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Implant Introduction and Scale-Up: lessons learned, best practices, and opportunities to scale through PSE

Interactive Filing Cabinet

Explore our filling cabinet of resources on programmatic learnings, tips, best practices, and challenges on contraceptive implant introduction and scale-up. Scroll through the different tabs (Implants, LARCs, Implants Task Sharing and Private Sector Engagement) to learn more about these topics and what global and national initiatives have taken place over the years to increase access to implants and other contraceptives.

Accelerating Private Sector Engagement Public-Private Engagement: A series on private sector approaches in family planning

This brief shares SHOPS Plus’s public-privates health sector engagement efforts in Nigeria, Senegal and Tanzania, and notes several lessons learned and tips for donors to support public-private engagement in health.

A comparative study on the availability of modern contraceptives in public and private health facilities in a peri-urban community in Ghana

This study looks at the availability of modern contraceptives in public and private facilities and influencing factors. Healthcare from private providers is perceived to better than public health care. A total of 51 facilities were used for this study, of which 43 were from the private sector- pharmacies (20), chemical shops (13), clinics/polyclinics/health centres/maternity homes (7), hospitals (3). The study found no statistically significant relationship between availability of implants and type of health facility (public/private).

Are modern contraceptives acceptable to people and where do they source them from across Nigeria?

This study speaks to differences in acceptability among modern contraceptives in Nigeria based on socioeconomic status and geographic location, including different sources of contraceptives (private vs. public channels). Implants were rated the second most acceptable modern contraceptive and were mainly sourced from public hospitals, despite most contraceptives being generally sourced from the private sector, such as private drug retailers (patent medicine vendors) and pharmacy shops. Proximity between providers and consumers influenced source of contraception. Patent medical dealers and pharmacy shops from the private sector were major sources of contraceptives in this study.

Best Bets for Accelerating Family Planning in Pakistan: The case for engaging family physicians and the for-profit private sector

The article encourages the engagement of private pharmacies and shops for family planning, particularly in cases where the public sector faces shortages and stockouts.

Scaling up delivery of contraceptive implants in sub-Saharan Africa: operational experiences of Marie Stopes International

This article touches on the successful scale up of implants in Sub-Saharan Africa, pointing to key implementation strategies for scale up, such as, focusing on clients with unmet family planning need, demand generation and multi-service delivery channels, high quality service delivery and leverage public and private partnerships. It also touches on provider supply (including leveraging task-sharing); commodity supply chain (to ensure a steady stream of reliable stocks) ; program financing mechanisms and capacity to support implant removal services.

Scaling Up Access to Implants: A Summative Evaluation of the Implants Access Program

This article speaks to the Implants Access Program, which increased access to implants for women in low-income countries by addressing price barriers, enhancing supply chain visibility and coordination to limit stock-outs, capacity building in targeted areas and coordination among global and country partners. The program led with 2 volume guarantee agreements that reduced the price of implants by 50% and led to a 10-fold growth in implant procurement from 2010 to 2019 across the world’s 69 poorest countries.

Regional trends in the use of short-acting and long-acting contraception accessed through the private and public sectors

This article details trends between Asia, Sub Saharan African and Latin America and the Caribbean across three time periods from 1992-2000, 1998-2006 & 2005-2012. It shares differences in modern contraceptive prevalence rate, particularly long-acting vs short-acting method uptake between the public and private sector.

Public-Private Partnerships for family planning Commodities 

This brief discusses the challenges and lessons learned from the use of public-private partnerships (PPPs) to distribute publicly managed commodities through the private health sector, in order to overcome barriers to method access and choice.

Leading With LARCs in Nigeria: The Stars Are Aligned to Expand Effective Family Planning Services Decisively

This article shares the increase in contraceptive implants due to reforms in Nigeria. Reforms such as task shifting that have allowed community health extension worker (CHEW) to provide implants and IUDs, and contraceptives being provided for free in public sector clinics have contributed to his increase. The article also shares notable initiatives have led to increase in implant prevalence by private sector providers.

Leveraging long acting reversible contraceptives to achieve FP2020 commitments in sub-Saharan Africa: The potential of implants

This article details the market composition, share, availability, price and readiness for LARCs, including the potential for implants across three countries: Ethiopia, Nigeria and the Democratic Republic of Congo.

Modern contraceptive availability and stockouts: a multi-country analysis of trends in supply and consumption

This article discusses findings that show the importance of engaging the private sector towards achieving national family planning goals. It refers to PMA Agile data looking at changes in contraceptive supply by method and sector (private vs public) in five countries- Burkina Faso, the Democratic Republic of Congo, India, Kenya and Nigeria, and emphasizes leveraging pharmacies and drug shops to meet unmet needs.

Private sector engagement in sexual and reproductive health

This brief discusses the opportunities and challenges for private sector engagement, and the modalities of donor support for private sector engagement in sexual and reproductive health across key areas, such as finance, procurement, market development and planning, supply chain and service delivery.

Improving Access to Implants through the Private Sector: Lessons from Tanzania 

This brief shares the efforts taken by SHOPs Plus to address barriers for the private sector to offer implant services in Tanzania and recommends more long-term sustainable training and supply options for private sector engagement with improving access to implants.

Improving Access to Family Planning Services through the Private Sector in Pakistan A Stakeholder Analysis 

This analysis discusses the challenges and supports required by private sector providers in the provision of contraceptives in Pakistan.

Getting to FP2020: Harnessing the private sector to increase modern contraceptive access and choice in Ethiopia, Nigeria, and DRC

This article shares data from three low-to-middle income countries. It encourages the provision of modern contraception through the private sector, particularly drug shops and notes that subsidies and interventions, like social marketing and social franchising, could help improve the private sector’s role in increasing access to a range of contraceptives.

Factors Influencing the Private Sector’s Contributions to Family Planning Market Growth: A Synthesis of Six Country Analyses

This SHOPS Plus analysis shares the economic, sociocultural, policy and programmatic factors that influenced the private sector’s contribution to increase modern contraceptive prevalence rate in six countries- Bangladesh, Cambodia, Kenya, Nigeria, the Philippines and Tanzania.

Ethiopia 2015 contraceptive commodity and service assessment: Findings from public and private sector outlets

This brief shares an overview of modern contraceptive use in Ethiopia across private and public sector outlets, noting limited evidence in the private sector provision of contraceptive methods.

Estimating private sector out-of-pocket expenditures on family planning commodities in low-and-middle-income countries

This article shares data of family planning users, specifically out of pocket expenditures for family planning commodities in 132 low-to-middle income countries.

Evaluating the impact of a quality management intervention on post-abortion contraceptive uptake in private sector clinics in western Kenya: a pre- and post-intervention study

This study aims to evaluate the effect of a quality management intervention on post-abortion family planning (PAFP) uptake in nine private clinics in Western Kenya. The intervention was effective in improving PAFP counselling and provision, and increased uptake of PAFAP on the same day, but did not increase overall uptake of PAFP 2 weeks post-abortion.

Exploring the potential for private pharmacies to provide family planning services in Senegal

This study aims to explore factors that inhibit and can strengthen the engagement of private pharmacies in family planning in Senegal.

Peer-reviewed journals

Grey Literature 

PSE

Situational analysis of the private sector in the delivery of family planning services in Egypt: Current status and potential for increased involvement

The study aims to determine the size, scope and scale of private sector family planning providers, including what the policy and regulatory framework is for private provision of family planning products and services. It provides several recommendations to strengthen the role of the private sector for family planning.

Sustaining health outcomes through the private sector plus project: Final Report 2015-2022

This report shares an overview, accomplishments, and lessons learned of improving private and public sector engagement in over 30 countries, as part of SHOPS Plus’s Sustaining Health Outcomes through the Private Sector Plus Project.

The Role of Public–Private Partnerships to Increase Access to Contraception in an Emergency Response Setting: The Zika Contraception Access Network Program

This article shares efforts taken to address unintended pregnancies and Zika-related adverse birth outcomes during the Zika outbreak in Puerto Rico. This included the establishment of a established a coordinated response among government and private sector partners to improve access to contraception during the outbreak, by the Centre for Disease Control.

The Private Sector: Key to Achieving Family Planning 2020 Goals 

This brief shares data from Family Planning 2020’s Core Indicator Estimates and Demographic and Health Surveys to forecast the potential role of the private sector with increasing access to modern contraceptives.

Who pays and how much? A cross-sectional study of out-of-pocket payment for modern contraception in Kenya 

This article notes that out of pocket expenses make up a large proportion of health financing in Kenya, with unmet need for family planning being the highest among the poor. Kenya has a growing private sector, owning half of all health facilities, with the use of private facilities and pharmacies increasing by wealth quintile. Further implants (and injectables) are the most common contraceptive method across all wealth quintile groups, accounting for nearly 80% of all modern method users.