FHI 360 has received a grant from the Bill & Melinda Gates Foundation to generate evidence to help determine if and how expanded access to the levonorgestrel intrauterine system (LNG-IUS) — a long-acting contraceptive — could increase contraceptive use and continuation rates in sub-Saharan Africa. FHI 360 will implement the project, the Learning about Expanded Access and Potential of the LNG-IUS (LEAP LNG-IUS) initiative, with partners Population Services International (PSI), Society for Family Health Nigeria and Zambia, and WCG (formerly known as WomanCare Global).

The LNG-IUS is one of the most effective forms of reversible contraception and has important noncontraceptive health benefits. Features of the LNG-IUS include a long duration of action, a reduction in menstrual cramps and blood loss, fewer side effects compared to other hormonal methods and possible alleviation of anemia for some women. Despite these advantages, availability and use of the method in low-resource settings have been very limited, largely due to the high cost of existing products. But, the landscape may be changing as new, more affordable LNG-IUS products start to become available in the global market.

The LEAP LNG-IUS initiative will generate evidence to better understand the potential demand for the LNG-IUS, experiences among users and providers, and continuation rates and cost-effectiveness compared with other long-acting contraceptive methods. Research will be conducted in three countries — Kenya, Nigeria and Zambia — where pilot introduction projects are being implemented by partners with funding from the U.S. Agency for International Development (USAID).

This new investment by the Gates Foundation builds on previous work completed by FHI 360 and collaborators to evaluate the potential impact of the LNG-IUS in sub-Saharan Africa, including a large cohort study in Kenya of LNG-IUS users and market assessments in Kenya and Zambia. Results from these projects demonstrate that women and health care providers have favorable perceptions of the method and, in settings where unmet need for family planning is high, increased availability of more affordable LNG-IUS products could result in increased demand among women. Knowledge gained through the LEAP LNG-IUS initiative is expected to provide additional evidence that will enhance decision-makers’ understanding of the potential value of adding the LNG-IUS to the contraceptive method mix in sub-Saharan Africa and could inform national introduction and scale-up plans.

The project is part of FHI 360’s Contraceptive Technology Innovation portfolio. For more information about the project, please email the Contraceptive Technology Innovation team.

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