CITATION: Liftoff: The Blossoming of Contraceptive Implant Use in Africa
Roy Jacobstein
Global Health: Science and Practice March 2018, GHSP-D-17-00396;

SUMMARY: Contraceptive implant use is rising rapidly, substantially, and equitably in many sub-Saharan African countries, across almost all sociodemographic categories. Gains in implant use have exceeded combined gains for IUDs, pills, and injectables. Key contributing factors include sizeable reductions in commodity cost, much-increased commodity supply, greater government commitment to expanded method choice, and wider adoption of high-impact service delivery practices that broaden access and better reach underserved populations. Continued progress in meeting women’s reproductive intentions with implants calls for further investment in quality services for both insertion and removal, and for addressing issues of financing and sustainability.


‘Why Has Uptake of Implants Been So Rapid and Substantial?
A number of factors have contributed to the increases in implant use documented in this article. Among the most salient are: (1) implants’ many positive method characteristics; (2) revised expert guidance supportive of wider client eligibility to receive an implant; (3) greater country commitment to ensuring broad access to a wider choice of methods, including implants; (4) donor and manufacturer action to ensure much-lowered commodity cost and greater commodity availability; and (5) continued and wider reliance on high-impact service delivery practices that expand access and reach underserved populations. [Each of these factors is described in some detail – recommended reading]

‘Demand-Side Considerations…
4. Considerable time is required for internationally promulgated guidance to be adapted to national guidelines and local contexts, and then to diffuse into common health care practice, preservice professional education, and in-service training. This process is under way for implants and will undoubtedly occur increasingly over the next few years, including with respect to new and important guidance regarding suitability of implants for breastfeeding women, as well as for adolescents
and young women, whether or not they have children.’

Best wishes, Neil

Joint Coordinator, HIFA Project on Family Planning