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Top 10 Voluntary Family Planning Articles of 2020

Before this remarkable year ends, we’re taking a look back at the most popular Global Health: Science and Practice Journal (GHSP) articles on voluntary family planning in the last year according to you—our readers—that garnered the most reads, citations, and attention.

GHSP is our no-fee, open-access journal that’s intended to be a resource for public health professionals who design, implement, manage, evaluate, and otherwise support health programs in low- and middle-income countries. Publishing articles on all public health topics and a range of cross-cutting issues such as gender and quality improvement, GHSP fills an important gap in the scholarly literature for evidence and experience from global health programs that are implemented under real-world conditions, with specifics on the “how” of implementation, documenting important lessons and relevant details that aren’t often documented. Our most popular voluntary family planning articles of 2020 related to themes of ensuring coverage of high-quality, voluntary family planning counseling and care by analyzing contraceptive use, improving method choice, and maintaining access, particularly during the COVID-19 pandemic.

Photo by Images of Empowerment.
Photo by Images of Empowerment.

10. Standardizing Measurement of Contraceptive Use Among Unmarried Women

Voluntary family planning information platforms monitor and report data on contraceptive use among married women uniformly. The same can’t be said of data on unmarried women. The key difference? How sexual recency—the last time a woman reported having sex—was defined. This study found that among married women, contraceptive prevalence and unmet need estimates didn’t vary much by sexual recency. However, for unmarried women, contraceptive prevalence was systematically lower and unmet need was systematically higher as the sexual recency window increased from 1 to 12 months. The authors recommended ways to overcome the measurement misalignment and better capture contraceptive prevalence data for unmarried women.

Authors: Short Fabic and Jadhav
Published: December 2019

Photo by Finnegan.

9. Using a Chord Diagram to Visualize Dynamics in Contraceptive Use: Bringing Data Into Practice

The chord diagram provides a more dynamic way to visualize contraceptive use trajectories, such as when women switch or quit methods. The authors suggested that this innovative tool could be helpful for generating new insights on women’s contraceptive use and contraceptive decision making. They also recommend that the tool could improve knowledge on country-specific contraceptive use trends to enable voluntary family planning programs to make improvements in supply chain management, programming, and budgeting.

Authors: Finnegan, Sao, and Huchko
Published: December 2019

Photo by CDC at Unsplash.
Photo by CDC at Unsplash.

8. Evaluating the Implementation of an Intervention to Improve Postpartum Contraception in Tanzania: A Qualitative Study of Provider and Client Perspectives

Women and providers were initially receptive and enthusiastic to adopt this new postpartum intrauterine device program—an important intervention designed to meet women’s contraceptive needs immediately after birth. However, interviews with women and providers revealed a different reality. Several factors—from the client to policy level—affected not only the program’s successful implementation but also the uptake of counseling and services. Constraints on staff, time, and supplies influenced implementation outcomes and threatened sustainability. Ensuring that new programs are sustainable in low-resource settings that already face constraints requires examining all the factors that can potentially hinder its implementation so that strategies can be developed for its future success.

Authors: Hackett, Huber-Krum, Francis, et al.
Published: June 2020

Photo by Images of Empowerment.
Photo by Images of Empowerment.

7. Unmet Need for Family Planning and Experience of Unintended Pregnancy Among Female Sex Workers in Urban Cameroon: Results From a National Cross-Sectional Study

Although condoms have a substantial impact on preventing HIV and pregnancy among female sex workers in Cameroon, relying on condoms alone is not enough, particularly because of their low and inconsistent use in this population. Mitigating both structural and facility-level barriers to the coverage of high-quality, voluntary family planning care and method choice in community services that focus on female sex workers is a key strategy to meeting their reproductive health needs.

Authors: Bowring, Schwartz, Lyons, et al.
Published: March 2020

Photo © Curt Carnemark / World Bank
Photo © Curt Carnemark / World Bank

6. Insights Into Provider Bias in Family Planning from a Novel Shared Decision Making Based Counseling Initiative in Rural, Indigenous Guatemala

Racial and ethnic bias in medicine, in general, and specifically among providers of voluntary family planning care, has been well-documented but remains invisible. Provider bias against racial and ethnic minority patients seeking voluntary family planning care can affect how providers counsel clients and what methods they recommend and provide. This article shares important insights and solutions on how to address and mitigate provider racial and ethnic bias through a client-centered counseling approach so that providers confront their biases and clients’ needs are met.

Authors: Nandi, Moore, Colom, et al.
Published: March 2020

Photo by USAID.
Photo by USAID.

5. Opportunities and challenges of delivering postabortion and postpartum family planning during the COVID-19 pandemic

Social distancing during the COVID-19 pandemic may have mitigated the spread of the virus but also reduced facility visits, changed individuals’ health-seeking behaviors, and created barriers to accessing voluntary family planning care. This article discussed ways to ensure pregnant, postpartum, and postabortion women don’t fall in the gap by suggesting how to optimize opportunities to provide voluntary family planning counseling and care to these specific populations of women at existing points of contact, such as antenatal care, postnatal care, and pharmacy visits.

Authors: Pfitzer, Lathrop, Bodenheimer, et al.
Published: October 2020

Check out this interview with the authors published on Knowledge SUCCESS.

© 2019/Cycle Technologies.
© 2019/Cycle Technologies.

4. Implementation and Scale-Up of the Standard Days Method of Family Planning: A Landscape Analysis

This study showed that pilot introductions in more than 30 countries of the Standard Days Method (SDM) demonstrated that the method has the potential to meet unmet contraceptive needs and increase contraceptive use. Both discontinuation and method failure rates varied across study sites, highlighting the importance of high-quality health worker training in teaching the method and screening potential users. At the national level, multiple barriers to the SDM’s implementation and scale-up remained. Only 12 countries had included the SDM in national voluntary family planning protocols, measurement tools, and health worker training.

Authors: Weis and Festin
Published: March 2020

Photo by Neil Brandvold, USAID.
Photo by Neil Brandvold, USAID.

3. Using Digital Technology for Sexual and Reproductive Health: Are Programs Adequately Considering Risk?

The use of digital technologies and telemedicine provides a way to overcome geographic distance and social distancing guidelines to access health care services. These technologies also carry some potential risk to women who can face stigma, discrimination, and violence if confidentiality is compromised. To reduce these potential harms, the authors suggested seeking both user and stakeholder input when designing digital interventions that consider potential harms, mitigate and minimize harms in design, and measure adverse outcomes.

Authors: Bacchus, Reiss, Church, et al.
Published: December 2019

Photo by Reproductive Health Supplies Coalition at Unsplash.
Photo by Reproductive Health Supplies Coalition at Unsplash.

2. Doing things differently: what it would take to ensure continued access to contraception during COVID-19

In 2020, COVID-19 changed the contraceptive landscape—reversing recent trends in contraceptive use toward long-acting methods back to an increase in self-care methods—driven by stay-at-home measures and service disruptions. Each country faced COVID-19 with unique circumstances in how to meet women’s contraceptive needs combined with different contraceptive method mixes among its current users and different supply chain barriers. The authors of this article, our second most read and third most cited article published in 2020, created scenarios that estimate the potential for method switching under different levels of COVID-19 related service disruption. The scenarios are meant to serve as a starting point for discussions by quantifying the programmatic implications of these policy changes and of the choices women may make about what methods to use.

Authors: Weinberger, Hayes, White, and Skibiak
Published: June 2020

Photo by Govind Krishnan at Unsplash.
Photo by Govind Krishnan at Unsplash.

1. Contraception in the Era of COVID-19

At the start of the COVID-19 pandemic, when services ground to a halt and many facilities shuttered, the authors of this article stressed the word adapt to maintain reproductive health care as an essential service. This article—our most read, second most cited, and one that garnered a lot of attention—listed ways to adapt the way contraceptive services are provided by using telehealth and adjusting how other methods are provided to ensure access.

Authors: Nanda, Lebetkin, Steiner, et al.
Published: June 2020

Photo by CDC at Unsplash.
Sonia Abraham

Scientific Editor

Sonia Abraham is the scientific editor for the Global Health: Science and Practice Journal and has been writing and editing for over 25 years. She holds a Bachelor’s in Biological Sciences from the University of Maryland and a Master’s in Writing from Johns Hopkins.

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