Progesterone Vaginal Ring: Results of a Three-Country Acceptability Study

The progesterone vaginal ring (PVR) is a contraceptive designed specifically for use by breastfeeding women in the first year postpartum. The PVR is inserted in the vagina 30–90 days postpartum for continuous use for up to 3 months and replaced with a new ring if breastfeeding is continued and extended contraception is desired.

Women can use four rings successively for up to one year. The progesterone vaginal ring functions by diffusing a continuous flow of progesterone through the vaginal walls—approximately 10 mg per day—which then enters the bloodstream and regulates the woman’s fertility by suppressing ovulation. Clinical trials have proven the PVR to be a safe and effective contraceptive; furthermore, it is currently registered in eight countries in Latin America. The PVR has also been included in the 2015 WHO Essential Medicines List and the Medical Eligibility Criteria guidance.

Global and national policies have refocused attention on postpartum family planning (PPFP) as an important intervention to ensure healthy outcomes for women and infants. In this policy context, underused technologies such as the PVR have the potential to contribute to national and global goals, especially in settings where breastfeeding is prevalent and unmet need for spacing is high.

The Population Council conducted a multicountry acceptability study of the PVR in Kenya, Nigeria, and Senegal with funding from the Bill and Melinda Gates Foundation (BMGF). The acceptability study was part of a series of activities that assessed the feasibility of and preparation for eventual introduction of the PVR in these markets. This report summarizes the results of the acceptability study from the three countries. Data were collected from 191 users of the PVR who had sought family planning services at 1 of 15 public-sector service-delivery points, their husbands (11), health care providers (141), and three focus groups with community members to evaluate factors influencing acceptability of the PVR. Data were also collected from 178 women who chose a method other than the PVR, to provide additional and contrasting insights into how users view new contraceptives.