Scaling up depot medroxyprogesterone acetate (DMPA): a systematic literature review illustrating the AIDED model

Reproductive Health

Elizabeth H Bradley²  Rafael Pérez-Escamilla¹  Emily Cherlin²  Sarah Wood Pallas¹  Lauren Taylor²  Leslie Curry² 

[1] Yale School of Public Health, 60 College Street, New Haven, CT 06520-8034, USA;Yale Global Health Leadership Institute, New Haven, CT, USA

关键词: Global health;    Innovation;    Low-income settings;    Depo-provera;    DMPA;    Family health;    Scale up;   

Others  :  811400
DOI  :  10.1186/1742-4755-10-39

 received in 2013-02-15, accepted in 2013-07-31,  发布年份 2013

【 摘 要 】

Background

Use of depot medroxyprogesterone acetate (DMPA), often known by the brand name Depo-Provera, has increased globally, particularly in multiple low- and middle-income countries (LMICs). As a reproductive health technology that has scaled up in diverse contexts, DMPA is an exemplar product innovation with which to illustrate the utility of the AIDED model for scaling up family health innovations.

Methods

We conducted a systematic review of the enabling factors and barriers to scaling up DMPA use in LMICs. We searched 11 electronic databases for academic literature published through January 2013 (n = 284 articles), and grey literature from major health organizations. We applied exclusion criteria to identify relevant articles from peer-reviewed (n = 10) and grey literature (n = 9), extracting data on scale up of DMPA in 13 countries. We then mapped the resulting factors to the five AIDED model components: ASSESS, INNOVATE, DEVELOP, ENGAGE, and DEVOLVE.

Results

The final sample of sources included studies representing variation in geographies and methodologies. We identified 15 enabling factors and 10 barriers to dissemination, diffusion, scale up, and/or sustainability of DMPA use. The greatest number of factors were mapped to the ASSESS, DEVELOP, and ENGAGE components.

Conclusions

Findings offer early empirical support for the AIDED model, and provide insights into scale up of DMPA that may be relevant for other family planning product innovations.

【 授权许可】

   
2013 Curry et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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