Why Introduce the SDM?
Expanding contraceptive choice increases
The success of a family
planning program depends on its ability to meet the
family planning needs of the populations it serves,
including their need for specific methods, whether they
are for spacing or limiting births. Research shows that
when people can choose among several different contraceptive
methods they are more likely to find – and use
– a method that appeals to them .
With the introduction of the SDM in Peru, for example,
approximately 5% of all new family planning users in
areas served selected the SDM in the first year the
method was introduced .
Most couples using periodic
abstinence do not have correct information on how to
It is estimated that 27 million couples worldwide,
representing 2.6% of all couples in reproductive age,
use periodic abstinence to avoid pregnancy .
The majority of them, however, do not know when they
are most likely to get pregnant – often making
their efforts to avoid pregnancy unsuccessful.
Reasons for Making the SDM Part of Your Program
Additionally, millions of women who do not want to get pregnant
are not using method family planning. Others using a method
inconsistently, switching methods frequently or discontinuing
a method after just a few months of use. Many of these women
could benefit from simple, accurate information about their
fertility – to help them know when to avoid unprotected
intercourse to prevent pregnancy.
SDM can be offered easily and effectively by
a wide range of organizations
Incorporating the SDM helps programs expand informed choice,
reduce unmet need and increase contraceptive prevalence. It
is easy for organizations to offer the SDM because the method
does not require special equipment or infrastructure. In fact,
a wide range of organizations – ministries of health,
family planning associations, faith-based groups and NGOs –
are now offering the SDM. It has been offered successfully by
community volunteers, community-based health workers and NGO
outreach workers as well as by auxiliary nurses and physicians.
Salvador, for example, the SDM was successfully incorporated
into rural programs addressing health, water and sanitation,
education, and micro-enterprise by Project Concern International
and the Reconstruction Committee of El Salvador (CIRES).
SDM offers a strategy to bridge the gap
between contraceptive commodity needs and donor commitment
The growing demand for family planning services and funding
levels that do not match the growing need are resulting in a
major gap. One alternative to alleviating this donor gap is
the introduction of low-cost, simple, and effective methods
of family planning, such as the SDM. The SDM may be particularly
important in settings where there is a high reliance on traditional
methods, high levels of unmet need for family planning, and
chronic depletion of contraceptive commodities. In most developing
countries, contraceptives and the educational materials that
support them are heavily subsidized and often are distributed
to users at no cost or at a very low fee .
The only “commodity” cost associated with the SDM
is CycleBeads—the device that women use to track their
menstrual cycle—which represents a low-cost one-time purchase.
In Burkina Faso, CycleBeads were sold to SDM users at 500 CFA
(approximately US$1)—and the majority of users reported
that this price was reasonable
The SDM has been accepted by clients and
providers in a variety of settings and programs worldwide
Around the world, approximately 90% of women participating
in operations research studies reported that the SDM is easy
to use and that they would recommend it to others. The reasons
men and women give for their positive attitudes towards the
SDM include that it is natural, has no side effects, and is
effective, affordable and easy to use.
Reasons for Choosing the SDM
Doesn’t affect health
to learn and use
1 Interviews with users in 6 countries, IRH
2 Survey of internet purchasers
The results of research worldwide also show that
women and men are able to successfully manage the woman’s
fertile period—either through abstinence or using other
means of protection. Women and men have also reported that the
SDM has helped them to improve couple communication—and
women are empowered by having better knowledge and information
about their bodies and reproductive health. Research shows that
women who complete one year of SDM use are very likely to continue
using the method. In a multi-year use study conducted by the
Institute for Reproductive Health, 66% of SDM users were still
using the method two years later.
SDM increases male participation in family
While program planners and providers often are concerned about
the acceptability of the SDM for men, research shows that men
generally are satisfied with the method. In the clinical trial
of the SDM, only 2% of women dropped out of the study because
their partners did not want to use the method. And in many instances
men actually increased their participation in family planning.
Results of the SDM introduction studies, which followed some
1,600 users in nine countries for up to 13 cycles, showed that
most men participated in method use by helping to keep track
of the fertile days and by abstaining or using condoms during
SDM attracts clients who are not interested
in other methods
While the SDM is used by a range of clients with different
backgrounds, research shows that the method is very attractive
for clients who never before have used any family planning method.
For example, research in Benin and Rwanda showed that 80% and
96% of SDM users, respectively, were first time users of family
SDM has no side effects and does not affect
the woman’s health
The SDM is an appropriate alternative for women seeking a family
planning method that does not cause side effects. Although the
SDM also attracts many clients with no previous family planning
experience, some SDM users are women who have discontinued other
methods because their concerns about side effects and other
health issues. When men and women were asked about their reason
for using the SDM, the majority stated that they chose it because
it has no effect on their health. In Burkina Faso, for example,
with the introduction of the SDM, 89% of women reported choosing
the SDM because it had no effect on their health.