Mothers and children in Antaralava Village, Ranomafana, Madagascar. Credit: 2017 David Alexander/CCP
On May 22, 2018, Family Planning 2020, Health Policy Plus (HP+), Palladium, and the Knowledge for Health (K4Health) project hosted Monitoring Matters: Tracking Progress Toward Family Planning Goals to discuss innovative tools within the Costed Implementation Plan (CIP) that are being used to help country governments accelerate their progress towards meeting family planning goals.
When it comes to female contraceptive products, innovation has been more evolutionary than revolutionary. With high unmet need still present, a huge opportunity exists to look at new ways to design products that respond to women’s needs and preferences, rather than forcing women to change their behaviors to suit existing products.
Human-centered design (HCD, also known as “user-centered” design) is a creative, solutions-based approach to problem-solving that puts “users” (in our case, women) at the center of the product design process. Users are actively engaged at every step to ensure their needs and expectations inform the design. We do this by testing the validity of our assumptions with users themselves, in an iterative fashion. This also allows us to move beyond the existing conditions of “what is” to the forward-thinking potential of “what if?” with sensitivity and empathy.
Vaginal rings are a novel drug delivery platform unlike other forms of existing contraceptives. Photo by James DeGroat, courtesy of the Population Council.
Expanding contraceptive options for voluntary family planning is critical for three reasons. First, different people have different needs for pregnancy protection depending on their own individual and family situations. Further, a woman’s needs may change as she progresses through her reproductive life. With that in mind, family planning programs that focus on high-quality services and human rights should offer a wide range of contraceptive options to meet her needs, wherever she’s at in life.
The author wishes to thank Thomas Crouzier, group leader at KTH Royal Institute of Technology in Stockholm, Sweden, for his contributions to this blog post.
Over the past several decades, contraceptive innovation has mainly focused on advancing hormone-based technologies, which proven themselves to be highly effective at preventing pregnancy. However, their side effects are often cause for discontinuance.
Concerns about hormonal contraception have been well documented by women living in the US and Europe. They are also being raised in low- and middle-income countries, where 26% of women who want to avoid pregnancy do not use hormonal contraceptives because of known or perceived side effects; another 24% opt out because they have infrequent sex and/or do not want a systemic solution.
Access to safe and effective methods of family planning is fundamental to health, education, economic opportunities, and empowerment. Access, however, must mean more than having products present on shelves (although it has to mean that too). To achieve what might be coined as “transformational access,” a level of sustainable access that truly meets the needs of women, we need products that are easier to use, readily fit with women’s lives and preferences, and don’t create their own barriers to continued use. Unfortunately, this is the challenge for millions of women globally who struggle with side effects associated with hormonal methods, particularly changes in menstrual bleeding patterns, which are strongly associated with method discontinuation. While these are among the most effective and safest pharmaceutical products that have ever been developed, they also present women with the regular decision to use a product that presents daily challenges in their life. For this reason, discovery of non-steroidal contraceptive drugs has long been something of a holy grail in contraceptive R&D.