NextBillion - An Initiative of the William Davidson Institute at the University of Michigan

Thursday, January 28, 2016

Despite much progress in increasing access to modern contraceptive methods, in Uganda, the unmet need for voluntary family planning is still a high 34%. Barriers including limited choice, availability and knowledge have led to gaps in access and affordability for the girls and women who want contraceptive options. This week at the International Conference of Family Planning, PSI’s Uganda network member PACE presented multiple presentations and posters offering insight into how it is working to build the market for long-acting reversible contraceptive (LARC) methods using innovative private-sector and total market approaches to meet the need.

Knowing the Market for IUCDs

According to the 2011 Uganda Demographic Health Survey (UDHS), Uganda’s contraceptive prevalence rate (CPR) is 30%. Currently, the market is dominated by short term methods. Injectables account for about half of the method mix, while long-term methods like intrauterine contraceptive devices (IUCDs) account for less than two percent.

To increase Uganda’s CPR, PACE/PSI aimed to increase method mix at private and public facilities, with a focus on IUCDs. To successfully add IUCDs to the menu for voluntary contraception in Uganda, PACE needed a clear understanding of current perceptions towards IUCDs among women of reproductive age. To better understand the market for IUCDs, PACE/PSI conducted a survey of women on their way out of both public and private health facilities, including PACE’s social-franchise Pro-Fam clinics.

Among the 1,505 women surveyed at 282 randomly selected facilities, less than 40% of women perceive IUCD use as a common behavior or social norm. The survey also found that only 35.6% had the correct knowledge about the device, however nearly two-thirds agreed they’re safe and a good method of family planning. Access and affordability also proved to be an issue. Only 51.4% of women surveyed believed that IUCDs were available close by and 45.5% believed that IUCDs are affordable. Low spousal support was also cited as a barrier to entry.