Contraceptive methods
lactational amenorrhea
SEXUALLY TRANSMITTED INFECTIONS, LACTATIONAL AMENORRHEA
The methods displayed by the app are the copper IUD, the implant, the injectable, the pill (combined or progestin-only), and lactational amenorrhea method (LAM) if the client is eligible. The Levonorgestrel (LNg) IUD was not available at HGOPY during the study period. Female sterilization in Cameroon is rare, subject to (age- and parity-based) eligibility rules, and often requires layers of approvals, including the consent of the husband. Condoms (male and female) are available at HGOPY, and every counseling session ends with a discussion of dual protection against sexually transmitted infections and free provision of condoms. Each nurse counselor has a set of cue cards for all the methods mentioned above, plus male sterilization, standard days method, and emergency contraceptive pills. If a client discusses (or skips) all the methods listed in the app but chooses to adopt none of them, then the nurse counselor presents the client with a summary cue card that shows these other methods that the clients can adopt to continue the discussion. Please see Supplemental Text section D.4 for an example of the cue cards used by nurse counselors at HGOPY.In this study, we deviate from a definition of short-acting methods that might typically include the pill, condoms, LAM, the standard days method, and emergency contraception and refer to only the pill and the injectable as SARCs. We do not categorize the injectable as a LARC because of the large differences in typical use effectiveness: 0.05% of women using the implant experienced an unintended pregnancy within the first year of use, the same figures were 0.8% for the copper IUD, 6% for the injectable, 9% for the pill, and 18% for the male condom. LAM, when used correctly, is as effective as a short-acting method for up to 6 months after giving birth (