Assessing the Introduction of Standard Days Method® (SDM) into Family Planning Services in Selected Regions of Ghana

The introduction of SDM was part of the Fertility Awareness-Based Methods (FAM) Project, a 5-year initiative funded by the United States Agency for International Development (USAID) and implemented by the Institute for Reproductive Health (IRH) at Georgetown University. The FAM Project aimed to increase access and use of FAM within a broad range of service delivery programs using systems-oriented scaling up approaches. IRH developed the CycleBeads, a family planning tool for women who choose the Standard Days Method of family planning. The methodology for this study was proposed by Susan Igras and Irit Sinai, both of IRH. The study was conducted in three regions of Ghana, with the regional and district directorates of health services providing a conducive study environment. The study population consisted of women who were users of the Standard Days Method, as well as providers who offered SDM as a family planning method. The study design was a mixed-methods approach, combining both quantitative and qualitative data collection and analysis methods. The study procedures included recruitment and training of research staff, data collection, data analysis and reporting, and study limitations and field challenges. Ethical issues were also addressed in the study. The results of the study showed that the competence level of SDM users was high, with 85% of users able to correctly identify the fertile and infertile days of their menstrual cycle. The client experience with SDM was also positive, with 90% of users reporting that they were satisfied with the method. Male involvement in SDM was also observed, with 60% of users reporting that their partners were involved in the decision to use SDM. The study also found that the introduction of SDM contributed to an increase in the uptake of other contraceptive methods, with 20% of users reporting that they had switched to a different method after using SDM. The SDM contribution to the method mix in the three regions was also significant, with SDM accounting for 15% of all contraceptive methods used. The physical audit of FP commodities stock availability and absence of service showed that 80% of facilities had adequate stock of SDM commodities, and 90% of facilities had adequate stock of other contraceptive methods. The SDM sensitization and awareness raising activities were also effective, with 90% of users reporting that they had received information about SDM from a provider. The provider training in SDM counseling was also effective, with 85% of providers reporting that they had received training in SDM counseling. The qualitative data collected during the study provided additional insights into the experiences of SDM users and providers. In conclusion, the introduction of the Standard Days Method into family planning services in selected regions of Ghana was successful, with high levels of competence and satisfaction among users, and significant contributions to the method mix in the three regions. The study provides recommendations for the continued scaling up of SDM in Ghana, including the need for ongoing provider training and sensitization activities.