Scaling Up Access to Implants: A Summative Evaluation of the Implants Access Program

document thumbnailThe Implants Access Program (IAP) was a partnership between public and private organizations that aimed to increase access to contraceptive implants for women in low-income countries. The partnership began with 2 volume guarantee agreements that reduced the price of implants by approximately 50% and was complemented by efforts to address supply chain, service delivery, and knowledge and awareness barriers. We conducted a summative evaluation to identify key insights related to the IAP’s relevance, effectiveness, and sustainability. We completed a desk review of program materials and published literature, followed by 42 in-depth interviews, including global stakeholders and country stakeholders in 3 case example countries: Kenya, Nigeria, and Uganda. The evaluation found evidence of increased access to implants including a 10-fold increase in procurement between 2010 and 2018 and an increase in prevalence of contraceptive implants during this same period. The IAP leveraged global family planning efforts taking place at the time, and its partnerships offered a business case for manufacturers to support increased access to implants. Enhanced supply chain visibility and coordination helped limit country-level stock-outs, and the IAP built on existing in-country delivery capacity. Although the IAP was able to address key challenges due to its effective collaboration and coordination at global and country levels, sustaining progress requires institutionalized mechanisms to continue global efforts and longterm assurances that the low price of implants will be maintained. Over 6 years, the IAP supported tremendous progress in increasing access to implants for women in low-income countries by building a public- and private-sector collaboration that focused on systems change in the family planning field. This partnership matched a unique response to a unique problem: building tools, systems, and capacity that can inform and support the introduction and scale-up of new and underutilized contraceptive methods.

Key Findings

The Implants Access Program increased access to implants by:

  • Devising an innovative solution to address price barriers
  • Enhancing supply chain data visibility and coordination to limit stock-outs
  • Leveraging existing delivery capacity and strengthening capacity in targeted areas
  • Coordinating global and country-level stakeholders to address key challenges

Key Implications

  • Donors, policy makers, and implementing partners should align method-specific efforts to support broader family planning goals and implementation plans at the global and country level.
  • Donors should engage private-sector manufacturers to identify mutually beneficial opportunities for collaboration to address price barriers.
  • National stakeholders and implementing partners should prioritize efforts to improve supply chain visibility, increase efficiency and sustainability of provider training, and support community sensitization and awareness raising to ensure clients can exercise free and informed contraceptive method choice.