Delivering contraceptive vaginal rings—Task sharing in the delivery of family planning programs: Experiences from Senegal

The Population Council is conducting activities to facilitate the introduction of vaginal rings in sub-Saharan Africa. This report notes that the first ring to be introduced will be the Council’s Progesterone Contraceptive Vaginal Ring (PCVR), which is relevant in contexts where women practice prolonged lactation. The PCVR will also address the high unmet need for family planning (FP), especially for postpartum women. The Council aims to expand the availability and affordability of vaginal rings in Kenya, Nigeria, and Senegal. One of the challenges is the lack of skilled providers. To design plans for involving mid- and lower-level health workers in PCVR provision, a review of task-sharing experiences was conducted in the three countries where task-sharing of critical MNCH service delivery functions to various degrees. Positive task-sharing and task-shifting initiatives undertaken in Senegal suggest that there is great potential for distribution of contraceptive vaginal rings by lower-level health workers. Recent task-shifting initiatives demonstrated that community health workers could provide good quality services in their communities. These experiences contributed to increased access and uptake of FP services

Providers\u27 and key opinion leaders\u27 attitudes and practices regarding emergency contraception in Senegal: Key findings

This study examines providers’ and key opinion leaders’ knowledge, attitudes, and practices regarding the emergency contraceptive pill (ECP) in Senegal, and synthesizes the findings to suggest program and policy recommendations. Analysis of providers’ opinions and beliefs reveals that although many providers believe ECP is a safe product, persistent negative views remain. KOLs and providers recognize the importance of ECP for preventing unintended pregnancy and are supportive of the integration of ECP into national guidelines. They note, however, the need to improve accessibility and quality of provision. Given the magnitude of sexual violence and abuse, considerable interest exists in devising strategies to protect the sexual and reproductive health and welfare of adolescents and young women, including through enhancing the provision of ECP

Willingness to pay for contraceptive vaginal rings in Senegal

Contraceptive vaginal rings are an innovative category of products that have not been introduced into any sub-Saharan African country. As a result, there is little experience to guide the introductory pricing for the PVR and the one-year NES/EE CVR when it becomes available. The evidence generated by this consumer willingness to pay, and provider/procurer study has shed light on critical aspects of PVR introduction in Senegal. In general, the results generated here complement and reinforce findings from an acceptability study of the PVR and stakeholder discussions that have been occurring over the past three years. Results confirm that contraceptive vaginal rings, and in particular the PVR, are an acceptable method in Senegal with broad-based support for introduction utilizing a Total Market Model. Consumers expressed their willingness to pay for the PVR, providers to deliver it, and procurers to purchase it. Their voices will guide the introductory strategies for the PVR, including communication and promotional activities, integration with appropriate services such as Maternal and Child Health, and continued engagement with all stakeholders including consumers

L’offre des anneux vaginaux contraceptifs— La planification familiale postpartum: experience du Sénégal

Le Gouvernement du Sénégal, à travers l’adoption du Plan National d’Action pour la Planification Familiale, s’est résolument engagé dans une politique de repositionnement de la planification familiale (PF) qui s’est fixé comme objectif d’augmenter le taux de prévalence contraceptive. L’introduction de l’anneau vaginal à progestérone (AVP) dans la gamme des méthodes contraceptives devra apporter une perspective intéressante pour la promotion de la planification familiale post-partum (PFPP). Pour faciliter cette introduction, il demeure important de bien comprendre le contexte dans lequel évolue le programme national de PF en général et celui de la PFPP en particulier. Grâce à un financement de l’USAID, le Population Council a procédé à une revue documentaire de l’expérience du Sénégal en matière de promotion de la PFPP. Les leçons tirées de cette revue permettront de mieux orienter l’introduction de l’AVP dans la gamme des méthodes contraceptives disponibles au niveau du programme national. --- The Government of Senegal, through the adoption of the National Plan of Action for Family Planning, has strongly repositioned family planning (FP), and set itself the goal of increasing contraceptive prevalence. The introduction of the vaginal progesterone ring (VPR) in the array of contraceptives should provide an interesting perspective for the promotion of postpartum family planning (PPFP). To facilitate this introduction, it is important to understand the context in which the national FP program in general and PPFP in particular evolve. With funding from USAID, the Population Council conducted a literature review of Senegal\u27s experience in promoting PPFP. The lessons learned from this review will better guide the introduction of VPR into the range of contraceptive methods available at the national program level

Understanding unintended pregnancy in Senegal: Country profile report

As part of the Strengthening Evidence for Programming on Unintended Pregnancy (STEP UP) research program, the Population Council has developed a Country Profile Report to understand unwanted pregnancies in Senegal. The Population Council conducted a literature review, analyzed available survey data, and conducted interviews to discuss some aspects in more detail with a number of key stakeholders. The Country Profile was discussed at a two-day workshop in Dakar bringing together key government actors at the central and regional levels, nongovernmental organizations, and civil society actors. The report is composed of six chapters, summarized in this evidence brief

Attitudes, beliefs, and practices of key opinion leaders (KOL) and providers about emergency contraception (EC) in Senegal

In 2010, the Reproductive Health Division in Senegal, with support from Population Council, performed an assessment of the emergency contraception (EC) integration process into the national health system through a national forum on EC. This forum revealed that there was a real promotional problem regarding EC in the national health system despite the efforts made. There was widespread lack of public awareness of the product, rumors concerning EC due to the sensitive nature of the product, low inclusion of EC in routine service delivery, especially during initial counseling in family planning awareness campaigns , and a better method of keeping service providers at pharmacies informed about EC provisions and protocols. This study’s overall objective is collecting information from Key Opinion Leaders (KOLs) and providers about their EC knowledge, attitudes, and practices, and understanding their options and perceptions that may influence EC policies and programs. Results from the study indicated an urgent need to improve EC accessibility and the quality of services

Country mapping: Senegal

The Population Council embarked on a three-year project to explore the acceptability of the progesterone vaginal ring (PVR) among women in sub-Saharan Africa and its potential introduction. This technical report presents results from assessments undertaken to map the existing landscape of family planning programs and new contraceptive technologies in Senegal in an effort to identify national priorities and assess the level of interest in the PVR among stakeholders and to design appropriate preintroductory activities. This country mapping exercise confirms that Senegal is a promising context for the introduction of the PVR: the government is committed to repositioning family planning and has created an enabling environment and there are various encouraging sociocultural trends which suggest potential for acceptance of the PVR. Some key accompanying measures will need to be taken to ensure proper execution of the acceptability study and subsequent introductory efforts, including early involvement of the Ministry of Health, development and dissemination of literature in French on the PVR and the project, and establishment of an appropriate communication plan to name a few. Its innovative, long- and mid-acting, user-controlled design will introduce a unique dimension to the current method mix and is a promising prospect for provision at the community level in Senegal

Knowledge and provision of misoprostol among pharmacy workers in Senegal: a cross sectional study.

BACKGROUND: Making misoprostol widely available for management of postpartum haemorrhage (PPH) and post abortion care (PAC) is essential for reducing maternal mortality. Private pharmacies (thereafter called "pharmacies") are integral in supplying medications to the general public in Senegal. In the case of misoprostol, pharmacies are also the main supplier to public providers and therefore have a key role in increasing its availability. This study seeks to understand knowledge and provision of misoprostol among pharmacy workers in Dakar, Senegal. METHODS: A cross-sectional survey was conducted in Dakar, Senegal. 110 pharmacy workers were interviewed face-to-face to collect information on their knowledge and practice relating to the provision of misoprostol. RESULTS: There are low levels of knowledge about misoprostol uses, registration status, treatment regimens and side effects among pharmacy workers, and corresponding low levels of training on its uses for reproductive health. Provision of misoprostol was low; of the 72% (n = 79) of pharmacy workers who had heard of the product, 35% (n = 27) reported selling it, though rarely for reproductive health indications. Almost half (49%, n = 25) of the respondents who did not sell misoprostol expressed willingness to do so. The main reasons pharmacy workers gave for not selling the product included stock outs (due to product unavailability from the supplier), perceived lack of demand and unwillingness to stock an abortifacient. CONCLUSIONS: Knowledge and availability of misoprostol in pharmacies in Senegal is low, posing potential challenges for delivery of post-abortion care and obstetric care. Training is required to address low levels of knowledge of misoprostol registration and uses among pharmacy workers. Barriers that prevent pharmacy workers from stocking misoprostol, including weaknesses in the supply chain and stigmatisation of the product must be addressed. Low reported sales for reproductive health indications also suggest limited prescribing of the product by health providers. Further research is needed to explore the reasons for this barrier to misoprostol availability

Providers\u27 and key opinion leaders\u27 attitudes, beliefs, and practices concerning emergency contraception: A multicountry study in India, Nigeria, and Senegal

The Population Council conducted a cross-sectional, descriptive, multicountry study in India, Nigeria, and Senegal aimed at understanding the attitudes, beliefs, and practices of providers and key opinion leaders (KOLs) regarding the provision and use of emergency contraception (ECP). The overarching goal of this study was to investigate and document providers’ attitudes, beliefs, and practices regarding ECP, and to capture the opinions and insights of providers and KOLs on a range of policy and program issues. Findings indicate that many provider-related barriers can be overcome through implementation of targeted interventions such as training and values clarification, whereas other barriers will require a broader strategy to address contextual and health systems-level factors that hinder women’s access to ECP. The brief includes a number of interventions that might prove useful in addressing these barriers

HIV/AIDS vulnerabilities, discrimination, and service accessibility among Africa\u27s youth: Insights from a multi-country study

This report contains information from a study implemented between August 2011 and July 2012 that sought to provide a comprehensive, evidence-based picture of the HIV-related issues facing young people across Africa, and the prevailing legal, policy, and programmatic responses. The study was designed to establish a basis for a sharper focus on youth within the response to HIV on the continent. Researchers conducted country-specific analytical reviews of the relevant literature on factors associated with HIV risk-taking and health-seeking behaviors among young people aged 15–24 in six countries across Africa—Egypt, Kenya, Nigeria, Senegal, South Africa, and Uganda. In addition, qualitative and quantitative analyses enabled an evaluation of the similarities and differences among countries regarding factors associated with young people’s sexual risk behavior, HIV-related health-seeking behavior, and the extent of policy and programmatic involvement