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Condoms: A Tried-and-True Family Planning Innovation

Lessons Learned and Concrete Steps To Promote Condoms’ Proven Impact

When used correctly, female (internal) condoms are up to 95% effective at preventing pregnancy. Male (external) condoms provide a nearly impermeable barrier to particles the size of STI pathogens and HIV and are up to 98% effective at pregnancy prevention when used properly. With approximately 121 million unintended pregnancies occurring worldwide each year between 2015 and 2019, reminding ourselves of the many benefits of condom usage is imperative.

Female condoms. Credit: Anqa, Pixabay.As we promote innovation in family planning, we must remember the impact of existing, proven, evidence-based methods and their potential for global health and development. Condoms are such a method.

Condoms remain the most used family-planning method among youth and the only method to offer triple protection from unintended pregnancy, STIs, and HIV. Their continued value is immense and should not be dismissed for newer methods.

“We currently only have two methods of contraception for people who produce sperm. While we are working to increase contraceptive options, it is important to be clear that this is not with the aim of displacing condom use. Condoms need to remain front and center because they work and for some people, they are the right method. They will always remain an important part of the method mix.”

Heather Vahdat, Executive Director, Male Contraceptive Initiative

As the world faces a pandemic and more humanitarian crises in the future, reliable self-care methods will become even more necessary and important for people who use or want to use family planning.

“Condoms are a user-controlled method, are easy to use and store, do not require medical prescriptions or direct provision by health care personnel or in facilities and can be used by anyone who is sexually active—including youth.”

Global Condom Working Group

Among adolescents and youth populations, condoms may be one of the most valuable (and affordable) methods of protection. In many geographic regions, youth are the largest proportion of the population, so it is important to invest in methods we know are used by young people.

Members of the WOGE women group cooperative. Credit: Jonathan Torgovnik/Getty Images/Images of Empowerment.
Credit: Jonathan Torgovnik/Getty Images/Images of Empowerment.

“I am calling on you, partners, to come up with solutions regarding the placements of the condoms. Condom use is going down and this is often less a supply issue in countries than access and demand creation issues…If 90% of sexually active adolescents use condoms, how about placing them in schools and using mobile phones to buy condoms so we can reduce teenage pregnancies?”

Dr. Bidia Deperthes, Sexual Health Team Lead, UNFPA

While the need for condoms may become greater, there also needs to be a focus on demand generation and the creation of reliable supply chains. There are gaps when it comes to getting condoms to the communities where they are needed and wanted most.

“Once you know which populations your program will target and the constraints that prevent them from using condoms regularly, it’s important to step back and create a vision for a healthier, sustainable condom market.”

Mann Global Health

Condoms 20 Essential CollectionKnowledge SUCCESS continues to emphasize the value of condoms and highlight the informative resources that have been created. The Condoms and Family Planning: 20 Essential Resources collection features a variety of resources on condom use, evidence-based condom program management and advocacy, condom market approaches and assessments, procurement standards, and program results within case studies.

Through state-of-the-art scientific evidence, programmatic guidance, and implementation tools, the Condom Use Toolkit assists health policymakers, program managers, service providers, and others in the planning, managing, evaluating, and supporting the provision of condoms.

Through conversations with condom experts and our review of resources, the authors of the 20 Essential Resources collection share our top five learnings gleaned from developing the collection.

Top Five Learnings

  1. Condoms have been in use for more than 10,000 years (!) and use is currently declining globally.
  2. Condoms are largely the domain of the HIV sector now, not family planning. This adds barriers to accurate estimation of procurement and tracking by family planning programs. It also adds to the stigma associated with using condoms and having HIV/STIs.
  3. Condoms are a top choice for people living through the instability of humanitarian crises or infectious disease pandemics. This will be increasingly important in the future.
  4. Significant work is necessary to generate demand for condoms in many contexts where it would be beneficial based on the prevalence of key populations.
  5. Without demand generating efforts, condoms will not be supplied. Similarly, without supply demand can’t be generated.

“From my HIV and key populations perspective, when talking about supplies and forecasting, condoms are consistently the method with the most reported stockout. That is important information to know and use.”

Christopher Akolo, Technical Director, LINKAGEs/EpiC

Now more than ever, it is important for stakeholders to invest in proven solutions like condoms. Here are concrete and tangible steps that decision-makers, funders, program managers, advocates, and knowledge management officers can take to promote condoms.

Steps for Promoting Condoms

  1. Know specific facts and information about condoms as a valuable method and know the ways condoms make the greatest impact (triple protection, youth, crisis, supply chain, etc.).
  2. Know the limitations of condoms as well (such as women needing methods they can control or needing more discreet methods of family planning) and how they could be packaged with other family planning methods.
  3. Budget for condom supply and distribution within programming work.
  4. Connect with condom champions locally and globally.
  5. Understand the current data on condom use in a specific context.
  6. Recognize and understand the myths and stigma associated with condom use in a particular community or for a particular population.
  7. In addition to family planning needs, understand the needs for prevention against STIs and HIV in your populations and how condoms play a central role in triple protection.
  8. Invest in (or advocate for) localized manufacturing of condoms and condom distribution markets.
  9. Explore the creation of regional working groups, in collaboration with the Global Condom Working Group, to continue the conversation on best-practices for condoms in family planning programs, as well as regional and national strategies.
  10. Recognize and promote the existing and future value of condoms in the family planning community in humanitarian settings, especially within post-crises settings.
  11. Place as much emphasis on the use, supply, and demand for condoms as newer methods.
  12. Attend and widely share events, dialogues, and conferences that are relevant to condoms and evidence-based methods.
  13. Finally, share this blog post and the Condoms and Family Planning: 20 Essential Resources collection widely with your colleagues and professional circles.

Condoms work, are being used, and are wanted. To harness their greatest impact, we must continue to keep condoms central to global health and development discussions and efforts. Each of us can do something.

Kirsten Krueger

Research Utilization Technical Advisor, FHI 360

Kirsten Krueger is a Research Utilization Technical Advisor for the Global Health, Population and Nutrition Group at FHI 360. She specializes in designing and conducting evidence utilization activities globally and in the Africa region to accelerate adoption of evidence-based practices through close partnerships with donors, researchers, health policy makers, and program managers. Her areas of expertise include family planning/reproductive health, community-based access to injectable contraception, policy change and advocacy, and capacity building.

Hannah Webster

Technical Officer, FHI 360

Hannah Webster, MPH, is a Technical Officer in the Global Health, Population, and Research department at FHI 360. In her role, she contributes to project operations, technical communication and knowledge management. Her areas of specialization include public health, research utilization, equity, gender and sexual and reproductive health.

Reana Thomas

Technical Officer, Global Health, Population and Nutrition, FHI 360

Reana Thomas, MPH, is a Technical Officer in the Global Health, Population, and Research department at FHI 360. In her role, she contributes to project development and design and knowledge management and dissemination. Her areas of specialization include research utilization, equity, gender, and youth health and development.

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