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A Behavioral Economics Approach to Reduce the Injectable Contraceptive Discontinuation Rate in Ethiopia: A Stratified-Pair, Cluster-Randomized Field Study

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Behavioral economics offers one way to design interventions by improving understanding of why people choose as they do and what motivates their decision-making and action. Behavioral economics has recently been used to improve reproductive health programming, suggesting that the approach could potentially be applied to mitigate the contraceptive discontinuation problem in Ethiopia.

This report highlights the behavioral economics methodology used to conduct a behavioral diagnosis and design an intervention package to change health-related behaviors and decision-making around the use of injectable contraceptives in Ethiopia.

Given that injectable methods are the primary method of choice among married women of reproductive age in the country and that the government sector provides 82% of contraceptive methods, JSI's Last Ten Kilometers project, in collaboration with ideas42, worked with Ethiopia's flagship Health Extension Program (HEP) to design and test behavioral approaches to mitigate the problem of discontinuation of injectable contraceptives.

The JSI team implemented a stratified-pair, cluster-randomized experiment in the eight primary health center units (PHCUs), each of which serves about 25,000 people.

This report highlights the four stages of behavioral health methodology used in the study, including the various interventions tested, and the results achieved by the end of the two-year activity. JSI, L10K Project. 2018.

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