United States Agency for International Development, Washington, DC, USA.
World Health Organization, Geneva, Switzerland.
Glob Health Sci Pract. 2020 Mar 31;8(1):114-124. doi: 10.9745/GHSP-D-19-00287. Print 2020 Mar 30.
The Standard Days Method (SDM), a modern fertility awareness-based family planning method, has been introduced in 30 countries since its development in 2001. It is still unclear to what extent the SDM was mainstreamed within the family planning method mix, particularly in low- and middle-income country (LMIC) settings, where the SDM had been introduced by donors and implementing partners. This review of implementation science publications on the SDM in LMICs first looked at community pilot studies of the SDM to determine the acceptability of the method; correct use and efficacy rates; demographics of users; and changes to contraceptive prevalence rates and family planning behaviors, especially among men and couples. Then, we examined the status of the SDM in the 16 countries that had attempted to scale up the method within national family planning protocols, training, and service delivery. At the community level, evidence demonstrated a high level of acceptability of the method; efficacy rates comparable to the initial clinical trials; diversity in demographic characteristics of users, including first-time or recently discontinued users of family planning; increased male engagement in family planning; and improved couple's communication. Nationally, few countries had scaled up the SDM due to uneven stakeholder engagement, lackluster political will, and competing resource priorities. Results of this review could help policy makers determine the added value of the SDM in the contraceptive method mix and identify potential barriers to its implementation moving forward.
标准日法（SDM）是一种基于生育意识的现代计划生育方法，自 2001 年开发以来已在 30 个国家推出。目前尚不清楚 SDM 在多大程度上已成为计划生育方法组合的主流方法，特别是在中低收入国家（LMIC）中，SDM 是由捐助者和实施伙伴引入的。本项关于 SDM 在 LMIC 中实施科学的文献综述首先研究了 SDM 的社区试点研究，以确定该方法的可接受性；正确使用和功效率；用户的人口统计学特征；以及避孕普及率和计划生育行为的变化，尤其是在男性和夫妇中。然后，我们研究了在 16 个试图在国家计划生育方案、培训和服务提供中扩大 SDM 规模的国家中 SDM 的状况。在社区层面，有证据表明该方法具有很高的可接受性；功效率与最初的临床试验相当；用户的人口统计学特征具有多样性，包括首次或最近停止使用计划生育的用户；男性更多地参与计划生育；以及夫妻沟通得到改善。在国家层面，由于利益相关者参与不均衡、政治意愿不强以及资源优先事项相互竞争，很少有国家扩大 SDM 的规模。本综述的结果可以帮助决策者确定 SDM 在避孕方法组合中的附加值，并确定其实施的潜在障碍。
