Series K, Number 7
Injectables and Implants

CONTENTS

Home (Key Points)

New Implants Can Expand Access
Table 1. Comparing Implants
Table 2. Continuation Rates for New Implants
Table 3. Estimated Worldwide Use of Implants

Box: Which New Implant to Introduce?

Spotlight: From Norplant to Jadelle: Smooth Transition in a Dominican Republic Clinic

Preparing to Offer New Implants

Spotlight: Training Nurses Increases Implant Use in Ghana

Box: Information and Communication Technology Supports Implant Programs

Meeting Demand for New Implants Requires Supply and Access
Table 4. Key Resources for Program Managers and Providers of Implants

Bibliography

Credits

• Box: What Clients Should Know About Insertion and Removal
• INFO Reports: “Implants: Tools for Providers”

• Table 1: Comparing Implants
• Table 4: Key Resources for Program Managers and Providers of Implants

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"Implants: Tools for Providers"
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As part of a training of trainers in Madagascar, providers prepare to insert Implanon into a woman’s arm. Insertion requires attention to infection prevention procedures, sterile conditions, correct placement of implants, and care to minimize tissue damage. (© 2005 Dr. Philippe Faucher/Paris)

KEY POINTS

New contraceptive implants are becoming available to family planning programs around the world—the one-rod system Implanon®, the two-rod system Jadelle®, and in some countries Sino-Implant (II)®, also two rods. By 2008 Norplant®, the six-capsule implant system will no longer be available. Like Norplant, the new implants are highly effective at preventing pregnancy, and, like Norplant, they alter women’s bleeding patterns. Their most important advantage over Norplant is easier and quicker insertion and removal.

• Implants have advantages. Implants are safe, highly effective, and quickly reversible long-term contraceptives that require little attention after insertion. Clients are satisfied with them because they are convenient to use, long-lasting, and highly effective. Continuation rates are high.
• Programs should consider offering new implants. The new implants offer the same benefits of the older system but are easier to provide. Programs may want to add the new implants to their method-mix, and programs currently offering Norplant should plan for transition to a new implant.
• Competency-based training works best. It ensures that each provider gets enough training and supervised practice to insert and remove implants correctly. Training also covers counseling, which includes preparing clients to expect bleeding changes.
• Demand appears high. Evidence suggests that many more women would choose implants if they could.
• Initial cost is high but is coming down. Despite potential demand worldwide, use of implants is low, largely because the implants themselves are costly. Still, when implants are used for several years, they are relatively cost-effective compared with other methods. The prices that donors pay for implants have fallen recently. Strategies to address the high cost of implants must involve donor and government subsidies, expanding registration of a lower-priced implant, and sharing the cost with users.

How To Use This Report

This report can help family planning program managers to:

• Decide how to adopt new implants into their method mix.
• Prepare their staff to provide the new implants.
• Meet the demand for implants by assuring availability and good-quality services.

Providers can use the companion issue of INFO Reports, “Implants: Tools for Providers,” to review the important elements of providing good-quality services to new and continuing users of implants. The issue of INFO Reports offers tools for counseling women and helping women use implants with satisfaction.