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This was presented by Ali Karim as part of a preformed panel at the International Conference on Family Planning (ICFP) in Kigali, Rwanda in November 2018.
Contraceptive prevalence in Ethiopia jumped from 6% in 2000 to 35% in 2016, primarily attributed to the increase in injectable contraceptive method use from 3% in 2000 to 23% in 2016. Nonetheless, discontinuation rate among injectable contraceptive users was 38%.
Given that injectable methods are the preferred method among married women of reproductive age in Ethiopia, the Last Ten Kilometers Project (L10K) of JSI Research & Training Institute, Inc. (JSI) in collaboration with ideas42 worked with Ethiopia’s flagship Health Extension Program to apply behavioral economics (BE) approaches to mitigate discontinuation of injectable contraceptives.
Methods: The project followed a BE methodology to conduct a behavioral diagnosis and design an intervention package, consisting of 1) health worker planner calendar, 2) client care checklist, and 3) client appointment cards.
Conclusion: Discontinuation can be influenced by health systems factors like supply issues. Nonetheless, the use of two BE tools—the appointment card and client care checklist—effectively decreased injectable discontinuation in the presence other health system bottlenecks. BE is an effective approach to enhance family planning programs in Ethiopia and elsewhere.