A Narrative Review of Demand Generation Strategies For Family Planning in Low-and Middle-Income Countries

In low-and middle-income countries LMICs, unmet need for sexual and reproductive health (SRH) and family planning (FP) contributes directly to many unwanted or unintended pregnancies and unsafe abortion. In turn, women and children experienced increased health problems, mortality, and socioeconomic challenges. Modern distribution programs have mitigated access and affordability issues, leaving psychosocial and sociocultural factors as the most prominent reasons for contraceptive nonuse among sexually active, non-married women. Successful interventions, therefore, aim to educate women about sexual health to address gaps in knowledge, myths, and misconceptions that drive nonuse. To identify specific strategies that create demand this way, a thorough search of relevant primary literature and supplemental secondary literature was conducted, followed by a qualitative analysis. For demand creation programs in LMICs, the following were identified as distinct yet interrelated components with unique strategies: mass media, social media, counseling and education, community outreach, and social marketing. Most successful or larger-scale interventions utilized a combination of these strategies, especially focusing on community involvement to ensure self-sustainability and extension into rural locales. The findings of the literature were then synthesized to generate theories, inferences, and frameworks regarding the effective use of demand-creation strategies, pointing out gaps in the data and analytical limitations.