Shifting Into High Gear on FP2020 Goals – The Critical Role of Implants and Other LARCs

By Katherine Thanel, Lead Behavioral Health Planner, J&M Global Solutions (formerly FPwatch Research Manager)

 Many women and couples around the world desire fewer children, want to space births, or prevent pregnancy. Without family planning, the inevitability of unintended pregnancy is a burden on the health of women and families. More than 214 million women in developing countries have an unmet need for family planning simply because they lack access to safe and effective contraception.

As we approach the FP2020 goal of reaching 120 million women and girls with modern contraceptives, we must ensure that the most reliable methods – long-acting reversible contraceptives (LARCs) – are available to those who want them.

LARCs are highly effective in preventing pregnancy, less likely to be discontinued compared with short acting methods, and offer the benefits of convenience and comparatively low cost over time. Until now, a lack of rigorous market data has limited our understanding of the potential of LARCs to increase contraceptive access and choice.

PSI’s FPwatch Project worked to address this critical gap in data. Supported by the Bill & Melinda Gates Foundation and the Three Millennium Development Goal (3MDG) Fund, the research project conducted family planning market surveys in five countries with high unmet need and underserved geographies and populations.

The results, outlined in the latest issue of PLoS ONE, examine market composition, trends in product availability, and pricing across three study countries — Ethiopia, Nigeria and the Democratic Republic of Congo. In these three countries, the FPwatch Project screened more than 23,800 points of distribution and sale and selected over 5,600 of these outlets for audits. These data yield key evidence to inform future policies, strategies, and funding decisions.

We found:

  1. Substantial government and other stakeholder investment is required to improve availability and affordability of LARCS, particularly implants.
  2. Promising strategies to increase LARC uptake include brand-specific subsidies that make products more affordable in the private sector; task shifting to spread LARC access to underserved geographic areas; and promotion of methods that require less equipment and training.
  3. High LARC prices limit access. There is an opportunity to leverage subsidies to lower prices and increase product affordability for consumers.
  4. LARCs represent a large share of the contraceptive market in areas where they are available among a range of methods. This suggests that consumers have a preference for implants and IUDs, and do not only buy them for lack of options.
  5. Findings suggest a market preference for implants and an affinity for the ease of insertion offered by Implanon NXT®, which requires less equipment than IUDs or other types of implants, saves time and effort on the part of providers, and facilitates implementation of task shifting policies.

As we approach 2020, it is imperative that investment in LARCs, especially implants, is prioritized.