by providers, policymakers, and program implementers.
Differentiate the considerations for implementation of a longer-acting injectable contraceptive from those of the existing injectables.
Assess the feasibility of introducing a new longer-acting injectable product in a specific country context.
Keyword(s): Contraception, Accessibility
Organization/institution whose products or services will be discussed: Product is not yet developed; research is qualitative on acceptability and planning process for possible future introduction of potential product.
Qualified on the content I am responsible for because: I am a qualitative health researcher with 7+ years of experience analyzing and managing data. Much of my work is grounded in research relating to qualitative methods, contraception, HIV, and men’s health both domestically and internationally. For this study, I served as the lead analyst and project manager.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.