Project Lead(s): Afra Nuwasiima
In Uganda, individuals living in urban slums have a low uptake of family planning services. Barriers such as the high costs of services in private clinics, wait times, and long distance travel to public health facilities continue to prevent family planning uptake among marginalized groups.
These issues have culminated in non-existent follow-up care and low awareness of comprehensive family planning services.
The project studied the acceptability, usability, and cost-effectiveness of a free family planning benefits card (FPBC) as an incentive to increase family planning uptake among individuals living in urban slums.
The study used a quasi-experimental design to assess the effectiveness of the program and to evaluated the economic impact of the program.
They partnered with the local insurance firm to design and manage the FPBC system. A network of clinics located in the neighborhood of slums were recruited to provide the necessary services.
10 community health workers (CHWs) were then recruited and trained to provide family planning services, as well as door-to-door family planning campaigns.
203 females and 23 males received benefit cards that provided free access to family planning services.
Acceptability of the FPBC was high (93%) as only 7% of people offered the cards refused. Reasons for refusal included: infrequent sex (30%), wanting to get pregnant (20%), and lack of interest (20%).
After 6 months, 72% of those who were issued cards reported using a family planning service at least once. Card usability was higher among females (72%) than males (50%).
Cards were used for: injectable and oral contraceptives, implants, and pregnancy and HIV tests. Contraceptive use increased overall by 16%, while birth spacing improved among women.
The study found female users of short-term contraceptive methods were 11 times more likely to discontinue use of FPBCs compared to those who used long-term methods.
The program was found to be cost-effective and garnered interest from local corporations who may be willing to commit in-kind cash and support.