Applying a standard measure of the method mix evenness suggests 4 patterns among 15 countries moving toward a more balanced mix: (1) rise of one previously underrepresented or new method, (2) replacement of traditional with modern methods, (3) continued but declining domination by a single method, and (4) general movement toward a balanced mix. Improving availability of underutilized or new methods can improve the method mix, although better implementation of more popular methods might increase contraceptive use more expeditiously.
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This review concludes that in order to build the evidence base on what works in the FP/RH field, it may be expedient to focus on those social accountability interventions with some track record in achieving positive outcomes. Such interventions could benefit from an implementation science approach that examines not only outcomes, but the strengths and shortcomings of their actual implementation.
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