Interest in long-acting family planning methods (particularly in hormonal implants) among Bangladeshi women has risen in recent years. National service statistics indicate that over the past five years, an average of about 11,000 women adopted the implant per month; more recently, the monthly number of implant insertions jumped, to about 44,000.1 This sudden increase suggests that latent demand for the implant is now being met because the device has become more widely available.
Currently, one type of implant (Implanon®) is available in Bangladesh. (Another brand of implant—Jadelle®—has been approved for use by Bangladesh’s National Technical Committee, but it is not yet available.) Sino-implant (II), which is produced by Shanghai Dahua Pharmaceutical Company, is similar to Jadelle® but has not yet been introduced in the Bangladesh family planning program. Like Jadelle®, Sino-implant (II) is a two-rod subdermal implant containing 150 mg levonorgestrel; both have an annual unintended pregnancy risk of less than 1%. A major difference between the two, though, is that the per-unit wholesale cost of Sino-implant (II) (approximately US $8) is less than half of that of Jadelle® ($19) and Implanon ($17). Sino-implant (II)’s contraceptive effectiveness and safety have been well established, and the device has been approved by more than 20 drug regulatory authorities throughout the world.2
Bangladesh’s Directorate General of Family Planning (DGFP) of the Ministry of Health and Family Welfare (MOHFW), interested in adding Sino-implant (II) to the range of methods available there, asked the RESPOND Project and Mayer Hashi3 (both led by EngenderHealth)4 to conduct an acceptability trial of Sino-implant (II). The purposes of the trial were to inform the DGFP National Technical Committee’s decision on whether to introduce Sino-implant (II) into the national family planning program and to provide lessons for scale-up. This brief includes main findings and observations at the midpoint of the one-year study.