Implementation and Scale-Up of the Standard Days Method of Family Planning: A Landscape Analysis

Abstract

Pilot introductions of the Standard Days Method (SDM) of family planning demonstrated its potential to meet unmet contraceptive needs in key populations, strengthen male involvement, and increase overall contraceptive uptake. Few countries had implemented national scale-up due to barriers, such as competing resource priorities and uneven stakeholder engagement. Demand-side user barriers, including insufficient fertility awareness knowledge, were also constraints. Policy makers should determine the SDM's added value to the contraceptive method mix and identify potential barriers to its implementation. ABSTRACTThe Standard Days Method (SDM), a modern fertility awareness-based family planning method, has been introduced in 30 countries since its development in 2001. It is still unclear to what extent the SDM was mainstreamed within the family planning method mix, particularly in low-and middle-income country (LMIC) settings, where the SDM had been introduced by donors and implementing partners. This review of implementation science publications on the SDM in LMICs first looked at community pilot studies of the SDM to determine the acceptability of the method; correct use and efficacy rates; demographics of users; and changes to contraceptive prevalence rates and family planning behaviors, especially among men and couples. Then, we examined the status of the SDM in the 16 countries that had attempted to scale up the method within national family planning protocols, training, and service delivery. At the community level, evidence demonstrated a high level of acceptability of the method; efficacy rates comparable to the initial clinical trials; diversity in demographic characteristics of users, including first-time or recently discontinued users of family planning; increased male engagement in family planning; and improved couple's communication. Nationally, few countries had scaled up the SDM due to uneven stakeholder engagement, lackluster political will, and competing resource priorities. Results of this review could help policy makers determine the added value of the SDM in the contraceptive method mix and identify potential barriers to its implementation moving forward.

A pharmacist-led medication review service with a deprescribing focus guided by implementation science

“…Further, the literature indicates that patient satisfaction with health interventions guided by implementation science is promising. The application of implementation science in family planning and in providing life narrative interviews for medical inpatients led to high satisfaction and acceptance among participants ( Rybarczyk et al, 2019 ; Weis and Festin, 2020 ). Moreover, an initiative to implement a measurement program of office and home blood pressure in primary care demonstrated favorable satisfaction among patients and providers towards the service that might decrease the use of unnecessary antihypertensive medications and enhance hypertension control ( Doane et al, 2018 ).…”

Use of Fertility Awareness-Based Methods for Pregnancy Prevention Among Ghanaian Women: A Nationally Representative Cross-Sectional Survey

“…Although 2 apps have received clearance from the United States Food and Drug Administration for use as a contraceptive method (Natural Cycles in 2018, 22 which also received CE Marking in Europe, and Clue in 2021 23 ), most such apps or devices are not tested or indicated for this purpose and may offer predictions of unknown accuracy regarding the timing of fertile days. 24,25 Research focused specifically on FABM use in low-and middle-income countries (LMICs) has been particularly limited (with exceptions from the United States Agency for International Development and the Institute for Reproductive Health at Georgetown University 18,[26][27][28][29][30][31] ). However, there are existing and emerging reasons for greater understanding around FABM use in LMICs.…”

Down But Not Out: Vasectomy Is Faring Poorly Almost Everywhere—We Can Do Better To Make It A True Method Option

“…We also note that some single-method projects (e.g., for the Standard Days Method) intended to add a less well-known method to the mix of available client options in LMICs have long been donor-funded. 50 …”