A Randomized-Controlled Trial to Increase the Uptake of LARCs in Cameroon
HGOPY
A Sequential and Adaptive Experiment to Increase the Uptake of Long-acting Reversible Contraceptives in Cameroon
1 other identifier
interventional
2,500
1 country
1
Brief Summary
Cameroon exhibits a high and non-decreasing level of maternal mortality (roughly 600 per 100,000 live births), partially related to its relatively high total fertility rate (roughly 4.6). Survey evidence furthermore suggests that a significant fraction of these pregnancies is unwanted or considered mistimed by the mother, especially among females aged 15-19. Despite this, the rate of utilization of family planning (FP) is low: e.g. only 48% of sexually active unmarried women use any form of (modern) contraception, or MC, and even then, it is primarily condoms. The use of LARCs (long-acting reversible contraceptives, i.e. the IUD and implant) is less than 1% according to the most recent Demographic Health Survey. The study investigators propose to use an integrated behavioral science approach to increase the take-up of both SARCs (short-acting reversible contraceptives, i.e. the pill and injectable) and especially LARCs among reproductive-age females in Cameroon, including adolescents who may be unmarried and/or nulliparous. In addition to decreasing maternal mortality and undesired pregnancies, indirect effects for the community will include: increased welfare from reduced side effects that arise due to current one-size-fits-all FP counseling; healthier children due to improved birth spacing; and increased human capital formation both for children and for young (often school-aged) potential mothers. The study investigators propose to conduct the study at HGOPY for a duration of 12 months. The study investigators will provide tablets to each of five nurses that conduct FP counseling to participants at the hospital. The tablets contain a counseling "app" (or decision-support tool or a job-aid) that was jointly developed by professionals from HGOPY, the World Bank, and the Ministry of Health. The study investigators propose an individually-randomized experiment, where the participants will be offered randomly varying discounts for the modern contraceptive methods they wish to adopt. The study investigators also propose to experiment with certain aspects of the "app" to improve its effectiveness - both for the participant and for the nurse. More details on the experimental design are provided below.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Mar 2021
Longer than P75 for not_applicable
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
October 31, 2018
CompletedFirst Posted
Study publicly available on registry
November 7, 2018
CompletedStudy Start
First participant enrolled
March 23, 2021
CompletedPrimary Completion
Last participant's last visit for primary outcome
December 31, 2022
CompletedStudy Completion
Last participant's last visit for all outcomes
December 31, 2024
CompletedMay 14, 2025
May 1, 2025
1.8 years
October 31, 2018
May 8, 2025
Conditions
Keywords
Outcome Measures
Primary Outcomes (2)
The client adopted a LARC
using data from the counseling sessions
1-day
The client adopted a modern contraceptive method (LARC or SARC)
using data from the counseling sessions
1-day
Secondary Outcomes (6)
Was the client treated with respect by the provider during the counseling session?
2-weeks
Did the client trust the provider during the counseling session?
2-weeks
Did the health provider give information about contraceptive methods that was easy to understand during the counseling session?
2-weeks
Client satisfaction with adopted contraceptive method
2-week and 16-week measurements
Discontinuation of adopted contraceptive method
2-week, 16-week, and 52-week measurements
- +1 more secondary outcomes
Study Arms (20)
Free SARC, Free LARC, Recommendation
EXPERIMENTALFree SARC, Free LARC, Sequential recommendation
Free SARC, LARC=500, Recommendation
EXPERIMENTALFree SARC, LARC=500 CFA, Sequential recommendation
Free SARC, LARC=1000, Recommendation
EXPERIMENTALFree SARC, LARC=1000 CFA, Sequential recommendation
Free SARC, LARC=2140, Recommendation
EXPERIMENTALFree SARC, LARC=2140 CFA, Sequential recommendation
Free SARC, LARC=5000, Recommendation
EXPERIMENTALFree SARC, LARC=5000 CFA, Sequential recommendation
Regular SARC, Free LARC, Recommendation
EXPERIMENTALRegular price SARC, Free LARC, Sequential recommendation
Regular SARC, LARC=500, Recommendation
EXPERIMENTALRegular price SARC, LARC=500 CFA, Sequential recommendation
Regular SARC, LARC=1000, Recommendation
EXPERIMENTALRegular price SARC, LARC=1000 CFA, Sequential recommendation
Regular SARC, LARC=2140, Recommendation
EXPERIMENTALRegular price SARC, LARC=2140 CFA, Sequential recommendation
Regular SARC, LARC=5000, Recommendation
NO INTERVENTIONRegular price SARC, LARC=5000 CFA, Sequential recommendation
Free SARC, Free LARC, No Recommendation
EXPERIMENTALFree SARC, Free LARC, Simultaneous recommendation
Free SARC, LARC=500, No Recommendation
EXPERIMENTALFree SARC, LARC=500 CFA, Simultaneous recommendation
Free SARC, LARC=1000, No Recommendation
EXPERIMENTALFree SARC, LARC=1000 CFA, Simultaneous recommendation
Free SARC, LARC=2140, No Recommendation
EXPERIMENTALFree SARC, LARC=2140 CFA, Simultaneous recommendation
Free SARC, LARC=5000, No Recommendation
EXPERIMENTALFree SARC, LARC=5000 CFA, Simultaneous recommendation
Regular SARC, Free LARC, No Recommendation
EXPERIMENTALRegular Price SARC, Free LARC, Simultaneous recommendation
Regular SARC, LARC=500, No Recommendation
EXPERIMENTALRegular Price SARC, LARC=500 CFA, Simultaneous recommendation
Regular SARC, LARC=1000, No Recommendation
EXPERIMENTALRegular Price SARC, LARC=1000 CFA, Simultaneous recommendation
Regular SARC, LARC=2140, No Recommendation
EXPERIMENTALRegular Price SARC, LARC=2140 CFA, Simultaneous recommendation
Regular SARC, LARC=5000, No Recommendation
EXPERIMENTALRegular Price SARC, LARC=5000 CFA, Simultaneous recommendation
Interventions
SARCs are offered free to the client
LARCs are offered at lower prices to the client
Top ranked methods are presented to the client sequentially or simultaneously
Eligibility Criteria
You may qualify if:
- Female
- Ages 10-49
- Presenting at HGOPY seeking FP counseling/services
- HGOPY clients referred to the family planning unit for consultation
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- World Banklead
- Stanford Universitycollaborator
- George Washington Universitycollaborator
- University of Exetercollaborator
- University of California, San Diegocollaborator
- Yaounde Gynecology, Obstetrics and Pediatrics Hospitalcollaborator
Study Sites (1)
Hôpital gynéco-obstétrique et pédiatrique de Yaoundé (HGOPY)
Yaoundé, Cameroon
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Berk Ozler, PhD
World Bank
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- SINGLE
- Who Masked
- PARTICIPANT
- Masking Details
- Participants are masked in some interventions related to the workings of the tablet-based decision-support tool, but not to the price discounts they receive for the contraceptive methods.
- Purpose
- HEALTH SERVICES RESEARCH
- Intervention Model
- SEQUENTIAL
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Principal Investigator
Study Record Dates
First Submitted
October 31, 2018
First Posted
November 7, 2018
Study Start
March 23, 2021
Primary Completion
December 31, 2022
Study Completion
December 31, 2024
Last Updated
May 14, 2025
Record last verified: 2025-05