What Have We Learned? Implementation of a Shared Learning Agenda and Access Strategy for the Hormonal Intrauterine Device

Abstract

In this review of early experiences providing the hormonal intrauterine device (IUD) in sub-Saharan Africa, we found: n Continuation and satisfaction were high among hormonal IUD users in pilot settings and generally comparable to those of other long-acting reversible contraceptives.n Hormonal IUD users reported positive attributes of the method including its effectiveness, long duration, convenience, potential for reduced bleeding, and fewer side effects compared to other hormonal methods.n Coordination across diverse organizations, including alignment on a shared learning agenda and access strategy, ultimately contributed to expanded access to the method.

Couple-Years of Protection Indicator: New Global Guidance for Updating Existing Methods and Adding New Methods

“…[13][14][15][16][17][18][19] This, coupled with product introduction efforts in multiple LMICs, will increase access to and use of the product. 20 In 2019 and 2020, respectively, the FDA extended the duration of use for the Mirena and Liletta hormonal IUDs from 5 to 7 years. In the coming years, national drug authorities in LMICs will update approvals accordingly.…”

End-to-end approach to ensuring equitable access to multipurpose prevention technologies in low- and middle-income countries

“…This, in combination with efforts to improve supply chain coordination, service delivery, and knowledge and awareness, was key in facilitating rapid scale-up in L/MICs ( 11 ). Between 2010 and 2018, there was a tenfold increase in implant procurement in the 69 lowest income countries with 27 million women using implants in L/MIC in 2019 ( 11 , 12 , 13 ). Effective collaboration at global and country levels contributed to institutionalizing mechanisms to maintain lower prices for long term sustainability ( 11 ).…”

Consensus recommendations for measuring the impact of contraception on the menstrual cycle in contraceptive clinical trials

“…When users find CIMCs undesirable, negative consequences can include contraceptive dissatisfaction, reduced quality of life, increased burden around managing menstrual health, reduced sexual wellness, and potential unintended pregnancy if users discontinue contraception while still wanting to prevent pregnancy [1][2][3][4]. On the other hand, experiences of CIMCs users consider desirable can result in benefits, such as management of for menstrual and gynecologic disorders and symptoms, method satisfaction, improved sexual wellness, and reduced burden or costs of menstrual materials [1][2][3][4][5][6]. Which CIMCs users determine to be desirable or undesirable for them can vary widely and is influenced by individual preferences and norms and community-level norms-especially around menstruation, menstrual health, and sexual and reproductive health-as well as perspectives of partners and wider social and contextual factors [1][2][3]7,8].…”