Behaviour change techniques and contraceptive use in low and middle income countries: a review

Abstract

The authors aimed to identify effective behaviour change techniques to increase modern contraceptive use in low and middle income countries. Literature was identified in Global Health, Web of Science, MEDLINE, PsycINFO and Popline, as well as peer reviewed journals. Articles were included if they had an outcome evaluation of contraceptive use, modern contraceptive use, contraceptive initiation/uptake, contraceptive adherence or continuation of contraception, were a systematic review or randomised controlled trial, and were conducted in a low or middle income country. They assessed the behaviour change techniques used in each intervention and included a new category of male partner involvement. They identified 6 studies meeting the inclusion criteria. The most effective interventions were those that involve male partner involvement in the decision to initiate contraceptive use. The findings also suggest that providing access to contraceptives in the community promotes their use. The interventions that had positive effects on contraceptive use used a combination of behaviour change techniques. Performance techniques were not used in any of the interventions. The use of social support techniques, which are meant to improve wider social acceptability, did not appear except in two of the interventions. The findings suggest that when information and contraceptives are provided, contraceptive use improves. This research is supported by the Department for International Development’s COMDIS-HSD Programme which is led by the University of Leeds