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Improving Contraception Continuation Rates in India


  • Injectable DMPA was not part of India’s Family Planning package
  • The Dimpa private network and phone-based counseling addressed client issues
  • Abt’s efforts increased access to and demand for DMPA
The Challenge

Family planning is a large, unmet need in India. And those who had access to and used depot medroxyprogesterone acetate (DMPA), an injectable contraceptive, had low continuation rates. Research suggested that counseling potential adopters on side effects at the time of administration was insufficient. Women needed additional reassurance but didn’t return to providers because of physical and financial barriers. Standard approaches to increasing use--such as in-person visits by health workers--were not cost-effective. 

The Approach

To address family planning in India, the USAID-funded, Abt-led Strengthening Health Outcomes through the Private Sector (SHOPS) project launched a pilot to increase access to and demand for DMPA through the private sector. The core of the program was a network of private sector clinics--the Dimpa network--which offered a full range of contraceptive options to their clients. SHOPS also used an innovative phone-based counseling program, a careline, to improve continuation rates.  

The Results

The project enrolled 12,300 voluntary registrant, 40 percent coverage of the estimated DMPA users in the project area. The first-year continuation rate was 38 percent, 65 percent higher than the 23 percent reported nationally. Users said careline counseling reassured them and made them feel cared for. Many providers appreciated that counseling by phone benefited users and reduced their costs for nonessential follow-up visits to providers. 

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