Family Planning Decision Support

Our Challenge

Many women face significant barriers in accessing family planning services to meet their reproductive health needs.  As a result, unintended pregnancy rates remain high and more than 220 million women worldwide continue to face an unmet need for contraception and family planning support.

Our Response

We develop and test innovative strategies using an implementation science framework to achieve sustainable progress in family planning.  We strive to evaluate novel family planning counseling tools and the success of transferable patient centered care delivery models.  These changes in patient care will support women and their families to make informed reproductive health decisions, and provide access to respectful and dignified family planning care.

Our Priority Areas

Health support technologies and novel data collection tools will bring the health care system closer to women and their families, bring their health concerns to the attention of decision makers, and reduce the unmet need for family planning.

By establishing and growing collaborations, we will responsibly scale and integrate these solutions to help women and their families, expand to other regions and populations and cultivate young innovators to ensure sustainability of this work.

Our passion for encouraging young Family Planning (FP) and Maternal-Child Health (MCH) researchers has led to the development of projects that bring family planning and contraceptive information and support to women and their partners, provide daily support to women and newborns during the critical postpartum period, and understand adolescent needs for contraception.

Our implementation science framework for family planning and maternal health focuses on person-centered, novel approaches to reaching women.  We design tools and improve health systems to empower and support women through family planning, pregnancy, and  the postpartum period.

Scientific Priority Co-Directors

Alison Drake
PhD, MPH
Assistant Professor, Global Health
Adjunct Assistant Professor, Epidemiology

Jennifer Unger
MD, MPH
Assistant Professor, Global Health and Obstetrics and Gynecology

Faculty Leads

Renee Heffron
PhD, MPH
Associate Professor, Global Health and Epidemiology

Keshet Ronen
PhD
Clinical Assistant Professor, Global Health

Alison Roxby
MD, MSc
Assistant Professor, Global Health and Medicine
Adjunct Assistant Professor, Epidemiology

Technical Advisors

Elizabeth Harrington
MD
Acting Instructor, Obstetrics and Gynecology

John Kinuthia
MBChB, MMed, MPH
Head of Research and Programs, Kenyatta National Hospital; Affiliate Associate Professor, Global Health

Trainees

Carlie Field
MD
Obstetrics and Gynecology Resident

Samantha Rice
BA
MPH Student in Global Health

Claire Watt Rothschild
MS
PhD Student in Epidemiology

Our Research

Sponsor:  United States Agency for International Development (AID-OAA-F-16-00026)

Award Years:  07/01/2016 – 06/30/2019

Principal Investigator:  Jennifer Unger

Co-Investigators:  Maneesh Batra, Alison Drake, Grace John-Stewart

This randomized trial was designed to determine the effect of systematic provision of tailored one-way SMS or two-way SMS dialogue on uptake of MCH strategies including facility delivery, antenatal care attendance, infant immunizations, exclusive breast feeding and postpartum family planning uptake.  We utilized a novel human-computer hybrid approach to deliver messaging to women targeted at increasing uptake of MCH and FP strategies.

Sponsor:  Fogarty International Center (1R21TW009908)

Award Years:  09/10/2014 – 04/30/2015

Principal Investigator:  Renee Heffron

Building on our current work to pilot a client-centered, evidence-based safer conception intervention, the goal of this project is to develop and pilot mHealth tools to enhance safer conception planning by HIV discordant couples including SMS (i.e. text message) surveys to capture data on fertility signs and a tablet-based application to facilitate in-clinic counseling between providers and couples.

Sponsor:  National Insitute of Child Health & Human Development (5K23HD071788)

Award Years:  07/01/2012 – 06/30/2016

Principal Investigator:  Alison Roxby

This study will determine whether progesterone-based contraception and pregnancy are associated with increased local and systemic immune activation in Kenyan HIV-1-seropositive women, which will elucidate progesterone’s immunomodulatory properties.

Sponsor:  Gates Grand Challenges Award (OPP1172004)

Award Years:  05/01/2017 – 10/31/2018

Principal Investigator:  Alison Drake

Trainees:  Claire Rothschild

The goal of this study is to develop deeper understanding of contraceptive behavior, including adherence, experience of side effects, continuation, and satisfaction, among a cohort of adult women and adolescent girls using modern contraception in western Kenya.  We test the feasibility and acceptability of a novel, tailored mobile messaging platform for collecting real-time, ongoing information from women on their family planning experiences.

Sponsor:  National Institutes for Health (K12HD001264)

Award Years:  07/01/2013 – 07/01/2015

Principal Investigator:  Jennifer Unger

Co-Investigators:  Elizabeth Harrington, John Kinuthia, MBChB, MMed

This randomized trial was designed to determine the effect of systematic provision of tailored one-way SMS or two-way SMS dialogue on uptake of MCH strategies including facility delivery, ANC attendance, infant immunizations, exclusive breast feeding and postpartum family planning uptake. We utilized a novel human-computer hybrid approach to deliver messaging to women targeted at increasing uptake of MCH and FP strategies.

Sponsor:  Veterans Administration Health Services Research & Development Career Development Program (CDA-2)

Award Period:  10/2015 – 09/2020

Principal Investigator:  Lisa Callegari

We will design and test a novel reproductive planning decision aid intervention to improve reproductive planning decision quality and contraceptive use.  This intervention employs innovative patient centered strategies, including reproductive planning and shared decision making, to address gaps in current reproductive health services and ultimately aims to improve reproductive and long-term health outcomes among women Veterans.