Decisions for Norplant programs

This issue of Population Reports is dedicated to Norplant, a new contraceptive.  Norplant is either widely available or its use is quickly increasing in 14 countries, especially Indonesia, Thailand, and the US.  Almost 1.8 million women use Norplant.  23 countries have approved its use. Norplant consists of 6 capsules inserted subdermally in the upper arm.  These capsules slowly release levonorgestrel continuously over 5 years.  The first-year pregnancy rate is .2% and the 5-year rate is 4%.  Implant removal restores fertility rapidly.  Women best suited for Norplant are those who want to avoid pregnancy for several years, those who want to stop childbearing but either cannot secure or do not want sterilization, those who want effective hormonal contraception but want to avoid side effects of estrogen, those who do not want to be concerned about taking a pill each day, and those who life far away from dependable supplies of contraceptives.  Family planning programs that provide Norplant must be dedicated to meeting client needs.  These needs are a free and informed choice among a variety of methods, mass media information, individual counseling to help clients to learn about Norplant and decide whether they should use it, convenient services, listening to clients and paying them the attention they require, and avoidance of unnecessary obstacles such as eligibility criteria.  Program managers must plan for introducing Norplant into their programs.  This positioning exercise includes determining what are the most significant qualities of Norplant and comparing those qualities with those of other methods and identifying the target audience (e.g., women who want longterm, reversible contraception).  Program staff should not coerce any client to choose or to continue Norplant.  Inserts entitled Norplant at a Glance and Guide to Norplant Counseling accompany this issue of Population Reports. Highlighted are Norplant use in Colombia, Indonesia, and Thailand.

Johns Hopkins Bloomberg School of Public Health,Center for Communication Programs,Population Information Program