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Providing More Than One Cycle of Oral Contraceptive Pills Is Cost-Effective (2009) |
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A USAID-supported study in Jamaica suggests that when women start using oral contraceptives, they are less likely to miss pills if their health care providers give them several packages of contraceptives at their first appointments. This practice can also reduce expenses for clinics and providers. A team of scientists from the United States and Jamaica conducted a study comparing these two ways of dispensing pills. Among the 655 women in the study, those who received one pack of pills at initiation, followed by counseling and a three-pack resupply, were no more likely to be using the pills after four months than women who received all four packs at initiation. However, when women received only one pack of pills at initiation (followed by a three-pack re-supply), nearly twice as many were late to clinics for their fifth cycle of pills, compared to those in the four-pack group. The study concluded that clinics should provide more than one cycle of pills at initiation, in order to reduce the likelihood that a woman will miss pills when she finishes a pack, because she does not have another pack handy. The researchers also noted that the extra clinic visit for resupply required of women who received just one pack at initiation adds to clinic and provider costs. This was the first study to compare regimens for distributing pills in a developing country. Previous research in the United States also suggests that providing multiple packs of pills improves compliance and lowers costs. Jamaica's current family planning service-delivery guidelines recommend providing one cycle of pills to new users and multiple packs to continuing users. However, the World Health Organization and the International Planned Parenthood Federation recommend providing new users with multiple packs. The authors of the study are affiliated with the following institutions:
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