Effectiveness of demand generation interventions on use of modern contraceptives in low‐ and middle‐income countries
Bibliographic record
Abstract
Abstract Objectives To synthesise evidence on the implementation, costs and cost‐effectiveness of demand generation interventions and their effectiveness in improving uptake of modern contraception methods. Methods A Cochrane systematic review was conducted. Searches were performed in electronic databases ( MEDLINE , EMBASE ) and the grey literature. Randomised controlled trials, cluster randomised trials and quasi‐experimental studies, including controlled before–after studies ( CBA s) and cost and cost‐effectiveness studies that aimed to assess demand interventions (including community‐ and facility‐based interventions, financial mechanisms and mass media campaigns) in low‐ and middle‐income countries were considered. Meta‐analyses and narrative synthesis were conducted. Results In total, 20 papers meeting the inclusion criteria were included in this review. Of those, 13 were used for meta‐analysis. Few data were available on implementation and on the influence of context on demand interventions. Involving family members during counselling, providing education activities and increasing exposure to those activities could enhance the success of demand interventions. Demand generation interventions were positively associated with increases in current use (pooled OR 1.57; 95% CI : 1.46–1.69, P < 0.01). Financial mechanism interventions (vouchers) appeared effective to increase use of modern contraceptive methods (pooled OR 2.16; 95% CI : 1.91–2.45, P < 0.01; I 2 = 0%). Demand interventions improved knowledge (pooled OR 1.02; 95% CI 0.63–1.64, P = 0.93) and attitudes towards family planning and improved discussion with partners/husbands around modern contraceptive methods. However, given the limited number of studies included in each category of demand generation interventions, the dates of publication of the studies and their low quality, caution is advised in considering the results. Very limited evidence was available on costs; studies including data on costs were old and inconsistent. Conclusion Demand generation interventions contribute to increases in modern contraceptive methods use. However, more studies with robust designs are needed to identify the most effective demand generation intervention to increase uptake of modern contraceptive methods. More evidence is also needed about implementation, costs and cost‐effectiveness to inform decisions on sustainability and scaling‐up.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".