Step UP Strengthening evidence for programming on unintended pregnancy


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What's New

New Research Uptake Case Study: STEP UP is proud to release a new Research Uptake Case Study: Bangladesh: Using strong evidence and strategic collaboration to increase access to menstrual regulation with medication. The case study highlights successful research uptake resulting from STEP UP’s collaboration on increasing women’s access to MRM in Bangladesh, including approval of MRM service introduction into the national family planning program and plans for STEP UP assistance in the scale up of MRM to nearly 4,000 health facilities.

Journal Article: Estimates of the potential impacts of contraceptive use on averting unintended pregnancies, total and unsafe abortions, maternal deaths, and newborn, infant, and child deaths are critically important for policy makers, donors, and advocates investing in family planning programmes. There are five mathematical models that estimate the impact of family planning on health outcomes, but each modeling approach was designed for different purposes, and consequently do not produce comparable estimates for the same outcome indicators. This article, Harmonizing Methods for Estimating the Impact of Contraceptive Use on Unintended Pregnancy, Abortion, and Maternal Health explores a collective harmonization process undertaken to address this. The models now produce more similar estimates (although they retain some minimal differences) and may assist in planning, resource allocation, and evaluation, and offer a more unified voice for quantifying the benefits of family planning.

Dissemination event in Nigeria: STEP UP findings from a study evaluating whether community health extension workers (CHEWs) can insert contraceptive implants to the same quality standards as nurses and midwives were shared at a dissemination meeting in Abuja last month. Over 100 participants attended, including high-level state and federal representatives, CHEWs & nurses, donors, and implementing partners. The plenary session was chaired by Dr. Kayode Afolabi (Director of reproductive health, FMOH) with support from Dr. Tony Udoh (FMOH).

The session yielded insight into key aspects of implant service provision, upon which the FMOH proposed that it review and extend the accreditation period to enhance service quality. The event also prompted commitments to be made by State officials to better support trained staff retention in training facilities, and by MSI Nigeria to provide technical support to States on scaling up this task shifting. See links for Nigerian media coverage of the event in the Daily Post, Premium Times, and Vanguard.

Journal article: In 2015, the Government of Bangladesh approved the use of the mifepristone-misoptostol drug combination to be administered up to 9 weeks from a woman’s last menstrual period by trained service providers for menstrual regulation with medication (MRM). This journal article, Provision of menstrual regulation with medication among pharmacies in three municipal districts of Bangladesh: A situation analysis, explores a STEP UP study which assessed the provision of MRM in randomly selected urban pharmacies in Bangladesh. The study revealed knowledge gaps among pharmacy workers regarding recommended dosage for MRM and inconsistent practice in informing women on effectiveness, follow-up visits, possible complications and provision of post-MRM contraceptives. Pharmacy workers need additional training and a strong monitoring and regulatory system for pharmacy provision of MRM in pharmacies should be established.

Activity update: The STEP UP team investigating reasons for unmet need for family planning (with particular attention to measurement of unintended pregnancy) in Matlab, Bangladesh has completed the second round of data collection. Over 2,300 women were interviewed. Follow-ups are also being completed with women in Nairobi and Homa Bay, Kenya.

STEP UP at the Brookings Institute: STEP UP researcher Chi-Chi Undie was invited to the Brookings Institution in Washington DC to participate in a panel at the Girls’ Education Research and Policy Symposium hosted by the Institute’s Center for Universal Education (CUE). CUE convenes policymakers, practitioners, and stakeholders in the girls’ education arena to discuss the most pressing issues as identified by the Echidna Global Scholars, a group of global leaders in girls’ education. Please click here to view video recording of the session in which Chi-Chi discusses STEP UP’s work with the Ministry of Education on school re-entry for girls in Kenya.