Rapid Contraceptive Uptake and Changing Method Mix With High Use of Long-Acting Reversible Contraceptives in Crisis-Affected Populations in Chad and the Democratic Republic of the Congo

Abstract

Offering a broad choice of contraceptives can rapidly expand use in crisis-affected settings, particularly when the choice includes long-acting reversible contraceptives (LARCs). Over 5 years, the governments of Chad and the Democratic Republic of the Congo, with support from an NGO, provided nearly 85,000 new clients with contraceptives. LARC users, which included an increasing number of IUD users, accounted for 73%.

Availability and Quality of Family Planning Services in the Democratic Republic of the Congo: High Potential for Improvement

“…In contrast, other recent studies have found high popularity of long-acting reversible contraceptives (LARCs) in several countries of Africa and Asia. For example, Jesse Rattan et al, reporting on an initiative to increase the availability, quality, and use of contraceptives in crisis-affected settings in Chad and the DRC, found a dramatic and sustained increase in use of implants and IUDs; these methods became among the most used methods in both country settings 36 . Similarly, Munroe et al, using data from social franchising programs in 17 African and Asian countries (not including the DRC), showed the majority of the clients chose LARCs 37 .…”

The promotion of intrauterine contraception in low- and middle-income countries: a narrative review

“…A total of 14 publications reported on projects for the general population [27][28][29][30][31][32][33][34][35][36][37][38][39][40]. The most common approach to promote IUD use in the general population is the simple one of training and supporting providers together with demand-creation activities.…”

“…A paper by Rattan et al [36], concerning Chad and the Democratic Republic of Congo (DRC), is of particular interest because of shifts over time in method-specific acceptance. Service data between 2011 and 2015 were used to document the outputs of a program, supported by CARE, to train public-sector providers in LARC services, supplemented by communitybased demand generation.…”

Family planning knowledge and use among women in camps for internally displaced people in the Democratic Republic of the Congo

“…Non‐governmental organizations (NGOs) such as CARE, working in collaboration with government and community leaders, have demonstrated that comprehensive reproductive health and family planning services can be offered and accepted in conflict‐affected regions . The CARE Supporting Access to Family Planning and Post‐Abortion Care (SAFPAC) program in eastern DRC, which supported 19 facilities, was able to serve more than 36 000 new users of modern contraceptive methods over 4 years . Critical elements for long‐term success included needs assessments, competency‐based training, management of the supply chain, and support and mobilization of the community .…”

“…11 The CARE Supporting Access to Family Planning and Post-Abortion Care (SAFPAC) program in eastern DRC, which supported 19 facilities, was able to serve more than 36 000 new users of modern contraceptive methods over 4 years. 12 Critical elements for long-term success included needs assessments, competency-based training, management of the supply chain, and support and mobilization of the community. 13 In long-standing conflicts, which are often accompanied by protracted displacements,…”