Product Brief: Caucus on New and Underused Reproductive Health Technologies - Cycle Beads

Publication date: 2011

PRODUC T BRIEF Caucus on New and Underused Reproductive Health Technologies CycleBeads® Description CycleBeads® are a colour-coded string of beads that help a woman use the Standard Days Method®, a clinically tested natural method of family planning that enables women to manage their own fertility. CycleBeads® work for women with menstrual cycles 26 to 32 days long. Using CycleBeads®, a woman can track her menstrual cycle, identify the days when unprotected intercourse is likely to result in pregnancy, and monitor her cycle length. She either uses a barrier method or abstains on her potentially fertile days—identi!ed as days 8–19 of the menstrual cycle—to avoid pregnancy. A woman can use CycleBeads® by placing the rubber ring on the RED bead on the !rst day of her period. She moves the ring one bead each day, even on the days when she has her period. She abstains or uses a condom when the ring is on any WHITE bead if she does not want to become pregnant. She can have unprotected sex when the ring is on any BROWN bead, as she is not likely to get pregnant on those days. She needs to move the ring to the RED bead again when her next period starts, skipping over any remaining beads. Efficacy Research has shown that the Standard Days Method® is more than 95 percent e"ective with correct use (condoms or abstinence during days 8–19 of the menstrual cycle), and more than 88 percent e"ective in typical use,1 similar to a number of other user-directed methods.2 Similar levels of e#cacy have been found when the method is o"ered in regular service delivery.3 Further, studies of women who purchased CycleBeads® in the context of social marketing—and thus relied on the CycleBeads® instructional insert and point-of-sale materials for method use—showed that their ability to understand and use the method correctly was equal to that of women who received instruction from a trained provider.4 $e Standard Days Method® provides two couple-years of protection (CYPs). Current programme/sector use To date, the Standard Days Method® and CycleBeads® have been used in more than 50 countries and have been successfully integrated into many existing family planning programmes and community networks, resulting in approximately two million users worldwide.5 $e Standard Days Method® does not require special equipment, medical procedures, facilities, or costly commodities, and as a knowledge-based method, it is easy to teach and learn. $us, it can be o"ered through a wide variety of programmes and by a range of providers—including physicians, nurses, auxiliary nurses, community volunteers, public- and private-sector reproductive health programmes, faith-based organizations, and social marketing programmes through pharmacies and other retailers—without signi!cant additional resources. $is method also addresses the needs of diverse populations with varied religious and ethical beliefs, education, and socioeconomic status. It has no side e"ects and can be used by women who want a pregnancy, as well as by those who do not. Programmes in several countries have found that including the Standard Days Method® and CycleBeads® among the options they o"er contributes to contraceptive prevalence, enhances the method mix, and brings !rst-time users to family planning.6 Given the scienti!c and programmatic evidence, the Standard Days Method® and CycleBeads® are included in numerous documents of the World Health Organization, the US Agency for International Development (USAID), International Planned Parenthood Federation, and Contraceptive Technology.7,8,9,10 $e primary impediment to expanded availability and use of this method is ensuring su#cient supply of CycleBeads®. Because the Standard Days Method® is a relatively new method, governments and implementing partners o%en do not have data about current use on which to forecast future demand and base estimations for CycleBeads® procurement. However, a toolkit is available to aid countries interested in procuring CycleBeads® by providing a step-by-step process for estimating the initial supply of CycleBeads® needed in their country. It is available electronically from the USAID | DELIVER PROJECT (email: askdeliver@jsi. com); individuals may also contact irhinfo@georgetown. edu. For additional information, see www.cyclebeads. com and www.irh.org. $e fact that CycleBeads® require no special storage facilities, have an inde!nite shelf-life, and are impervious to environmental conditions makes them an ideal product for low-resource settings. C A U C U S O N N EW A N D U N D ER U S ED R EP R O D U C TI V E H EA LT H T EC H N O LO G IE S P R O D U C T B R IE F For more information on the Caucus on New and Underused RH Technologies, please visit our web page at http://www.rhsupplies.org/working-groups/caucus-on-newunderused-rh-technologies.html. This publication forms part of a series of technical briefs, written by members of the Caucus on New and Underused Reproductive Health Technologies, a thematic group established under the auspices of the Reproductive Health Technologies Coalition. The Caucus’ aim is to broaden the discussion within the Coalition of reproductive health technologies that are not well integrated into the public or commercial health sectors. Responsibility for the selection and contents of the product briefs rests solely with the Caucus and does not imply endorsement by the Coalition or its wider membership. For additional information, please contact secretariat@rhsupplies.org. This brief was last updated January 2011. References 1 Arevalo M, Jennings V, Sinai I. E#cacy of a new method of family planning: the Standard Days Method. Contraception. 2002; 65:333–338. 2 Sinai I, Jennings V, Arevalo M. $e two-day algorithm: A new algorithm to identify the fertile time of the menstrual cycle. Contraception. 1999; 60(2):65–70. 3 Gribble J, Lundgren R, Velasquez C, Anastasi E. Being Strategic about Contraceptive Introduction: $e Experience of the Standard Days Method®. Contraception, 2008; 77: 147–154. 4 Kavle J, Foreit J, Eber M, Lundgren R, Jennings V. $e Potential for Social Marketing a Knowledge-Based Family Planning Method. Article pending publication, 2011. 5 Data provided by Cycle Technologies, the licensed manufacturer and distributer of CycleBeads. 6 Gribble J, Lundgren R, Velasquez C, Anastasi E. Being Strategic about Contraceptive Introduction: $e Experience of the Standard Days Method®. Contraception, 2008; 77: 147–154. 7 Medical Eligibility Criteria for Contraceptive Use 3rd Ed. Geneva: World Health Organization, 2004. Available at: www.who.int/ reproductive-health/publications/mec/fab.html. 8 Jennings V, Lundgren R. Standard Days Method: A Simple E"ective Natural Method. USAID Global Health Technical Briefs 2004. Available at: http://irh.org/sites/default/!les/USAID%20 SDM%20Technical%20Brief%202004.pdf 9 IPPF Medical and Service Delivery Guidelines for Sexual and Reproductive Health Services 3rd Ed. 2004. Available at: www.ippf.org/en/Resources/Medical/IPPF+Medical+and+Service +Delivery+Guidelines.htm. 10 Jennings V, Arevalo M. Chapter 15: Fertility Awareness-Based Methods. In: Hatcher RA, Trussell J, Nelson AL, Cates W, Stewart F, Kowal D, eds. Contraceptive Technology 19th Revised Edition. New York: Ardent Media Inc., 2007:343–349. Additionally, up-to-date data on CycleBeads® procurement by country and donor can be found on the Reproductive Health Supplies Coalition’s online RHInterchange, which supports pipeline monitoring, commodity management, analysis, and planning for programme managers, donors, researchers, and advocates. Manufacturer/supplier Cycle Technologies (contact: 1+202-237-0662, info@cyclebeads.com) is the licensed manufacturer of CycleBeads®. CycleBeads® have been available since 2003 and are now o"ered through nongovernmental organizations, faith-based organizations, and public social-marketing programmes. Public-sector price agreements CycleBeads® are now o"ered as part of the contraceptive method mix available through the Central Contraceptive Procurement (CCP) Project of the Commodities Security and Logistics (CSL) Division at USAID, and can be ordered by USAID programmes alongside other contraceptive methods. Missions can provide funding requests for procurement of CycleBeads® to the CCP project either as !eld support or as a Modi!ed Acquisition and Assistance Request Document. Orders should be forwarded to the CSL country backstopper. Non USAID-funded groups interested in purchasing CycleBeads® should contact the manufacturer, Cycle Technologies, directly (see www.cyclebeads.com).

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