Contraceptive Technology Innovation

  • Blog post
    CycleBeads and mobile phone

    Two ways to use CycleBeads: the physical product and the app. Courtesy of Cycle Technologies, Inc.

    Millions of women in low- and middle-income countries have used evidence-based fertility awareness methods over the past several years. Most of them have used CycleBeads®, a low-cost, easy-to-use way for a woman to track her menstrual cycles and determine whether she is on a fertile day. CycleBeads are based on the Standard Days Method®, which has been proven over 95% effective in perfect use and 88% effective in typical use. It’s designed for women with cycles between 26-32 days long. CycleBeads has been widely successful because of its ease of use (it relies only on period tracking), lack of side effects, and its acceptability in a range of cultural contexts.

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    A provider at a health center in Senegal holds the injectable contraceptive, subcutaneous DMPA (DMPA-SC, brand name Sayana® Press).

    A provider at a health center in Senegal holds the injectable contraceptive, subcutaneous DMPA (DMPA-SC, brand name Sayana® Press). Subcutaneous DMPA is a lower-dose, all-in-one injectable contraceptive that is administered every three months under the skin into the fat rather than into the muscle. © 2016 PATH/Gabe Bienczycki, Courtesy of Photoshare

    In Senegal, the modern contraceptive prevalence rate (mCPR) doubled within a decade, rising from 10% in 2005 to 21.2% in 2015. This increase has placed Senegal at the forefront of the international family planning movement.

    The country has adopted a vision for family planning based on what’s knowns as the three Ds—democratization, decentralization, and demedicalization—and has set a very ambitious goal to reach 45% mCPR by 2020.

    One of the guiding principles of Senegal’s Ministry of Health and Social Action (MOHSA) is to ensure the availability of a wide range of contraceptive methods at all levels of health service. This involves introducing as many new high-quality contraceptive products as possible both in public health facilities and at the community level.

  • Blog post
    Un prestataire de soins au dispensaire au Sénégal tient le contraceptif injectable DMPA en sous-cutané

    Un prestataire de soins au dispensaire au Sénégal tient le contraceptif injectable DMPA en sous-cutané (DMPA-SC, de la marque Sayana® Press). Le DMPA sous-cutané est un contraceptif injectable à petite dose qu’on administre tous les trois mois sous la peau dans la graisse plutôt que le muscle. © 2016 PATH/Gabe Bienczycki, avec l'aimable autorisation de Photoshare

    De 2005 à 2015 au Sénégal, le taux de prévalence contraceptive est passé de 10% (EDS 2005) à 21,2% (FP2020). Une véritable révolution qui a placé le Senegal au-devant de la scène internationale.

    Le pays a adopté une vision pour la Planification Familiale : les 3 D (Démocratisation – Décentralisation - Démédicalisation) et s’est fixé un objectif ambitieux d’atteindre un taux de prévalence de 45% en 2020. Un bien grand défi !

    L’un des principes directeurs du Ministère de la santé et de l’Action Sociale est de garantir la disponibilité d’une gamme variée de méthodes contraceptives a tous les niveaux. Cela implique des efforts pour élargir la gamme disponible de méthodes contraceptives en introduisant autant que possible de nouveaux produits contraceptifs à la fois dans les points de prestations du public et au niveau communautaire.

  • Blog post
    happy Woman's Condom couple

    The EECO team hopes that targeted marketing and education will lead to an increased interest in female condom products, and thus more protected sex. Photo: PSI

    Imagine a woman named Cynthia who lives in Malawi.

    Cynthia’s boyfriend Ben doesn’t like to use condoms. And she doesn’t feel like she can insist on condom use. At 20 years old, Cynthia dreams of finishing her studies before having kids. She doesn’t want to get pregnant right now, or risk contracting HIV. Without the use of condoms, Cynthia feels she has few options.

    Cynthia is an archetype, a fictional character typical of a broader group. Globally, there are many women like Cynthia who lack negotiating power within their relationship to insist on condom use. Women account for just over half of the 37 million people worldwide who are living with HIV or AIDS1. In sub-Saharan Africa, the rate of new infection disproportionately affects women, with the highest burden among young women ages 15-242. Condoms are a well-known method of preventing both sexually transmitted infections and unintended pregnancy, but for many women, this isn’t an option. Due to this gender-based inequality, there is a dire need for methods that are woman-initiated.

  • Blog post
    Men in the Kasana Market in Luwero, Uganda.

    Men in the Kasana Market in Luwero, Uganda. © 2016 David Alexander, Courtesy of Photoshare

    The idea of male contraception has been around for 60 years. Gregory Pincus, the co-inventor of the female contraceptive pill, tested the same hormonal approach on men in 1957, and various hormonal and non-hormonal methods have been explored since. Based on side effects and other research complications, there are still only two reliable, non-hormonal contraceptives on the market for men today: condoms and vasectomy.

  • Blog post
    As contraceptive product developers, we should support development of contraceptive options that rapidly and reliably eliminate bleeding to offer women a liberating choice.

    As contraceptive product developers, we should support development of contraceptive options that rapidly and reliably eliminate bleeding to offer women a liberating choice.

    This piece was originally published by the CTI Exchange blog, Exchanges.

    Menarche—the onset of menstruation—is a rite of passage for young girls everywhere. In many cultures, this milestone of womanhood comes with celebrations steeped in tradition. But following the ritual comes the reality of having to manage this aspect of being female for 40 or more years.

    Worldwide, women refer to menstruation in various ways, reflecting their many attitudes toward it. Where I grew up in northeastern Pennsylvania, my family and friends called it the “curse” (in my opinion, for good reason). And, as much as many women dread “Aunt Flo’s” monthly visit, they have come to rely on their “friend” as a confirmation they are not pregnant. Others see it as affirmation of womanhood or view it as a natural and necessary means of cleansing to remove accumulated blood.

  • Blog post
    Flip chart posters used to train community health workers in Uganda illustrate the difference between subcutaneous DMPA (DMPA-SC or brand name Sayana® Press) and intramuscular DMPA (DMPA-IM or brand name Depo-Provera®).

    Flip chart posters used to train community health workers in Uganda illustrate the difference between subcutaneous DMPA (DMPA-SC or brand name Sayana® Press) and intramuscular DMPA (DMPA-IM or brand name Depo-Provera®). Sayana Press and Depo-Provera are registered trademarks of Pfizer Inc. Uniject is a trademark of BD. © 2014 PATH/Will Boase, Courtesy of Photoshare

    Injectable contraceptives are used by more than 50 million women globally. In much of sub-Saharan Africa, they are the most commonly used family planning method. The most popular version, Depo-Provera (depot-medroxyprogesterone acetate, or DMPA), is administered intramuscularly (IM) or subcutaneously (SC) every three months. The SC form is marketed globally as Sayana® or Sayana® Press.

    Injectable contraceptives appeal to many women because of their relatively long duration of action (one to three months depending on formulation), high effectiveness (>94%), and ease and discreet nature of administration.

    So what’s a well-established family planning method doing in a blog series about contraceptive technology innovation?

  • Blog post
    A man and his daughter attend a community family planning meeting in Bontibor, Ghana.

    A man and his daughter attend a community family planning meeting in Bontibor, Ghana. © 2003 Melissa May, Courtesy of Photoshare

    After being embedded in reproductive health work for 15+ years, I’ve found myself intrigued by the novelty of male contraception. I accepted a position on the Board of Male Contraception Initiative (MCI) two years ago, and then stepped in during a leadership gap as Interim Executive Director at the end of 2017.

    Why Now?

    The time has come for innovation in the contraception space. Don’t get me wrong—I love the Pill and LARCs, but they all rely on interrupting female hormonal cycles. And think about it: There has been little to no innovation in contraception since the ‘50s, and it’s 2018.

    After the Pill hit the market and sparked a virtual revolution in women’s lives, researchers invented new ways to deliver hormones, including injectables, implants, patches, and hormonal IUDs. Women now have an array of hormonal contraceptive choices with the ensuing side effects. Because this method of action—the interruption of the menstrual cycle using hormones—is so effective, there has been little research on non-hormonal contraception with fewer side effects for either men or women to date.

  • Blog post
    A young mother walks her infant back from a health clinic in Uganda.

    A young mother walks her infant back from a health clinic in Uganda. © 2016 Rubini Naidu, Courtesy of Photoshare

    Use of contraceptive implants has increased dramatically over the past several years. This trend is especially evident in several Family Planning 2020 (FP2020) focus countries, where the addition of implants is increasing the diversity of the long-acting contraceptive method mix. This is all good news.

    Contraceptive implants are attractive because they are more than 99% effective at preventing pregnancy for three to five years, depending on product type. Once inserted, they are “forgettable,” with women only having to think about them when the period of effectiveness is about to expire. What these women cannot forget is that these implants require removal by a trained professional. While the procedure itself is relatively easy, finding a trained provider or making arrangements to get to the implant removal clinic can present challenges—especially in low-resource settings.

  • Blog post
    Women should be able to find and use a contraceptive method of their choice, and self-injection with DMPA may be an appealing option for those who want to manage their own reproductive health.

    Women should be able to find and use a contraceptive method of their choice, and self-injection with DMPA may be an appealing option for those who want to manage their own reproductive health. Photo: PATH/Will Boase

    Recent evidence on self-injection of a new injectable contraceptive called subcutaneous DMPA (DMPA-SC) is providing one possible answer to an age-old question in family planning: How do we address barriers that make it difficult for women to keep using contraception consistently?

    According to three recent studies, women who self-inject with DMPA-SC in their own homes or communities may continue using injectable contraception longer than those who receive injections from providers. In many Family Planning 2020 (FP2020) countries, injectable contraception is already popular, but often requires women to return to clinics every three months for injections. This can pose a significant barrier to consistent contraceptive use, especially for women who live in rural and remote areas. These new findings on self-injection should be very good news for women who like injectable contraception—if the global FP field has the courage to put this option for pregnancy prevention directly in women’s hands.

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