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How User Fees Influence Contraception in Low and Middle Income Countries: A Systematic Review
Author(s) -
Korachais Catherine,
Macouillard Elodie,
Meessen Bruno
Publication year - 2016
Publication title -
studies in family planning
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.529
H-Index - 68
eISSN - 1728-4465
pISSN - 0039-3665
DOI - 10.1111/sifp.12005
Subject(s) - family planning , developing country , medicine , low and middle income countries , developed country , randomized controlled trial , reproductive health , population , environmental health , economic growth , business , economics , research methodology , surgery
Accessible and quality reproductive health services are critical for low‐ and middle‐income countries (LMICs). After a decade of waning investment in family planning, interest and funding are growing once again. This article assesses whether introducing, removing, or changing user fees for contraception has an effect on contraceptive use. We conducted a search of 14 international databases. We included randomized controlled trials, interrupted‐time series analyses, controlled before‐and‐after study designs, and cohort studies that reported contraception‐related variables as an outcome and a change in the price of contraceptives as an intervention. Four studies were eligible but none was at low risk of bias overall. Most of these, as well as other studies not included in the present research, found that demand for contraception was not cost‐sensitive. We could draw no robust summary of evidence, strongly suggesting that further research in this area is needed.