Long-Acting and Permanent Methods: Addressing Unmet Need for Family Planning in Africa

The class of long-acting and permanent methods (LAPMs) of contraception comprises four highly effective methods for delaying, spacing, or limiting births. These include the intrauterine device, contraceptive implants, vasectomy, and female sterilization. Despite their many advantages, LAPMs are the least accessible and least used methods of family planning in sub-Saharan Africa. Increasing access to high-quality LAPM services will ensure that women and men can choose from a balanced mix of contraceptive methods and fulfill their reproductive intentions.

FHI has developed a set of eight advocacy briefs on the benefits of LAPMs and the rationale for introducing or revitalizing them within national reproductive health and family planning programs. These briefs will inform policy-makers, program managers, and donors committed to evidence-based policies and programs that respond to people's changing reproductive needs. They will also provide diverse stakeholders with ideas on how to improve and expand LAPM provision within their communities.

The complete set is available as one file (PDF, 1.74 MB) or you may download the individual briefs below. They will soon be available in French as well. To request hard copies, send us an e-mail.

Brief 1: The Case for Long-Acting and Permanent Methods (PDF, 502 KB)

All individuals and couples have a basic human right to decide freely and responsibly the number, spacing, and timing of their children. Yet, only a small proportion of women in sub-Saharan Africa who want to space or limit their pregnancies are using any form of family planning. This brief describes the current status of family planning in Africa, including evidence that suggests a substantial unmet need for LAPMs in the region. Furthermore, the brief highlights the prospect of change if the key challenges that policy-makers and program managers face can be addressed. This will help ensure that LAPMs are consistently part of the method mix and that women and couples have access to a range of contraceptive choices.

Brief 2: The Benefits of Long-Acting and Permanent Methods for Individuals (PDF, 252 KB)

LAPMs offer individuals and couples advantages that other methods of family planning do not. This brief demonstrates how LAPMs offer an untapped opportunity to meet the needs of a variety of people, including men, lactating women, and people living with HIV/AIDS. It also describes the unique advantages of LAPMs, such as being the most effective methods for preventing pregnancies, as well as some non-contraceptive health benefits for users. Finally, the brief outlines the contribution of LAPMs to family health and well-being.

Brief 3: The Role of Long-Acting and Permanent Methods in National Programs (PDF, 231 KB)

In general, programs should always strive to address unmet need for family planning and contraceptive method choice.  An increase in contraceptive use is not the only measure of a successful program. Successful programs also fulfill individual preferences, promote correct and continuing use of family planning, provide cost-effective and sustainable methods, and reach long-term national and international health goals. This brief provides evidence that, because of their distinctive attributes, LAPMs are vital to the overall success of reproductive health and family planning programs.

Brief 4: Strategies to Improve Availability, Access, and Acceptability (PDF, 189 KB)

Programs in low-resource settings have demonstrated that when LAPMs are effectively introduced or revitalized, women and men will use them. This brief describes examples of several pilot and national efforts that have incorporated both traditional and innovative approaches to address key barriers, including responding to concerns about policies, training midlevel providers to offer clinical contraceptives, and launching media campaigns to increase awareness of LAPMs.

Brief 5: Contraceptive Implants: Safe, Effective, Long-Acting, Reversible (PDF, 199 KB)

This brief provides a summary of implants, including method characteristics, programmatic considerations, and key lessons learned to increase the likelihood of program success.

Brief 6: IUDs: A Resurging Method (PDF, 605 KB)

This brief provides a summary of the intrauterine device, including method characteristics, programmatic considerations, and key lessons learned to increase the likelihood of program success.

Brief 7: Female Sterilization: The Most Popular Method of Modern Contraception (PDF, 572 KB)

This brief provides a summary of female sterilization, including method characteristics, programmatic considerations, and key lessons learned to increase the likelihood of program success.

Brief 8: Vasectomy: Safe, Convenient, Effective — and Underutilized (PDF, 213 KB)

This brief provides a summary of vasectomy, including method characteristics, programmatic considerations, and key lessons learned to increase the likelihood of program success.