Albertine,* a 34-year-old mother of five, was determined to get a long-acting family planning method. Because she lives in a remote part of Benin, a country of around 9 million in West Africa, she needed to travel many kilometers in the hot sun with her youngest child on her back to reach a health facility that provides contraceptives. Although she lives in an area where less than 1 percent of women use a modern family planning method, a community health worker had counseled and referred her to the health facility using a mobile phone-based tool (a service provided through the PRISE-C project, which is supported by University Research Co., LLC’s Center for Human Services and funded by the U.S. Agency for International Development).
Once she reached the health facility, Albertine insisted on getting what she called “the five-year method,” the two-rod Jadelle implant that is effective for five years of continuous use. She waited until the late afternoon — when the day’s immunization services were complete — before the midwife could see her. In a scene not uncommon in rural settings, Albertine lay across a small exam table and nursed her son on her right side while the midwife swabbed her left arm, injected the anesthesia, positioned the trocar and inserted the rods one by one. When the insertion was complete, Albertine smiled, took her implant card, and said she would be back in five years for another one!
With this month marking the one-year anniversary of the landmark London Summit on Family Planning, Albertine’s story helps us reflect on all that has been accomplished to reach an additional 120 million women with contraceptives. One key achievement of Family Planning 2020 (FP 2020), an initiative that builds on the partnerships established through the summit, has been the roll-out of two unprecedented public–private partnerships with Bayer Healthcare (the manufacturer of Jadelle) and Merck/MSD (the manufacturer of Implanon, a one-rod implant that is effective for three years of use) that have reduced the price of both products by more than 50 percent.
Such changes mean that Jadelle and Implanon are now available at a price that is comparable to that of Sino-implant (II), a two-rod implant manufactured by Shanghai Dahua Pharmaceuticals Co., Ltd. Under the Sino-implant (II) initiative, which is led by FHI 360 and funded by the Bill & Melinda Gates Foundation, the product has been registered in 25 countries. Over 870,000 units have been procured in countries included under the project, which translates into the prevention of more than 1.2 million unintended pregnancies, almost 3,500 maternal deaths and 150,000 abortions.
Collectively, these accomplishments mean that affordable, high-quality implants are becoming increasingly available to women like Albertine in low-resource settings.
While great strides have been made toward increasing access to family planning, there is still an incredible amount of work to do in Benin and elsewhere around the world. Estimates indicate that there are over 200 million women in developing countries who want to prevent or delay a pregnancy but are not using a family planning method. At the health facility Albertine attended, some contraceptive options, including intrauterine devices and tubal ligation, were not readily available. Ensuring choice by providing women with a diverse method mix is essential. It is also critical that women like Albertine are guaranteed access not only to the provision of the family planning methods they want, but also to high-quality removal services for a long-acting, reversible method such as an implant.
For over forty years, FHI 360 has been at the forefront of helping to ensure the availability of high-quality family planning methods and services through projects like the Sino-implant (II) initiative and PROGRESS. As we celebrate the collective achievements of the global reproductive health community, we set our sights on the challenges that remain as we strive to achieve the ambitious goals of FP 2020.
Trinity Zan provides technical assistance to family planning programs and research initiatives. She recently returned from a trip to Benin for the Advancing Partners and Communities project, where she witnessed the service delivery experience described above. Kate Rademacher works on several contraceptive development and introduction projects, including the initiative to increase access to Sino-implant (II) in low-resource settings.
*Name has been changed.