Mixed methods study on community preparedness, health system readiness and user’s acceptance of implant contraceptives in India
Client: International Planned Parenthood Federation (IPPF) and Family Planning Association of India (FPAI)
Location: Delhi, Maharashtra, Jharkhand, Karnataka and West Bengal
Background Context: IPPF South Asia Regional Office, a global healthcare provider and a leading advocate of sexual and reproductive health and rights (SRHR) for all, is working to advocate for the introduction of implants in the basket of choices for contraceptives in the public health system in India. FPAI, a premier civil society organization delivering essential health services focusing on sexual and reproductive health, is working in 17 States/UTs across India at 44 locations and 10 out of 39 static clinics are providing hormonal implant contraceptives to women.
Objectives
Development Solutions was commissioned to conduct a preparedness study consisting of community preparedness and health system readiness study in Delhi, Karnataka, Maharashtra, and Jharkhand. In addition, an acceptance study was also commissioned in the above locations along with West Bengal to understand the profiles, decision-making pathways, and user experience of implant users in India. The following were some of the specific objectives:
Community Preparedness Study
- To assess the potential market demand along with health system readiness for the introduction of implants
- To assess the community preparedness for the introduction of implants in India
- To understand the health system’s readiness for the introduction of implants in India
User’s Acceptance Study
- To understand the profile of implant contraceptive users
- To explore the decision-making and information pathways of the acceptors.
- To understand the acceptance, experience, and satisfaction among the implant users
Approach and Methodology
- Method/ Design: Mixed methods- quantitative Surveys, in-depth interviews, secondary data analysis
- Key Respondents/ Informants:
- Community Preparedness Study: Married women of reproductive age (15-49 years), domain experts from family planning (FP), government officials from FP division of Ministry of Health and Family Welfare, front-line health workers, health providers from private and public health facilities, contraceptive manufacturers, Federation of Obstetric and Gynecological Societies of India (FOGSI), National Family Health Survey (NFHS)-5,4,3 data (for secondary analysis)
- User’s Acceptance Study: Married women of reproductive age (15-49 years) using implant or those who removed implant, their spouse/mother-in-law, FPAI clinic staff
- Key Areas of Inquiry:
- Community Preparedness Study: Market segmentation for implant contraceptives using NFHS data; demographic, economic, and reproductive profile of women; contraceptive use and dynamics; awareness and knowledge of contraceptives; the agency for contraceptive use; current contraceptive use and method mix; interspousal communication and family support; awareness and knowledge of implants; willingness and intent to use implants; perspectives of other key stakeholders on knowledge, attitudes, perceptions related to contraceptives and implants; support required for roll out of implants; system preparedness for provision of implants; current challenges and barriers with respect to the provision of implants; enablers for provision of implants.
- User’s Acceptance Study: Knowledge and awareness of implants; decision-making the pathway for acceptance and removal of implants; use of implants, removal and experience with the process; willingness to continue and recommend implants; experience of FPAI service providers.
- Sample:
- Community preparedness Study: Quantitative (215); Qualitative(26)
- User’s Acceptance Study: Qualitative(36)
Impact
Findings helped IPPF and IPPF formulate evidence-based strategies for advocacy with the Government of India for a smooth and successful rollout of implant contraceptives in the country. The insights from the study informed the overall scale-up strategy, and the user experience from pilot studies, which included community knowledge, perceptions, and stakeholder feedback on implants, contributed to the assessment of barriers and enablers for scaling up implants.
Contact
17/109, Lower Ground Floor, Vikram Vihar, Lajpat Nagar IV, New Delhi – 110024