Long-Acting Reversible Contraceptive Implants: An Effective Method to Meet Unmet Need and Save Lives

Stephen Goldstein

JHU∙CCP | Senior Consultant

About 600 million women in the developing world use some form of contraception, but only 1% to 2% of them are using long-acting, contraceptive implants. Surveys show that as many as 20% would prefer them, if they were available, according to a USAID press release.

Jadelle package plus trocar

Jadelle ® levonorgestrel contraceptive implants

Availability is now less of a problem thanks to a new partnership agreement between the government of Norway and other partners and the manufacturer of one of three implants, Jadelle, to reduce the current price, from US$18/set to around $8.50/set, in return for a commitment to assure funding for at least 27 million contraceptive devices for women and girls in low-income countries over the next six years.

The partnership agreement is expected to prevent almost 30 million unwanted pregnancies by 2018 and will save an estimated US$250 million in global health costs. When fully implemented, the agreement will avert more than 280,000 child and 30,000 maternal deaths due to improved birth spacing and by avoiding other problems such as preterm births. According to the WHO, waiting at least 2–3 years between pregnancies reduces infant and child mortality and benefits maternal health.

Jadelle is composed of two thin, matchstick-sized, flexible silicone rods, each containing 75 mg levonorgestrel (a synthetic progestin) and is effective for up to five years. Trained health workers—nurses, midwives—can insert the rods and remove them any time a woman wants her fertility restored.

Jadelle is suitable for almost all women and is also safe for women who are breastfeeding. “These contraceptive devices are a very cost effective means of contraception and they are ideal for women in rural areas, who must often travel miles by foot to reach health clinics,” says President Goodluck Jonathan of Nigeria, a co-chair of the UN Commission on Life-Saving Commodities for Women and Children.

The partnership hopes that the agreement will remove some of the barriers to family planning by providing health workers with training and counseling in family planning and ensuring that the now-affordable modern contraception will be available.

Learn more about Jadelle and two other hormonal implants, Implanon and Sino-implant (II), at K4Health’s  Implants Toolkit.

FHI 360’s Sino-implant (II) (video) initiative for the Katerva People’s Choice Awards has also been at the forefront of helping to reduce the cost of contraceptive implants in resource-constrained settings. The cost of the implant is now $8. FHI 360 and the Gates Foundation have worked with Shanghai Dahua Pharmaceuticals (Dahua), to distribute almost 900,000 units to low-resource countries. The WHO’s Prequalification group recently determined that the Chinese manufacturer was operating in compliance with WHO Good Manufacturing Practices (GMP)—an important milestone for Sino-implant because WHO prequalification is necessary before some international donors may purchase the implant.

Both of these initiatives should help close the unmet need gap for contraceptives, which  I wrote about in my January 2013 blog, Meeting Unmet Need: Signs of Hope?