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Assessing the impact of new contraceptive technologies on user satisfaction, use-dynamics, and service systems.
PROGRESS. 1989; (11):2-3.A summary of the recommendations stemming from conference on the Demographic and Programmatic Consequences of Contraceptive Innovations, sponsored by the U.S. National Academy of Sciences in 1988, is provided by the WHO. While typical research on introduction of new contraceptive methods concerns cohort studies of users' problems and perspectives, a larger view of use-dynamics, choice behavior and client satisfaction with overall care is lacking. It is popular to hypothesize that user satisfaction improves with numbers of contraceptive options, but the literature does not provide clear evidence on this point, and none at all on introduction of new methods. Three main issues should be addressed: what is the impact of a new method on client perception of overall care, on contraceptive behavior, and on operation of the family planning program. To get this information usually requires prohibitively costly, time-consuming research. Low cost approaches are available, however, taken from the type of large-scale, community-based repeat observation studies now used to monitor trials of pharmaceuticals for tropical diseases, and treatments of rare conditions, such as vitamin A. Statistical techniques have been developed to adjust for censoring bias. Another type of field research that can be adapted to this research is the epidemiological field research of the type used in the Matlab, Bangladesh cholera vaccine study, later utilized to study acceptance of family planning services. Without such studies, the social and programmatic rationale for introduction of new contraceptives will be open to debate.